bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Functional Outcomes after Endoscopic versus Open-Neck Supraglottic Laryngectomies
Authors: Peretti Giorgio , Piazza Cesare , Cattaneo Augusto , De Benedetto Luigi , Martin Eva , Nicolai Piero 
Published: October 2014

Objectives: Endoscopic supraglottic laryngectomy (ESL) by carbon dioxide laser for selected T1-T3 supraglottic squamous cell carcinomas is a sound procedure with oncological results comparable to those obtained by open-neck supraglottic laryngectomy (ONSL). The aim of this study was to retrospectively evaluate functional outcomes after ESL in comparison with ONSL. Methods: We performed perceptual voice evaluation by GRBAS (grade, roughness, breathiness, asthenicity, strain), subjective analysis by Voice Handicap Index, objective analysis with the Multidimensional Voice Program, swallowing evaluation with the M. D. Anderson Dysphagia Inventory, video nasal endoscopic examination of swallowing, videofluoroscopy, and analysis of hospitalization time, need for and duration of feeding tube and tracheotomy, and complication and aspiration pneumonia rates in a group of 14 patients treated with ESL. These results were compared to those obtained in a historical group of 14 patients matched for T category who were treated with ONSL at the same institution. Statistical analysis was performed with the Mann-Whitney U and Pearson χ2 tests. Results: Comparison of comprehensive voice analysis, M. D. Anderson Dysphagia Inventory, and complication and aspiration rates showed no statistically significant differences between the Two groups. However, significant differences were found for video nasal endoscopic examination of swallowing (p = .03), videofluoroscopy (p = .03), hospitalization (p = .0001), feeding tube duration (p = .0001), and tracheotomy duration (p = .0001). Conclusions: Endoscopic supraglottic laryngectomy had a significantly lower functional impact on swallowing than ONSL, even though it was not subjectively perceived by patients, and was associated with less morbidity and a shorter hospitalization time.
Changing Trends in the Success Rate of Anterior Cricoid Split
Authors: Rotenberg Brian W. , Berkowitz Robert G. 
Published: October 2014

Objectives: We determined the historical trends at our institution in the extubation success rate, defined as avoiding tracheostomy, for infants with acquired laryngotracheal stenosis (LTS) who undergo anterior cricoid split (ACS) as primary treatment. Methods: We performed a retrospective chart review of all neonates with acquired LTS treated with ACS between 1989 and 2005. Successful extubation rates were assessed over the study's time period. Student's t-test was used to compare identified subgroups. Results: Thirty-one neonates (14 male, 17 female) were identified, with an average gestational age of 27.6 weeks. During 1989 to 1995, a successful cumulative extubation rate of 71.4% was achieved in 14 children. By 2005, though, following a further 17 children, the successful cumulative extubation rate had dropped to 54.8%. The extubation rate in the time period 1996 to 2005 specifically was only 41.2%. The factor identified that most significantly correlated with this change was the difference in average duration of preoperative intubation. Relatively higher numbers of significant neurologic, respiratory, and cardiac comorbidities were identified both in the 1996 to 2005 grouping and in the ACS failure grouping. Conclusions: The success rate of ACS as a means of avoiding neonatal tracheostomy appears to have declined over the past 10 years at our institution. A prolonged period of preoperative intubation, as well as associated increasingly significant comorbidities, may be explanatory for this change. Revising the accepted selection criteria for ACS, or broadening the indications for alternative techniques, may be warranted.
Selective Neck Dissection in Patients with Upper Aerodigestive Tract Cancer with Clinically Positive Nodal Disease
Authors: Simental Alfred A. , Duvvuri Umamaheswar , Johnson Jonas T. , Myers Eugene N. 
Published: October 2014

Objectives: We evaluated the efficacy of the application of selective neck dissection to cases of clinically node-positive disease. Methods: We performed a retrospective review at the University of Pittsburgh Head and Neck Cancer Database. A database of 65 patients was followed for an average of 36 months (range, 2 to 128 months) after they underwent selective neck dissection for clinically node-positive regional disease. Results: Regional failure occurred in 8 patients (12.3%). In-field failure was experienced in 4 patients (6.1%), and failures outside the field of dissection occurred in 4 patients (6.1%). The overall incidence of extracapsular spread was 33.8% (22 of 65). Only 2 of 8 regional recurrences were associated with extracapsular spread at the initial neck dissection; however, both recurrences were in the contralateral, undissected side of the neck. Four regional failures were salvaged with surgery, with eventual overall regional control in the neck of 93.9%. Only 1 of 4 ipsilateral recurrences (25%) was successfully salvaged. In contrast, 3 of 4 contralateral failures (75%) were successfully salvaged. In our study population, 21 of 65 cases (32%) that were initially staged as clinically node-positive had no evidence of nodal metastases on pathologic examination. Conclusions: The application of selective neck dissection and postoperative irradiation in patients with clinically N1 and limited N2 clinical disease appears to be oncologically efficacious. Clinical overstaging occurred frequently in this sample, and may put patients at risk for more morbid surgical procedures.
Stapedotomy with Microdrill or Carbon Dioxide Laser: Influence on Inner Ear Function
Authors: Somers Thomas , Vercruysse Jean-Philippe , Zarowski Andrzej , Verstreken Margriet , Offeciers Erwin 
Published: October 2014

Objectives: A prospective randomized audiological analysis of 336 otosclerosis operations was conducted to compare the evolution of bone conduction thresholds after primary stapedotomy with Two different techniques to open the footplate: microdrill and carbon dioxide laser stapedotomy. Methods: To monitor the inner ear function, we compared the preoperative bone conduction thresholds with the postoperative levels at day 2, week 2, week 6, and month 6. Evolution of the bone conduction was compared for the Two studied groups (laser versus microdrill). Results: An average bone conduction loss of 1.8 dB was measured at day 2 for the middle frequencies (0.5, 1, and 2 kHz). At 4 kHz, a bone conduction loss of 7 dB was found. The bone conduction thresholds measured in the first and second months after surgery showed a gradual recovery with overclosure as the end result. Conclusions: Our results confirm the transient depression of inner ear function in the immediate postoperative period, with recovery within the first weeks after surgery. In the studied population, no statistically significant difference was found between the Two techniques that were used to make the calibrated hole (laser versus microdrill). These results demonstrate that both techniques possess the same early effect regarding inner ear function. The authors hypothesize that an early inflammatory reaction could be the cause of the transient bone conduction shift.
Transient Evoked Otoacoustic Emissions in Vestibular Neuritis
Authors: Gouveris Haralampos , Victor Anja , Mann Wolf 
Published: October 2014

Objectives: Partial or total degeneration of the vestibulocochlear anastomosis at its takeoff from the saccular ganglion and regenerating efferent neural buds under the cochlear outer hair cells (OHCs) have been found in the temporal bones of human patients with a history of vestibular neuritis (VN). We sought to test whether VN has any functional impact on the ipsilateral OHCs by means of transient evoked otoacoustic emission (TEOAE) testing. Methods: We retrospectively analyzed prospectively collected TEOAE data of 28 patients (19 female, 9 male; age range, 21 to 60 years; median age, 42.5 years). The pure tone air conduction hearing thresholds at each standard audiometric frequency (0.125 to 8 kHz) and the amplitudes of the TEOAEs at the 1-, 2-, 3-, and 4-kHz frequency bands were compared between the lesional and contralateral sides by use of the nonparametric sign test for 2 paired samples. Results: No significant difference was found in the pure tone air conduction hearing thresholds between the lesional and contralateral ears at any of the 11 standard tested frequencies. No significant difference was found between the TEOAE amplitudes of the lesional and contralateral sides. Conclusions: Subclinical OHC functional impairment is not present in VN. Moreover, no apparent significant changes in medial olivocochlear bundle resting activity accompany VN.
Microbiology of Intracranial Abscesses Associated with Sinusitis of Odontogenic Origin
Authors: Brook Itzhak 
Published: October 2014

Objectives: The unique microbiology of sinusitis of dental origin that is associated with intracranial abscesses (IAs) and the correlation between the organisms at the Two sites has not been reported before. This report describes the author's experience during a 30-year period in studying the microbiology of 8 IAs and their corresponding sinusitis of dental origin. Methods: Aspirates of pus from 8 infected sinuses associated with odontogenic infections and their corresponding IAs were studied for aerobic and anaerobic bacteria. Polymicrobial flora was found in all 8 sinuses and 7 IAs, and the number of isolates varied from 1 to 5. Results: Anaerobic bacteria were isolated from all sinuses and IAs. A total of 28 isolates (3.5 isolates per site; 25 strict anaerobic, 1 aerobic or facultative, and 2 microaerophilic) were recovered from the sinuses, and 20 isolates (2.5 isolates per site; 16 strict anaerobic, 1 aerobic or facultative, and 3 microaerophilic) were found in the IAs. The bacterial isolates were Fusobacterium spp (14), Prevotella spp (11), Peptostreptococcus spp (13), microaerophilic streptococci (5), Veillonella parvula (3), and β-hemolytic streptococci group F (2). Concordance in the microbiological findings between the sinus and the IA was found in all instances; however, certain organisms were only present at one site. Conclusions: These data illustrate the concordance in the organisms recovered from sinusitis of dental origin and their associated IAs and confirm the importance of anaerobic bacteria in sinusitis and IAs of dental origin.
Characterization of Rat Spiral Ligament Cell Line Immortalized by Adenovirus 12-Simian Virus 40 Hybrid Virus
Authors: Yian Christopher , Moon Sung K. , Jin Sunji , Webster Paul , Rhim Johng S. , Andalibi Ali , Lim David J. 
Published: October 2014

Objectives: Spiral ligament fibrocytes play an important role in inner ear ion homeostasis and are classified into several subtypes according to expression of specific enzymes such as Na+,K+-ATPase, Ca++-ATPase, and carbonic anhydrase. Although our understanding of the cell and molecular biology of spiral ligament fibrocytes has increased over time, access to these cells still remains a significant hurdle hindering future studies. In this study, we aimed to establish a rat spiral ligament cell line with minimal disruption of the original characteristics. Methods: The primary spiral ligament fibrocytes were exposed to adenovirus 12-simian virus 40 hybrid virus for immortalization. Karyotypic analysis was performed after stabilization of the infected cells, and the population doubling time was compared to that of the primary cell. The cell line was characterized by immunolabeling and electron microscopy. Results: We describe the establishment and characterization of a line of type I spiral ligament fibrocytes immortalized with an adenovirus 12-simian virus 40 hybrid virus. Conclusions: This cell line can be a useful research tool for investigating the role of spiral ligament fibrocytes in homeostasis and inflammation of the inner ear.
Asymmetric Hearing Loss in a Random Population of Patients with Mild to Moderate Sensorineural Hearing Loss
Authors: Segal Nili , Shkolnik Mark , Kochba Anat , Segal Avichai , Kraus Mordechai 
Published: October 2014

Objectives: We evaluated the correlation of asymmetric hearing loss, in a random population of patients with mild to moderate sensorineural hearing loss, to several clinical factors such as age, sex, handedness, and noise exposure. Methods: We randomly selected, from 8 hearing institutes in Israel, 429 patients with sensorineural hearing loss of at least 30 dB at one frequency and a speech reception threshold not exceeding 30 dB. Patients with middle ear disease or retrocochlear disorders were excluded. The results of audiometric examinations were compared binaurally and in relation to the selected factors. Results: The left ear's hearing threshold level was significantly higher than that of the right ear at all frequencies except 1.0 kHz (p < .05). One hundred fifty patients (35%) had asymmetric hearing loss (more than 10 dB difference between ears). In most of the patients (85%) the binaural difference in hearing threshold level, at any frequency, was less than 20 dB. Conclusions: Age, handedness, and sex were not found to be correlated to asymmetric hearing loss. Noise exposure was found to be correlated to asymmetric hearing loss.
Somatic Modulation of Tinnitus: Test Reliability and Results after Repetitive Muscle Contraction Training
Authors: Sanchez Tanit Ganz , Lima Adriana da Silva , Brandão Ana Laura , Lorenzi Maria Cecília , Bento Ricardo Ferreira 
Published: October 2014

Objectives: We sought to study the reliability of tinnitus modulation by muscle contractions and to observe the effect of their prolonged repetition. Methods: Thirty-eight patients with tinnitus underwent 9 maneuvers of muscle contractions in test and retest situations. After a 2-month training period of repeating the maneuvers, tinnitus modulation and daily perception were evaluated. Results: There was no difference between the occurrence of tinnitus modulation in test (57.9%) and retest (63.2%) situations. After 2 months, the occurrence of modulation during the maneuvers was similar (55.3%), but a new pattern showed an increase in tinnitus improvement and a decrease in tinnitus worsening. The daily perception of tinnitus was unchanged. Conclusions: Maneuvers of head and neck muscle contractions evoked tinnitus modulation in a frequent and reliable manner. Also, the repetition of such maneuvers for 2 months altered the pattern of modulation.
Cost Savings of Unsedated Office-Based Laser Surgery for Laryngeal Papillomas
Authors: Rees Catherine J. , Postma Gregory N. , Koufman Jamie A. 
Published: October 2014

Objectives: Unsedated office-based laryngeal laser surgery (UOLS) is now an effective alternative to traditional operating room-based suspension microdirect laryngoscopy under general anesthesia. This procedure includes pulsed dye laser (PDL) treatment of recurrent respiratory papillomas, granulomas, leukoplakia, and polypoid degeneration. The objective of this study was to determine the magnitude of the cost savings derived by moving these types of procedures from the operating room to the office setting. Methods: Retrospective cost-identification analysis was performed by comparing the billing records of patients who underwent surgical laser treatment for recurrent respiratory papillomatosis in the operating room to the costs and charges for patients who underwent similar procedures with the in-office PDL. Results: In performing surgery with the PDL in the office, the average cost savings was more than $5,000 per case. Current reimbursement rates do not cover the cost of performing UOLS. Conclusions: The potential cost savings of UOLS are tremendous; however, at present significant financial disincentives prevent proliferation of this technology.
Treatment of Squamous Cell Carcinoma of the Tongue Base: Irradiation, Surgery, or Palliation?
Authors: Jones Andrew S. , Rafferty Mark , Fenton John E. , Jones Terence M. , Husband David J. 
Published: October 2014

Objectives: Squamous cell carcinoma of the tongue base has a poor prognosis, and treatment is accompanied by a number of major problems. In view of this, it is important to recognize which patients will benefit from treatment with curative intent and which treatment method to use. Methods: One hundred sixty-five patients with squamous cell carcinoma of the tongue base were identified on our database. Eighty-two patients were treated by radical irradiation, and 41 by surgery. A further 42 patients were considered unsuitable for curative treatment. Results: The 5-year cause-specific survival rate was 41% for those treated by irradiation, 58% for those treated by surgery, and 9% for untreated patients. There was no difference in the efficacy of treatment methods (p = .5362), but a highly significant difference was seen in survival rate between treated and untreated patients (p = .0028). The decision regarding administration of curative treatment was based on the extent of locoregional involvement at the primary site (p = .0139; odds ratio, 0.43) and in the neck (p = .0078; odds ratio, 0.23). No factors affected the decision to treat by irradiation or surgery. When the observed survival rate was calculated, there was no significant difference in 5-year survival rate between treated and untreated patients (p = .2762). Those with early (T1-2) disease at the primary site had an improved survival rate from 0.5 to 4 years compared with those who were untreated (T3-4; p = .0081; odds ratio, 2.2). In addition, those with early (T1-2) disease had a better survival rate than those with advanced cancers (p = .0139; odds ratio, 2.09). There was, however, no difference in survival rate at 5 years. Those with early disease compared with those with advanced disease were twice as likely to be alive at 2 years; however, all survival advantages had disappeared by 5 years. Conclusions: In terms of observed survival, treating tongue base squamous cell carcinoma that is locally advanced (T3-4) at presentation offers no survival advantage over palliation alone. Treating early disease (T1-2) doubles the survival rate for up to 4 years, but by 5 years this survival advantage is lost. The present study finds radiotherapy and surgery to be equivalent at controlling this disease.
Features of Muscle Tension Dysphonia before and after Correction of Unilateral Vocal Cord Paralysis
Authors: Su Wan-Fu , Hsiao Yu-Che , Hung Chung-Ching 
Published: October 2014

Objectives: We performed a retrospective, longitudinal study to compare the prevalence of hyperkinetic laryngeal features before and after successful correction in patients with unilateral vocal cord paralysis (UVCP). Methods: Eighty-six patients with UVCP who had a successful surgical correction were enrolled. Preoperative and postoperative videolaryngostroboscopy images were analyzed, and the muscle tension patterns (MTPs) were rated according to the Morrison-Rammage classification. A 4-item glottal closure index was used for each patient on study entry and for 40 normal subjects as the control group. Results: There was no significant difference in MTP prevalence before (57%) and after (55%) surgical correction for UVCP. Although the glottal closure symptoms were tremendously improved through surgical medialization for UVCP, they persisted and were more prevalent than those in normal individuals. Conclusions: Persistence of MTPs after correction of UVCP may be due to intractable vocal habits or psychogenic factors.
Artificial Voice Modulation in Dogs by Recurrent Laryngeal Nerve Stimulation: Electrophysiological Confirmation of Anatomic Data
Authors: Broniatowski Michael , Grundfest-Broniatowski Sharon , Tucker Harvey M. , Tyler Dustin J. 
Published: October 2014

Objectives: We hypothesized that voice may be artificially manipulated to ameliorate dystonias considered to be a failure in dynamic integration between competing neuromuscular systems. Methods: Orderly intrinsic laryngeal muscle recruitment by anodal block via the recurrent laryngeal and vagus nerves has allowed us to define specific values based on differential excitabilities, but has precluded voice fluency because of focused breaks during stimulation and the need to treat several neural conduits. Such problems may be obviated by a circuit capable of stimulating some axons while simultaneously blocking others in the recurrent laryngeal nerve, which carries innervation to all intrinsic laryngeal muscles, including the arguably intrinsic cricothyroideus. In 5 dogs, both recurrent laryngeal nerves received 40-Hz quasi-trapezoidal pulses (0 to 2,000 μA, 0 to 2,000 μs, 0 to 500 μs decay) via tripolar electrodes. Electromyograms were matched with audio intensities and fundamental frequencies recorded under a constant flow of humidified air. Data were digitized and evaluated for potential correlations. Results: Orderly recruitment of the thyroarytenoideus, posterior cricoarytenoideus, and cricothyroideus was correlated with stimulating intensities (p < .001), and posterior cricoarytenoideus opposition to the thyroarytenoideus and cricothyroideus was instrumental in manipulating audio intensities and fundamental frequencies. Conclusions: Manipulation of canine voice parameters appears feasible via the sole recurrent laryngeal nerve within appropriate stimulation envelopes, and offers promise in human laryngeal dystonias.
Adductor Spasmodic Dysphonia versus Muscle Tension Dysphonia: Examining the Diagnostic Value of Recurrent Laryngeal Nerve Lidocaine Block
Authors: Roy Nelson , Smith Marshall E. , Allen Brynn , Merrill Ray M. 
Published: October 2014

Objectives: Differentiating adductor spasmodic dysphonia (ADSD) from muscle tension dysphonia (MTD) can be difficult. This investigation examined the precision of response to unilateral lidocaine block of the recurrent laryngeal nerve (RLN block) as a potential diagnostic test to discriminate ADSD from MTD. Methods: Patients with ADSD (n = 23) and MTD (n = 20) were audio-recorded before and during RLN block. The patients completed self-ratings of dysphonia severity, vocal effort, and laryngeal tightness, and blinded listeners completed auditory-perceptual ratings of overall severity, breathiness, and strain of voice samples before and during the block. Results: Repeated-measures analysis of variance, with “group” (ADSD/MTD) as the between-subjects variable and “time” (before block/during block) as the within-subjects variable, confirmed significant “time” effects, but no significant “group-by-time” interaction effects, indicating that both disorder groups responded favorably to RLN block, according to patient- and listener-based ratings. Furthermore, low estimates of sensitivity and specificity and weak receiver operating characteristic curves confirmed that a positive response to the RLN block test did not distinguish ADSD from MTD. Conclusions: We conclude that RLN block offers little discriminatory value in the differential diagnosis of ADSD versus MTD, and a positive response to RLN block should not be considered confirmatory of ADSD.