bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Refractory and Delayed De Novo Otitis Media Requiring Pressure Equalization Tube Insertion
Authors: Bowe Sarah N. , Vargo James D. , Abramoff Claire , Jatana Kris R. , Kang D. Richard 
Published: September 2014

Objectives:There is substantial information regarding environmental and clinical risk factors for otitis media in young children; however, limited data exist in 6‐ to 12‐year‐old patients and specifically those in which surgical intervention is performed. This study investigated potential risk factors for de novo or refractory otitis media in this older age group who required pressure equalization tube (PET) insertion.Methods:A retrospective study was performed at a tertiary care academic hospital for children 6 to 12 years old undergoing PET insertion between October 1, 2010, and September 30, 2011. The data were stratified into 2 separate age cohorts (6‐7 versus 8‐to 12‐year‐olds) for analysis.Results:A total of 263 patients met the inclusion criteria. PET insertion was more common in the 6‐year‐old age group (36%, 95/263), which decreased by age with a negative relationship. No significant sex‐based difference was observed. Presence of siblings (P <. 05), otalgia (P <. 05), otorrhea (P <. 001), nasal discharge (P <. 001), and trends of parental smoking (P =. 09) and hearing loss (P =. 06) were identified in the older cohort. No statistical significance was found for history of recurrent acute otitis media (RAOM), allergy, asthma, or atopy between the 2 groups (P =. 22‐.97).Conclusions:The older cohort (ages 8‐12 years old) had more infectious symptoms including otalgia, otorrhea, and nasal discharge than the younger cohort (ages 6‐7 years old). In contrast, history of RAOM, allergy, asthma, and atopy were not significantly different between these age groups. Overall, this study provides further understanding of pertinent risk factors in older children requiring new or recurrent PET insertion.
The Effect of Jaw Exercise on Trismus in Head and Neck Cancer Patients
Authors: Finizia Caterina A. , Pauli Nina 
Published: September 2014

Objectives:Trismus is a symptom that impacts daily life activities and adversely affects patient health‐related quality of life (HRQL). Radiation‐induced fibrosis is probably one of the most important etiological factors to trismus in head and neck cancer (HNC). The aim of this randomized prospective study was to compare 2 different jaw exercise devices, regarding improvement in mouth opening (MIO) and patient‐reported symptoms in HNC patients with trismus.Methods:The 50 study patients were enrolled in a 10‐week structured MIO training program and randomized to training with either TheraBite® device or Engström jaw device. The patients were regularly assessed by an oral surgeon and answered different questionnaires (ie, EORTC HN35 and the Gothenburg Trismus Questionnaire [GTQ])).Results:Both groups improved their MIO, 7.2 mm (22.9%) and 5.5 mm (17.6%) for TheraBite® and Engström, respectively. The largest increase in MIO was seen during the first 4 weeks of exercise. After the exercise periods 84% in the TheraBite® group (n = 21) and 60% in the Engström group (n = 15) no longer fulfilled the trismus criteria. A statistically significant improvement regarding trismus related symptoms in both groups with less pain, jaw‐related problems, and eating limitations after the exercise period was found (P <. 05 and P <. 01).Conclusions:Structured intervention with a jaw exercise device improved the mouth opening capacity with less trismus‐related symptoms in HNC patients. No statistically significant differences between the different devices were found. We suggest a feasible exercise program for radiation‐induced trismus in HNC patients.
Role of Cochlear Microphonics in Newborn Hearing Screening
Authors: Kwak Min K. , Chung Jae Ho , Lee Seung Hwan , Park Chul Won , Cho Seok Hyun , Jeong Jin Hyeok 
Published: September 2014

Objectives:Investigate the role of cochlear microphonics (CM) that could be simultaneously acquired in auditory brain stem response (ABR) test in neonatal hearing screening.Methods:From April 2013 to January 2014, hearing screening tests were performed on 51 newborns treated in neonate intensive care unit. The subjects underwent transient evoked otoacoustic emission (TEOAE) and auditory brain stem response (ABR). The amplitude of CM was acquired by applying 90 dB‐click sound of condensating and rarefacting polarity.Results:There were 68 ears with normal results in ABR, CM and OAE. Auditory neuropathy was suspected in 2 ears that had presence of CM and OAE with abnormal ABR waveform. Amplitude of CM correlated with reproducibility of OAE (p<.01) inversely correlated with latencies of wave I and III (P =. 016, P =. 010). The subjects with presence of OAE showed higher amplitude of CM than those with absent OAE (P <. 01). Mean CM amplitude of subjects with normal ABR threshold was higher than those with abnormal ABR, but there was no statistical significance. Five subjects who had normal ABR threshold showed no OAE response but CM was measured.Conclusions:Amplitude of CM had correlation with results of OAE and ABR test. CM might provide more stable information about cochlear hair cell than OAE test which could be easily influenced by condition of middle ear or external ear. We suggest CM as a useful supplementary tool for OAE test.
Role of Polysomnography in Children When Clinical Indicators of Sleep‐Disordered Breathing Are Met
Authors: Lam Herman P. , Ramadan Hassan H. 
Published: September 2014

Objectives:Sleep‐disordered breathing (SDB) affects approximately 12% of children, ranging from snoring to obstructive sleep apnea (OSA). Polysomnography (PSG) is the gold standard for diagnosing SDB and has been increasingly obtained in children. Some feel PSG is underutilized given recent clinical guidelines; however, others believe that if the clinical indicators for OSA are present, a PSG is unnecessary. The purpose of this study was to determine the effectiveness of clinical indicators in predicting PSG results in children.Methods:A retrospective review of PSG on children between 2 and 18 years old ordered by an otolaryngologist at West Virginia University between January 2011 and November 2013. Recorded variables included: age, sex, symptoms of gasping, snoring, restlessness, body mass index, previous adenoidectomy, tonsil size, and apnea‐hypopnea index (AHI). Statistical analysis was used to compare positive PSG with clinical indicators.Results:Ninety‐five patients were reviewed with 73 meeting inclusion criteria. Age range was 2 to 17 years (mean, 5.3 years) and mean AHI was 3.26. Gasping showed a statistical significant correlation with positive PSG (61.9% positive, P <. 05). Overweight/obese patients with gasping had a 73.3% positive PSG. Snoring and restlessness did not have a statistically significant correlation with positive PSG; however, restlessness was approaching clinical significance. One patient (25%) without gasping and restlessness combined had positive PSG. Gasping had a statically significant higher mean AHI of 4.3 compared to 2.2 without symptoms of gasping. Neither snoring nor restlessness showed statistically significant higher AHI.Conclusions:Gasping is an effective clinical indicator in predicting positive PSG and diagnosing OSA in children.
Treatment and Outcome of Otitis Media with Effusion in Cleft Palate Patients
Authors: Tan Amanda En‐Pei , Tan Bernard W. , Hoe Ying Min , Ang Annette Hui‐Chi 
Published: September 2014

Objectives:Otitis media with effusion (OME) is established to be universally present in children with cleft palate. It is found to be most prevalent during the age of 4 to 6 years. This problem may continue to recur in this group of patients, seeming to settle during adolescence. The aim of this retrospective study was to examine OME in cleft palate pediatric patients, with or without cleft lip, and determine the average number of ventilation tube insertions required for this group of patients from birth to 16 years of age.Methods:This retrospective study reviewed 258 pediatric patients who have undergone cleft palate repair and myringotomy with ventilation tube insertions in KKWCH during the period from 1990 to 2012. Information to be collated included: type of cleft, when repair of the cleft was performed, when ventilation tubes were inserted, and how many ventilation tube insertion procedures were performed.Results:The period of follow‐up ranged from 2 to 13 years. The ratio of boys to girls was 1.3 to 1. It was found that a large percentage of patients between 2 years to 13 years of age had 3 or less sets of ventilation tube insertions. The youngest to have received tube insertion was 7 weeks old. The oldest was 14 years old.Conclusions:OME in cleft palate patients may be a recurrent problem. Knowing the likely progression of the disease is useful when counseling the parents involved.
Use of Concentrated Light to Determine Middle Ear Effusion: The Laser Otoscope
Authors: Seth Rahul , Ford Matthew R. , Hawley Karen A. , Rollins Andrew , Krakovitz Paul R. 
Published: September 2014

Objectives:(1) Appreciate the current diagnostic limitations and significant misinterpretation rate (nearly 50%) of acute otitis media (AOM) and otitis media with effusion (OME) by general practitioners and pediatricians using the conventional otoscope. (2) Recognize the optical properties of middle ear effusion (MEE) and this innovation's ability to improve diagnosis using a concentrated (laser) light.Methods:Laser otoscopes were developed and designed with class IIIa lasers. The laser propagates with the incandescent light to illuminate on the tympanic membrane (TM). An institutional review board–approved prospective pilot study was completed at a tertiary care hospital. Study patients were 1 to 18 years and undergoing ear tube placement. The laser otoscope was used on each ear for assessment of MEE prior to myringotomy. The simple objective presence or nonpresence of a glow of the laser on the TM surface was recorded. Presence of a glow signified MEE due to the dispersion quality of light through liquid versus air. True presence of MEE was then determined with myringotomy.Results:Fifty ears (25 patients) were enrolled. Assessing only for a simple objective glow without any further interpretation of the middle ear contents yielded an 89.4% accuracy for determining MEE.Conclusions:The laser otoscope is a novel, simple, and potentially extremely useful tool for assisting in otoscopic determination of fluid in the middle ear. Particularly among primary care givers, MEE assessment may be able to be increased from nearly 50% to nearly 90%, by simply assessing for a laser glow or no‐glow on the TM surface.
Utilization of Exome Sequencing for Diagnosis and Discovery of Genetic Causes of Sensorineural Hearing Loss
Authors: Tilton Richard K. , Noon Sarah E. , Wilkens Alisha , Jayaraman Vijayakumar , Brunton Joshua , Krantz Ian D. , Germiller John A. 
Published: September 2014

Objectives:Exome sequencing (ES) is a single platform test that screens the exons of nearly all genes and is increasingly being used in the clinical diagnosis of hearing loss due to the large number of genes etiologically implicated. Our goals were to explore (1) the utility and limitations of ES for diagnosis in children with sensorineural hearing loss (SNHL) and (2) its ability to discover novel genes causing SNHL.Methods:Thirty‐six children with bilateral SNHL underwent ES: 26 without an etiology for their SNHL after standard clinical testing, and a control group of 10 with known mutations. Exome variants were initially filtered using a list of 264 genes associated with hearing loss.Results:In the 10 children with known mutations, all were correctly identified by ES except 3 large deletions. Analysis of the 26 unknown samples found likely pathogenic mutations in 8 (31%). A definitive diagnosis was obtained in 1 additional child, who had an unusual MITF mutation that led to the diagnosis of Waardenburg syndrome. In one other family, a novel candidate gene was identified which previously has never been implicated in human disease. Affected children in that family had profound SNHL accompanied by malformation of the vestibular labyrinth. Mutations in this gene segregated as expected among the 8 family members.Conclusions:ES is a powerful tool for both diagnosis and discovery for genetically heterogeneous conditions like SNHL. Despite limitations inherent to using gene lists and only sequencing exons, this technology has great promise for helping ascertain the etiology of SNHL in children.
Advantages of Gloved Finger–Coated Polyvinyl Acetate Pack in Partial Inferior Turbinate Surgery
Authors: Woo Hyun‐Jae 
Published: September 2014

Objectives:Nasal packing is commonly used to control postoperative bleeding in patients undergoing inferior turbinate surgery. During packing removal, patients usually undergo severe pain and bleeding. The objective of this study was to investigate the efficacy and safety of glove finger‐coated polyvinyl acetate (PA) pack on hemostasis, pain levels, and wound healing after partial inferior turbinectomy.Methods:A prospective, randomized, double‐blinded controlled study was conducted on 30 patients undergoing partial bilateral inferior turbinectomy using microdebrider for hypertrophic rhinitis. Fifteen patients (control group) had both nasal cavities packed with PA pack (Merocel; Medtronic Xomed, Jacksonville, FL) and another 15 subjects (experimental group) had their nasal cavities packed with PA in a glove finger. Pain levels were assessed by patients on a visual analog scale 12 hours after surgery and at the time of packing removal. The amount of bleeding on removal was quantified by weighing it after removal.Results:Both nasal packs effectively prevented postoperative bleeding. However, bleeding on packing removal was statistically less frequent and less severe with PA pack in a glove finger (P =. 004). In addition, pain was statistically lower with PA pack in a glove finger than with PA pack alone (P =. 001). There was no significant difference in the outcome measure of wound healing.Conclusions:PA packing in a glove finger is a recommendable method in terms of pain, bleeding on packing removal, compared with PA pack only.
Aspergillus Fumigatus Extract Suppresses the mRNA Expression of the IP‐10 in Human Bronchial Epithelial Cells
Authors: Bhushan Bharat , Norton James E. , Gupta Dave , Sha Quen , Schroeder James W. , Schleimer Robert P. 
Published: September 2014

Objectives:Immunologic reactions to antigens released by Aspergillus fumigatus can cause infections such as allergic bronchopulmonary aspergillosis (ABPA). The mucosal surface of the respiratory tract provides host defense mechanism. The aim of this study was to investigate whether respiratory epithelial cells recognize A. fumigatus extract (AE) and initiate an immune response. We report inhibition of Th1 biased epithelial inflammation by an Aspergillus extract.Methods:BEAS‐2B epithelial cells were cultured in a 37°C incubator in media supplemented with 5% FBS. Cells were treated in duplicate with AE for 1 hour and were stimulated with the TLR3 activator dsRNA for 6 hours. RNA was isolated and was reverse transcribed to cDNA. Realtime polymerase chain reaction analysis was performed in the presence of specific primers and fluorescently labeled probes.Results:IFN‐β and dsRNA both induced IP‐10 mRNA expression in BEAS‐2B cells (IFN‐β 1081‐fold; n = 3; P <. 001) (dsRNA 3044‐fold; n = 3; P <. 001). When BEAS‐2B cells were pretreated with AE for 1 hour and then stimulated with IFN‐β or dsRNA for 6 hours, induction of IP‐10 mRNA was suppressed relative to levels produced by IFN‐β and dsRNA alone. Suppressive effects increased with increasing AE concentration. IP‐10 protein was induced by IFN‐β (control [undetectable] vs IFN‐β treated [16.6 ± 9.5 pg/mL] at 6 hours) and by dsRNA (control [undetectable] vs dsRNA [25.3 ± 6.9 pg/mL], at 6 hours, n = 3). We observed significant suppression of IP‐10 protein when cells were treated with 1:320 W/V AE concentration (16.6 ± 9.5 pg/mL control vs 2.4 ± 0.25 pg/mL AE treated: P =. 005, n = 3).Conclusions:We found that AE inhibits the IP‐10 mRNA and protein secretion in bronchial epithelial cells.
Comparison of Intranasal Ciclesonide, Oral Levocetirizine, and Combination Treatment in Patients with Allergic Rhinitis
Authors: Kim Chang‐Hoon , Kim Jin Kook , Kim Hyun Jun , Cho Jin Hee , Kim Young‐Dae , Lee Heung‐Man , Yoon Joo‐heon 
Published: September 2014

Objectives:Ciclesonide is an intranasal corticosteroid for the treatment of allergic rhinitis. To date, concrete evidence to justify a definitive recommendation of intranasal corticosteroid over oral antihistamine has not been demonstrated. This study aimed to evaluate the efficacy and safety of once‐daily ciclesonide in comparison to both levocetirizine alone, and a ciclesonide/levocetirizine combination in patients with seasonal (SAR) and perennial AR (PAR).Methods:Subjects exhibiting moderate to severe allergic rhinitis for longer than 1 year were randomized in an open‐label, 3‐arm, parallel group, multicenter study. Subjects received 200 µg ciclesonide, 5 mg levocetirizine, or a combination of both. Changes from baseline until the end‐of‐study visit (2 weeks following) were evaluated by reflective total nasal symptom scores (rTNSS), reflective total ocular symptom scores (rTOSS), physician‐assessed overall nasal signs and symptoms severity (PANS), and rhinoconjunctivitis quality‐of‐life questionnaires (RQLQ).Results:Significant improvements in rTNSS, PANS, and RQLQ in the ciclesonide monotherapy group were observed in comparison to the levocetirizine alone group. Three individual symptoms of rTNSS were improved in the ciclesonide‐treated group. rTOSS scores for ciclesonide monotherapy improved from baseline, but no superiority over levocetirizine was shown. Ciclesonide spray was more effective than levocetirizine in reducing nasal symptoms in both SAR and PAR patients. Ciclesonide and levocetrizine were well tolerated alone and in combination.Conclusions:Our results provide support for an AR and its Impact on Asthma (ARIA) recommendation stipulating that ciclesonide is superior to levocetirizine for the treatment of AR, with tolerable safety. Addition of levocetirizine to ciclesonide did not give further clinical benefit over monotherapy.
Efficacy of Sublingual Immunotherapy after Early Adverse Events in Allergic Rhinitis
Authors: Hong Seung , Ahn Jae‐Cheul , Han Doo Hee , Lee Sang Yeon , Kim Dong‐Young , Lee Chul Hee , Rhee Chae‐Seo 
Published: September 2014

Objectives:Sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment of allergic rhinitis (AR). However, some patients experience early adverse events (EAE) during SLIT. This study aimed to investigate the predisposing conditions of EAE and the influence of EAE on treatment outcomes in the house dust mite (HDM) SLIT for AR.Methods:As a retrospective cohort study, 226 patients diagnosed with AR and sensitized to HDM started HDM‐SLIT in 2010. The symptomatic improvement was measured by a total nasal symptom score (TNSS) before and 6 months after SLIT. EAE were divided into 3 categories, local and systemic EAE and aggravation of nasal symptoms. The TNSS in the 3 groups of EAE were compared. The medical records and diaries of 125 patients were reviewed.Results:TNSS decreased from 9.7 to 3.9 six months after SLIT. There were 28 patients (22.4%) who experienced EAE. TNSS was improved in both non‐EAE and EAE groups 6 months after SLIT, and there was no difference in the 6‐month changes of TNSS between the non‐EAE and EAE groups. Significant improvement of TNSS was found in local EAE or early aggravation of the symptoms. The rescue medication score in the group of local EAE stayed relatively low both 1 month and 6 months after SLIT.Conclusions:Even though HDM‐SLIT sometimes caused EAE, it did not affect SLIT. The cumbersome local EAE in SLIT was self‐limited and neither gave an adverse influence to the symptomatic improvement nor elevated the frequency of the rescue medication.
Endoscopic versus Traditional Headlight Approach for Septal Surgery: A Prospective Controlled Study
Authors: Martellucci Salvatore , Pagliuca Giulio , Gallipoli Camilla , Rosato Chiara , De Vincentiis Marco , Greco Antonio , Gallo Andrea 
Published: September 2014

Objectives:(1) Describe a totally endoscopic‐assisted technique for septoplasty. (2) Assess the outcomes of endoscopic‐assisted technique according to subjective and objective criteria. (3) Compare the outcomes of the endoscopic‐assisted approach with those obtained with the traditional headlight technique.Methods:This prospective, randomized, controlled trial was conducted from September 2010 to September 2013 at the ENT University Unit of the A. Fiorini Hospital, Sapienza University of Rome. A total of 160 patients undergoing surgery for septal deviation meeting strict inclusion/exclusion criteria were recruited. Patients were randomly assigned to either the endoscopic (Group A) or the conventional group (Group B). Endoscopic evaluation and anterior rhinomanometry were carried out pre‐ and postoperatively. Nasal Obstruction Symptom Evaluation (NOSE) scale was used to measure the nasal obstruction before and after surgery. At the end of each procedure the junior residents compiled a 10 cm visual analog scale (VAS) which evaluated their overall understanding of the surgical procedure. Surgical times and complications were recorded.Results:All patients showed a significant improvement of nasal obstruction (P <. 05) in both subjective and objective evaluation without a statistically significant difference between the 2 groups. The overall incidence of peri‐ and postoperative complications was significantly lower in Group A than in Group B (P <. 05) without differences in surgical time. The VAS score regarding understanding of the surgical steps was significantly higher for endoscopic‐assisted septoplasty (P <. 001).Conclusions:The endoscopic approach represents a viable alternative to traditional headlight septoplasty. Furthermore, endoscopic‐assisted septoplasty may be considered to be better than the traditional approach in a teaching perspective.
Histamine Promotes the Release of IL‐6 in Nasal Fibroblasts
Authors: Park Il‐Ho , Shin Jae‐Min , Cho Jung Sun , Um Ji‐Young , Lee Heung‐Man 
Published: September 2014

Objectives:Based on the close relationship between histamine and IL‐6, we hypothesized that histamine plays a role in the production of cytokines such as IL‐6 and is involved in the microenvironmental controls of the allergic inflammatory process. We describe in nasal fibroblasts the effect of histamine on the production of IL‐6, the major histamine receptors, and the related underlying mechanisms.Methods:Nasal fibroblasts from eight normal patients were incubated. Reverse transcriptase polymerase chain reaction was performed for histamine receptors (H1R, H2R, H3R, and H4R) to identify which histamine receptor is expressed in nasal fibroblasts. The fibroblasts were treated with histamine with or without a histamine‐receptor antagonist, and IL‐6 production was measured using ELISA. Three MAP kinases (p38, ERK, and JNK) and NF‐κB were evaluated as downstream signaling molecules by Western blot analysis and Luciferase reporter assay.Results:Expression levels of all histamine receptors were elevated. The level of IL‐6 protein expression increased significantly with histamine stimulation. Among the histamine‐receptor specific antagonists, only H1R antagonist significantly decreased IL‐6 production in histamine‐stimulated nasal fibroblasts. Histamine increased the level of phosphorylated p38 (pp38), pERK, pJNK expression, and NF‐κB induction. H1R antagonist reversed the increased expression of pp38 and NF‐κB in histamine‐induced nasal fibroblasts, but not pERK and pJNK. p38 inhibitor markedly suppressed the increased production of IL‐6 in histamine‐stimulated nasal fibroblasts.Conclusions:The results of the present study suggest that antihistamines could be involved in the regulation of cytokines such as IL‐6, beyond the blockage of the histamine effect as an inflammatory mediator in nasal fibroblasts.