bluuebunny/crossref_metadata_2025_split huggingface dataset:
Manual Dexterity Aptitude Testing: A Soap Study
Authors: Tang Christopher G. , Hilsinger Raymond L. , Cruz Raul M. , Schloegel Luke J. , Byl Frederick M. , Rasgon Barry M. 
Published: February 2015

ObjectiveTo determine whether or not manual dexterity aptitude testing in the form of soap carving during otolaryngology residency interviews at Kaiser Permanente Oakland Medical Center predicts surgical skill at the time of graduation from otolaryngology residency programs.MethodsOver the past 25 years, applicants to the residency program at Kaiser Permanente Oakland were required to carve soap. This study was conducted to determine how applicants with the best and worst soaps compared at the time of graduation with respect to various metrics including visiospatial ability and manual dexterity.ResultsThe best and worst soaps from 1990 to 2006 were determined. Sixty‐two individuals qualified for the study and matriculated into otolaryngology residency programs. Surveys were sent to their residency programs to evaluate those individuals on a 5‐point Likert scale in various categories. There was no difference between individuals with the “best soaps” and those with the “worst soaps” in all categories: cognitive knowledge, visiospatial ability, manual dexterity, decision making, and overall score (P >. 1 for all categories). There was a 95% response rate with 35 of 37 residency programs responding, and 59 of 62 surveys returned.ConclusionAlthough further studies need to be conducted to determine the role of manual dexterity and visiospatial aptitude testing in the otolaryngology application process, individuals who have the “best soaps” did not score higher than those with the “worst soaps” in several metrics.
Treatment of Obstructive Sleep Apnea with Multiple Surgeries
Authors: Pinto José A. , Kohler Rodrigo , Godoy Luciana B. M. , Wambier Henrique , Sônego Thiago B. , Mizoguchi Elcio I. 
Published: February 2015

Objective1) Be able to determine the effects of multiple surgeries in the treatment of moderate and severe obstructive sleep apnea. 2) Confirm the importance of identifying the sites of obstruction in the treatment of obstructive sleep apnea.MethodA retrospective review of a prospective dataset of 40 patients with moderate and severe obstructive sleep apnea who had undergone multiple surgeries. Patients studied underwent palatal surgery with or without nasal and tongue base surgery. Charts between 1997 and 2011 were reviewed and the surgical results were determined.ResultsThirty‐two patients (80%) underwent UPPP, associated with midline glossectomy in 26 patients (65%). Five patients (12.5%) underwent expansion sphincter pharyngoplasty, associated with midline glossectomy in 1 patient (2.5%). One patient (2.5%) underwent lateral pharyngoplasty. At least some improvement occurred in 4 patients (40%) in the moderate OSAS group (n = 10), but 4 patients (40%) in this group showed a slight (nonsignificant) worsening in mean apnea/hypopnea index. In the severe OSAS group (n = 30) 25 patients (83.3%) showed significant improvement (decrease in mean number of events per hour; P <. 0001). Minimum oxygen saturation improved in the moderate and severe OSAS groups.ConclusionIn our study, as indicated by the apnea/hypopnea index, the use of multiple procedures appears to have better results in severe OSAS than in moderate OSAS. The results of surgical procedures are difficult to predict. Lack of success is usually due to failure to identify all sites of obstruction.
Upper Airway Dimensions in Snoring: Acoustical and MRI Findings
Authors: Chen Po‐Yueh , Wang Pa‐Chun , Lo Men‐Tzung , Chang Yi‐Chung , Lin Chen , Chen Yunn‐Jy 
Published: February 2015

ObjectiveOSA is caused by soft tissue collapse of the upper airway; treatment strategies can be determined depending on accurately localizing the obstruction sites. Acoustic analysis of snoring might provide a valuable way to localize the obstruction, if the association between the acoustics and the dynamics of the upper airway during OSA can be identified.MethodNine PSG OSA patients were enrolled. Dynamics of upper airway and the acoustic manifestations of snore events during natural sleep were recorded with dynamic MRI and a fiber‐optic microphone simultaneously. The Gabor/wavelet transformation was applied to extract the acoustic representation of OSA events by removing the repeated‐appearing MRI scanning background noises.ResultsAll of the 9 patients were men (mean age, 48.3 ± 9.9 years, mean BMI, 25.1 ± 1.9). The snore events were categorized into typical (velopharyngeal) and mixed (combined with hypopharyngeal) obstructions. The mean frequency (161 ± 17.4 vs 188 ± 24.1 Hz; P < 10‐16) and high (151~350 Hz)/low(80~150 Hz) frequency power ratio (1.08 ± 0.31 vs 1.55 ± 0.42 Hz; P < 10‐16) of the snore sounds were significantly higher in mixed obstructions. However, the dynamic patterns of the frequency modulation varied with structural changes identified by dMRI. During the snore events, different characteristics of shifts in frequency were found (mean frequency changes: −28.3 ± 21.4 in typical obstruction vs 12.5 ± 22.9 Hz for mixed obstruction; P < 10‐32), which gives better discrimination power.ConclusionThe dynamics of acoustic patterns derived by Gabor spectrogram are unique and characteristics in different types of obstruction with the advantage of low cost and easy availability. Therefore, the dynamics of acoustic patterns warrants further investigation in combination with instantaneous structural changes of the obstruction sites in OSA patients through dMRI.
Oropharyngeal Syphilis among HIV‐Infected Patients
Authors: Ablanedo‐Terrazas Yuria , Alvarado‐de La Barrera Claudia , Ruiz‐Cruz Matilde , Reyes‐Terán Gustavo 
Published: February 2015

ObjectiveThis study was aimed at describing oropharyngeal manifestations of secondary syphilis in HIV‐infected patients. We also sought to determine the clinical risk factors for the development of oropharyngeal syphilitic lesions in patients with HIV and secondary syphilis.MethodWe conducted a case‐control study in HIV‐infected patients at a tertiary referral center in Mexico City. All HIV‐infected patients admitted at our center during the period between November 2009 and February 2012 who fulfilled the CDC criteria for syphilis were included in this case control study.ResultsWe identified 35 cases of syphilis; 17 patients had secondary syphilis, and 9 had oropharyngeal manifestations. Lesions involving the anterior tonsillar pillar were the most common, observed in 5 patients; and tongue lesions were observed in 3 patients. Multivariate analysis showed that the development of oropharyngeal lesions was independently associated with age, CD3, CD4, and CD8 cell counts and HIV RNA viral load.ConclusionThe present work shows that oropharyngeal manifestations of secondary syphilis are frequent in HIV‐infected patients.
Quantitative Assessment of Aspiration: A Novel Porcine Model
Authors: Kanotra Sohit P. , Forte Vito 
Published: February 2015

ObjectiveDevelop a porcine model for quantitative assessment of pulmonary aspiration.MethodThe porcine model consists of an endotracheally inserted pH probe with the distal end of the probe at the carina. The pH probe is sutured to the posterior tracheal wall, and the position is verified by a flexible endoscope. An acidic solution of known pH (2.5) is delivered through a catheter attached to the endotracheal tube, with the distal end on the cuff of the tube. The pH probe is connected to a multifunctional data acquisition device (NI USB 6009. National Instruments, USA) with an analogue output signal measuring the voltage generated, which is analyzed on software (Lab View 2011, National Instruments). This continuously provides a quantitative assessment of aspiration by detecting any voltage changes over a period of time indicating leakage of fluid around the endotracheal cuff.ResultsThe mean voltage measured with the cuff fully inflated and a column of 10 mL of a solution of known pH on the cuff over a period of 2 hours was 885.74 ± 7.8 mvolts. With deflation of the endotracheal tube cuff a significant drop in voltage (mean voltage drop = 363.24 mvolts, P =. 001) was measured, indicating leakage of the acidic solution across the endotracheal tube cuff.ConclusionThe model provides a reliable method of quantifying the amount of aspiration. The model can be run for a long period of time and serves as an effective way of analyzing various techniques and devices for reducing aspiration.
Reducing Risks in Tonsillectomy
Authors: de Abajo Jorge , Cervera Javier , Baptista Peter M. 
Published: February 2015

ObjectiveTonsillectomy is one of the most common procedures performed by the otolaryngologist. Now, many different surgical systems offer advantages related to less pain or postoperative bleeding. In our institution Tissue Welding Starion System (TW) has been used for over 281 patients. We have compared results using TW with bipolar cautery (BC).MethodBetween August 2008 and January 2012, 482 consecutive surgeries were performed in our institution by 2 different surgeons using the clinical guidelines of the AAO‐HNS. Two hundred eighty‐one patients (58.2%) were operated using the TW technology, and 201 (41.8%) were operated using BC. We have evaluated surgical outcomes and complications.ResultsSurgeries performed with TW were significantly faster with less bleeding and carbonization of tissue in comparison with BC. Postoperative pain was significantly lower and patients returned to normal diet faster in the TW group. Eleven patients (2.3%) developed major complications (need for revision surgery, or admission to hospital). Seven of them (1.4%) were from the BC group (3 postoperative bleeding and 4 admissions because of pain). Four of them (0.8%) were from the TW group (3 postoperative bleeding and 1 admission due to persistent fever).ConclusionTonsillectomy with TW proved to reduce by half postoperative bleeding and admissions to hospital compared to BC. These suggest that TW could be an advantageous technique concerning safety.
Smoking Tobacco Use among Operating Room Personnel
Authors: Gonzalez‐Castro Javier , Pascual Jeamarie , Gonzalez‐Aquino Carlos , Tarrats Luisam 
Published: February 2015

ObjectiveTo evaluate the prevalence of smoking in operating room (OR) personnel and compare this with that of the general public. Given the first‐hand exposure of these individuals to patients with smoking‐related illnesses, we believe they should have a decreased tendency to smoke.MethodA survey instrument was given to OR personnel at the University of Puerto Rico in order to learn the prevalence of smoking among other tobacco use related data. Prevalence for the general population and other healthcare‐related populations was investigated using various search engines and compared with our results.ResultsA total of 113 individuals completed the survey; 6.19% were found to be current smokers, and 7.96% were found to be past smokers. Data from the Centers for Disease Control show that the prevalence of cigarette smoking among US adults is 20.9%, which is significantly higher than what we found in our population (P =. 01). In Puerto Rico, the prevalence of smoking is 10.6%, which is also significantly higher than our study population (P =. 05). Among current smokers, (n = 7), 85.7% have tried to quit at least once (P =. 02), and all claimed to have knowledge of the possible complications associated with smoking.ConclusionSmoking tobacco remains the number one cause of preventable death in the United States despite many efforts to educate the general public on the dangers associated with its use. A more visual or hands‐on encounter with the effects of smoking may help decrease tobacco burden in the general population.
The Acute Loss of Weight in Eustachian Tube Function
Authors: Pascoto Gabriela R. , Abreu Cassiana B. , Silva Maria Laura S. , Weber Raimar , Pignatari Shirley S.N. , Stamm Aldo E.C. 
Published: February 2015

ObjectiveTo evaluate the frequency and intensity of auditory tube dysfunction related to obese patients before and after bariatric surgery.MethodNineteen patients with a formal indication for bariatric surgery underwent surgery prior to a hearing evaluation (otoscopy, tonal and vocal audiometry, and impedanciometry) and a questionnaire on hearing; and in 3 and 6 months after surgery. Patients with disease or a history of ear surgery were excluded.ResultsWe found that 5 (26.3%) patients showed symptoms related to dysfunction of the Eustachian tube at the first postoperative evaluation. After 6 months of follow‐up, 9 (47.3%) patients presented symptoms of tubal dysfunction.ConclusionThis study suggests that bariatric surgery can cause symptoms of Eustachian tube dysfunction, probably due to rapid weight loss and the consequent loss of peritubal fat.
Ultrasound Assessment after Parotid Sialolithotomy
Authors: Joshi Arjun S. , Sood Amit J. 
Published: February 2015

Objective1) To demonstrate the utility of ultrasound in the assessment of residual parotid sialoliths or fragments after endoscopic‐assisted or purely open sialolithotomy. 2) To discuss limitations of using ultrasound for detection of sialolithiasis of the parotid glands.MethodFrom August 2009 to January 2012, 5 adult patients with symptomatic parotid sialolithiasis underwent endoscopic‐assisted or purely external sialolithotomy in a tertiary‐level hospital setting. Pre‐and intraoperative post‐sialolithotomy ultrasound was performed. Outcomes included presence of residual stones/fragments and proximal ductal dilatation.ResultsFive patients with symptomatic parotid sialolithiasis refractory to sialendoscopic extraction underwent either endoscopic‐assisted sialolithotomy or pure open sialolithotomy. Four of 5 patients demonstrated proximal ductal dilatation on ultrasound. One of 5 (20%) demonstrated residual sialolithiasis on ultrasound immediately after sialolithotomy. That patient underwent re‐exploration at the time of the procedure and was demonstrated to have residual sialolithiasis with successful delivery of the fragments. There were no instances of infection, ductal stenosis, loss of glandular function, or permanent buccal facial nerve paralysis, with follow‐up ranging from 6 months to 1 year.ConclusionAfter cases of endoscopic‐assisted or purely external parotid sialolithotomy, there is no widely used method to assess for residual stones. As a first, and in this small cohort of patients, we propose that ultrasound is effective and should be considered for the assessment of residual stones after external parotid sialolithotomy.
Ultrasound Localization during Parotid Sialolithotomy
Authors: Joshi Arjun S. , Sood Amit J. 
Published: February 2015

Objective1) To describe a novel operative technique that has been demonstrated to be successful in stone localization and subsequent retrieval in patients with parotid sialolithiasis. 2) To demonstrate feasibility of the technique and discuss its indications.MethodFrom August 2009 to January 2012, patients with symptomatic parotid sialolithiasis underwent ultrasound needle localization and open sialolithotomy in a tertiary‐level hospital setting. Outcomes included success of delivery, presence of infection, ductal stenosis, loss of glandular function, or facial nerve paralysis. Independent variables included size of and location of sialoliths.ResultsFive patients were treated using transcutaneous ultrasound‐guided needle placement and injection of methylene blue prior to external sialolithotomy in the operating room. Patients were chosen if they had failed prior sialendoscopic extraction. Postoperative outcomes and long‐term follow‐up results were obtained. Follow‐up ranged from 6 to 12 months. Mean operative time from skin incision to closure was 52 minutes (range, 43‐85 minutes). Five of 5 (100%) cases were successful for stone retrieval. Stents were placed in 4 of 5 cases. The average stone size was 5.3 mm. There were no complications of infection, ductal stenosis, loss of glandular function, or permanent buccal facial nerve paralysis. No patients had salvage parotidectomy.ConclusionAfter failing a purely endoscopic approach, sialoliths of the parotid gland pose a problem for precise localization and treatment. Ultrasound has been demonstrated to be reliable for identifying sialoliths. We propose a novel technique and assert that ultrasound‐guided needle localization is a reliable aid to effective external parotid sialolithotomy.
Advanced Juvenile Nasopharyngeal Angiofibroma
Authors: Ceylan Alper , Yılmaz Metin , Ataç Mustafa , Üstün Selin 
Published: February 2015

ObjectiveThe aim of this study was to describe a case of advanced juvenile nasopharyngeal angiofibroma from our practice and discuss the controversies of surgical treatment.MethodWe present a 13‐year‐old boy who underwent external resection of advanced juvenile nasopharyngeal angiofibroma at the Gazi University medical faculty otorhinolaryngology department, in 2012.ResultsNo complication was seen after surgery. Postoperative radiotherapy was given for small residual tumor.ConclusionSurgical treatment is the basic tactics in management of advanced juvenile nasopharyngeal angiofibroma. Stage of the tumor is the main factor contributing to the choice of the appropriate surgical approach.
Approaches to Parapharyngeal Space Tumors
Authors: Duggal Prahlad 
Published: February 2015

ObjectiveParapharyngeal tumors, owing to diversity of pathologies and the close proximity to vital structures, pose both a diagnostic enigma as well as a therapeutic challenge. The present study is an attempt to present our past 4 years experience in the surgical management of parapharyngeal tumors using various approaches.MethodA retrospective analysis of records of 22 patients who were operated for parapharyngeal tumors during the past 4 years was done. Only those cases where the primary neoplasm was of parapharyngeal space were included. The data so collected was analyzed for clinical presentation, radiological findings, surgical management and outcome.ResultsThe most common pathology found was salivary gland tumors (9) followed by neural origin tumors (5), carotid body tumor (2), and miscellaneous (6). Of the recommended approaches for parapharyngeal tumors, transcervical, trans‐cervical transparotid, and transcervical with mandibular swing approaches were used in the present study, while trans‐oral approach was not used. Transcervical transparotid approach was the most commonly used approach followed by transcervical approach. Transcervical with mandibular swing approach was used in cases with large tumors going to skull base. Size and extent of tumor along with type of pathology and vascularity were the main factors determining the approach selected.ConclusionTranscervical transparotid and transcervical approaches are the most frequently used approach in the present study providing adequate exposure depending upon the extent of tumour in parapharyngeal space. Mandibular swing approach should be used for huge tumors where dissection under vision is not possible and vascular control is compromised otherwise.
Endoscopic Transnasal Approach for Orbital Floor Fracture
Authors: Omura Kazuhiro 
Published: February 2015

ObjectiveIn recent years, we developed a more minimally invasive technique of endoscopic transnasal approach to repair orbital floor fractures (OFF) with preserving and repositioning the fractured bones. This study reviews our technique of endoscopic transnasal approach to OFF patients.MethodOFF patients treated with endoscopic transnasal approach were reviewed in a retrospective fashion. Type of fracture, locations, period from injury to surgery, surgical outcomes including patient’s subjective symptom and objective examinations, and complications were collected from patient charts. Preoperative and postoperative (>6 months) CT scans were also evaluated.ResultsA total of 5 patients were treated with endoscopic transnasal approach. The subjective symptoms were recovered in all patients. Hess screen test showed no limitation of eye movement after surgery. Postoperative CT scan also showed that the fractured bone of the orbital floor was identified in the almost original anatomic location 6 months after surgery. No complications or bone absorption were found after surgery.ConclusionThe novel technique of endoscopic transnasal approach to OFF patients resulted in excellent outcomes. It allows more minimally invasive surgery for the patients without any incisions and graft placement. We still have to watch for late complications and the presence/absence of the fractured bone absorption.
Isolation and Characteristics of Human Muscle Stem Cells
Authors: Wei Yan 
Published: February 2015

ObjectiveTo establish the methods for purification, culture, and identification of adult human skeletal muscle stem cells in vitro and to explore the biological properties of the cells.MethodMuscle stem cells were obtained from the consenting donors and cultured in serum‐free medium. Phenotypic characteristics of the cells and expression of cell‐specific markers were determined using RT‐PCR and immunocytochemistry. The cells were analyzed for their multi‐lineage differentiation potential into osteoblastic, adipocyte, and smooth muscle cell lineages.ResultsPrimary cultured human skeletal muscle stem cells proliferated and formed the big spheres when cultured with serum‐free medium. Immuno‐fluorescent staining displayed PaX7 and ALDH1 positive expression in the cell spheres. Furthermore, Myod and Desmin showed positive expression in the monolayer cells derived from the spheres. The gene expressions of 0ct3/4, Nanog, Sox2, and Pax7 in the cells were determined by RT‐PCR. The cell clones formed from single cells grew well. In addition, they were capable of spontaneous differentiation into myotubes in the differentiation medium and into other mesodermal cell lineages in induction medium.ConclusionHuman muscle stem cells with properties of self‐renewal capacity and multidifferentiation could be successfully isolated and expanded in vitro.
Cervicoscopic Coblation Thyroid Surgery
Authors: Rao‐Merugumala Srinivasa 
Published: February 2015

Objective1) To evaluate the efficacy and safety of cervicoscopic and coblation assisted surgery (CCAS) of thyroid. 2) To present a rare case of myofibroblastic nodule with focal embryonal tissue in a 72‐year‐old woman. 3) To understand these rare presentations for effective management.MethodTo evaluate the safety and efficacy of outcomes CCAS and conventional thyroid surgical procedures from October 2008 to September 2010. Arthrocare EVac 70 Xtra Plasma Wand was used for hemostasis and subcapsular dissection.ResultsOne representative case includes a 72‐year‐old Afro‐Caribbean woman who presented with 3‐year history of progressive exertional dyspnea and hoarse voice due to diffuse multinodular goiter with a dominant solid nodule on ultrasound and a thy2 on needle aspirate. She was refused general anaesthesia. CCAS of thyroid under cervical block as a day case, revealed moth‐eaten appearance thyroid follicles with areas of hemorrhage and cholesterol clefts with focal embryonal thyroid tissue and a prominent myofibroblastic nodule formation. In contrast the third patient in this series showed areas of fibrotic hemorrhagic nodules with cystic degeneration.ConclusionThis study illustrates that CCAS of thyroid provides a minimally invasive technique with less morbidity and has good cosmetic outcome and is amenable to be performed under cervical block in selected patients. Myofibroblastic proliferation commonly reported in papillary carcinoma was contrary to association with benign pathology in this case.