bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the Mode of Delivery Affect Wideband Reflectance Measurements in Newborns?
Authors: Masaoudi Laila Al , Pitaro Jacob , Daniel Sam J. 
Published: August 2013

Objectives:Determine whether wideband reflectance (WBR) measurements in babies who were born by vaginal delivery are different from those of babies born by C‐section. Our working hypothesis is that babies delivered by Caesarian section have higher reflectance scores on WBR, as they have more fluid and debris in the outer and middle ear. This can have an impact on universal hearing screening passing rates.Methods:Following standard newborn hearing screening, WBR was measured in 225 healthy babies. Sixty‐six babies were delivered by Caesarean section compared to 159 babies delivered vaginally. A total of 123 ears were included in the C‐section group and were compared to a total of 288 ears in the second group. The results were obtained for 60 frequencies.Results:The mean screening age for babies in the C‐section delivery group was 27.5 hours compared to 24.3 hours for babies in the vaginal delivery group. For both groups reflectance was high between 0.24 to 0.79 kHz and 2.50 to 4.80 kHz, with the highest at 4.5 kHz. Low reflectance was observed between 0.84 kHz and 2.50 kHz, with a second decrease in reflectance between 4.8 kHz and 8 kHz for both groups. In general, reflectance of the C‐section group was slightly lower than the reflectance for babies in the vaginal delivery group.Conclusions:Further studies are needed to conclude whether the type of delivery may have an effect on hearing screening results and possibly on the optimal timing for screening babies delivered via C‐section.
Parotid Duct Injury in Temporalis Tendon Transfer
Authors: Peterson Nathaniel , Shipchandler Taha Z. 
Published: August 2013

Objectives:1) Know the course of the parotid duct relative to the path of dissection for temporalis tendon transfer. 2) Apply anatomic concepts and technique modifications to protect the parotid duct during temporalis tendon transfer.Methods:A retrospective chart review of 40 consecutive adult patients undergoing temporalis tendon transfer for unilateral facial reanimation was performed. Cases represent operations done with the technique described in the literature as well as those performed with the additional step of parotid duct cannulation. In the latter, the path of dissection and course of the parotid duct were documented with introperative X‐ray. Instances of parotid duct injury using both techniques were recorded. Treatment course for patients with parotid duct injury was also reviewed.Results:Two instances of parotid duct injury were identified (incidence = 5%). Both were in cases without parotid duct cannulation. However, only 3 cases have been performed since the addition of parotid duct cannulation to our surgical technique. Intraoperative plain films showed that the path of dissection and the course of the parotid duct run obliquely and passed within 5 mm of each other. Both patients with parotid duct injury had resolution of symptoms with medical management, including botulinum toxin injection into the affected parotid gland and placement of pressure dressings.Conclusions:Parotid duct injury is an uncommon complication of temporalis tendon transfer that can be adequately managed with medical treatment. Cannulation of the parotid duct allows for intraoperative localization and possibly prevention of injury to this important structure.
Lack of Significant Seasonality in Detecting Respiratory Viruses on Hypertrophic Adenotonsillar Tissues Suggests Persisting Infections
Authors: Valera Fabiana , Tamashiro Edwin , Proença‐Modena Jose L. , Buzatto Guilherma P. , Paula Flavia E. , Arruda Eurico , Anselmo Lima Wilma T. 
Published: August 2013

Objectives:Determine the seasonality of respiratory viruses in adenoids and palatine tonsils in children with chronic adenotonsillitis. These seasonal oscillations were used to estimate the presence of persistent or acute asymptomatic viral infections.Methods:This was a cross‐sectional study which included 172 children with adenotonsillar hypertrophy and clinical evidence of obstructive sleep apnea syndrome or recurrent adenotonsillitis from 2010 through 2012. The respiratory viruses were detected by TaqMan real‐time polymerase chain reaction (qPCR) in nasopharyngeal secretions, adenoids, and palatine tonsils biopsies from all analyzed patients.Results:Frequency of several respiratory viruses was extremely high in the adenotonsillar tissues among all analyzed patients. In fact, genomes of at least one respiratory virus were detected in over 87% of them. Although some viruses have not shown any discernible seasonal variations, human enterovirus detection peaks in summer/autumn months and summer nadirs of human respiratory syncytial virus in both years of the study, they were discrete, and not significant. No obvious seasonality was observed among the analyzed viruses.Conclusions:This frequent rate of viral detection associated with the lack of significant seasonality of detection of respiratory viruses in patients with chronic adenotonsillar diseases during the 2‐year study period supports the notion that such high frequency of virus genome detection is related to virus persistence in lymphoepithelial tissues of the upper respiratory tract, which can function as natural reservoirs of respiratory viruses for the community.
Older Siblings Are at Increased Risk for Head and Neck Foreign Bodies
Authors: Bartindale Matthew R. , Rosenthal Laura S. , Fridirici Zachary 
Published: August 2013

Objectives:1) Describe the role siblings play in foreign bodies of the head and neck. 2) Recognize the locations where children are most at risk for foreign bodies.Methods:This is a prospective case‐control study in a tertiary care facility conducted from 2011‐2013. Any child (0‐17yo) with a foreign body removed from the head or neck was included. Data collected included location of the foreign body (eg, esophagus), location of acquisition (eg, home), and the number and ages of siblings. Controls were matched by age, gender, and location of removal (clinic, operating room, or emergency department).Results:There were 27 patients enrolled (16 male, 11 female). The average age was 5.2yo (median 4.6yo, range 9mo‐13yo). The average age of patients with foreign bodies in the ear was 6.0yo (n = 17), esophagus 4.3yo (n = 6), and nose 3.2yo (n = 4). Children with a younger sibling are more likely to have a foreign body than children with no younger siblings (odds ratio [OR] = 3.025, P = 0.0738). This is particularly true when children are at home (n=17, OR 11.20, P = 0.0153). There is no statistically increased risk for patients with older siblings compared to no older siblings (OR = 0.6250, P = 0.4023) or having a sibling compared to no siblings (OR = 0.6786, P = 0.5346).Conclusions:Older siblings are more likely to acquire foreign bodies in the home than younger siblings. Increased awareness of this may help prevent some foreign bodies of the head and neck.
Outcomes of Combined Furlow Palatoplasty and Sphincter Pharyngoplasty for Velopharyngeal Insufficiency
Authors: Bohm Lauren A. , Padgitt Noëlle , Tibesar Robert J. , Lander Timothy , Sidman James D. 
Published: August 2013

Objectives:Compare surgical outcomes between pharyngeal flap, sphincter pharyngoplasty, and concomitant Furlow palatoplasty and sphincter pharyngoplasty in the management of pediatric velopharyngeal insufficiency.Methods:Retrospective review of 96 patients with velopharyngeal insufficiency, who underwent surgical intervention at a tertiary pediatric care center between 2008 and 2012. Patients with velocardiofacial syndrome were excluded from the study. Surgical interventions were categorized as pharyngeal flap, sphincter pharyngoplasty, and concomitant Furlow palatoplasty and sphincter pharyngoplasty. Main outcome measures included perceptual speech analyses, complications, and surgical revision rates.Results:Of the 96 reviewed patients, 38 (39.6%) underwent pharyngeal flap, 20 (20.8%) sphincter pharyngoplasty, and 38 (39.6%) concomitant Furlow palatoplasty and sphincter pharyngoplasty. The mean improvement in postoperative perceptual speech analysis scores was significantly higher in both the combined procedure and pharyngeal flap when compared to sphincter pharyngoplasty alone (P =. 013, P =. 031). No statistically significant difference in speech improvement was observed between the combined procedure and pharyngeal flap. There were no differences in complications among the three surgical interventions. However, the combined procedure required significantly less surgical revisions than the pharyngeal flap (P =. 019).Conclusions:Concomitant Furlow palatoplasty and sphincter pharyngoplasty is an effective procedure for the management of pediatric velopharyngeal insufficiency and may result in superior speech outcomes and lower revision rates than sphincter pharyngoplasty and pharyngeal flap, respectively.
Pediatric Vocal Fold Immobility: An 11‐Year Review
Authors: Jabbour Jad R. , Martin Timothy J. , Beste David J. , Robey Thomas C. 
Published: August 2013

Objectives:1) Describe the etiologies, manifestations, clinical course, and prognosis of vocal fold immobility (VFI) in a pediatric population. 2) Recognize the morbidities associated with neonatal VFI.Methods:Retrospective review of patients at a private pediatric otolaryngology practice in a metropolitan area. All patients seen between July 15, 2001, and September 1, 2012, with a diagnosis of complete or partial VFI were included. Records were reviewed for data regarding demographics, etiologies, symptomatology, follow‐up, and resolution.Results:A total of 418 patients were identified. Left VFI was present in 66.0%, right VFI in 7.9%, and bilateral VFI in 26.1%. Median age at presentation was 90 days. Major etiological categories included cardiac surgery in 68.2%, neurologic disease in 8.1%, idiopathic causes in 11.7%, and paralysis associated with prematurity/prolonged neonatal intubation in 9.1%. On presentation, 61.7% experienced dysphonia, 54.1% respiratory symptoms, and 49.3% dysphagia. Tracheostomies were performed in 25.8% and gastrostomies in 40.7%. Outpatient follow‐up occurred in 90.7% of patients, with median follow‐up of 16 months. Resolution evidenced by laryngoscopy was found in 35.6%, with median time to resolution of 5 months. In patients without laryngoscopic resolution, median follow‐up was 20 months, and 24.1% reported symptomatic resolution.Conclusions:Vocal fold injury early in life, often secondary to cardiac surgery, may lead to lasting VFI and considerable morbidity. In this large database, the majority of patients did not experience resolution. This warrants further investigation into predictors of VFI and possible interventions to reduce morbidity.
Supraglottoplasty in Premature Infants: A Comparison Study
Authors: Durvasula Venkata S. , Lawson Bradley , Bower Charles M. , Richter Gresham T. 
Published: August 2013

Objectives:Prematurity is thought to be to be an independent risk factor for supraglottoplasty (SGP) failure. This study aimed to compare the outcomes of SGP in premature (<36 weeks) versus term infants.Methods:Retrospective analysis was performed on 325 patients undergoing SGP between 2004 and 2012. Patients >12 months age, syndromic, or with neurological or cardiac comorbidities were excluded. Resolution of airway symptoms after SGP was considered a success while revision SGP and tracheostomy were considered failures. The rates of secondary airway lesions (SAL), dysphagia, and gastrostomy tube (GT) placement were also compared.Results:A total of 178 infants (138 term, 40 premature) were identified for the analysis. SGP was successful in 91% (126/138) term and 90% (36/40) premature infants with no significant difference (P = 0.8) in success rates. Twelve term infants and 3 preterm infants required revision SGP. One premature infant required tracheostomy. Incidence of SAL was significantly higher in premature (72.5%) compared to term infants (34.97%) (P = 0.0002). Intubation rates were significantly higher in premature infants. This did not affect the higher SAL in premature infants compared to term infants. Dysphagia rates were also higher in premature (13/40, 32.5%) versus term infants (10/138, 7.25%, P < 0.001) and lasted longer on follow‐up. The rate of GT insertion was greater in premature (27.5%) compared to term infants (7.25%) (P = 0.003).Conclusions:Supraglottoplasty outcomes in term and premature infants were similar. However, premature infants experience significantly more SAL and dysphagia.
Acute Dacryocystitis with Empyema of the Lacrimal Sac: Is Immediate Endoscopic Dacryocystorhinostomy Justified?
Authors: Lombardi Davide , Mattavelli Davide , Semeraro Francesco , Nicolai Piero 
Published: August 2013

Objectives:To evaluate the efficacy of endoscopic dacryocystorhinostomy (endoDCR) in the treatment of acute dacryocystitis with lacrimal sac empyema (ADLSE).Methods:Design: Single center cohort study. Setting: Academic tertiary center. Patients: Twenty‐one consecutive patients who underwent endoDCR for ADLSE between August 2005 and December 2012 were included. Main outcome measures: The success of the procedure was defined as complete complaint relief and DCR patency. Time from referral to surgery, post‐operative complications, and revision surgery data were also reported.Results:The present cohort of patients included 3 males (14.3%) and 18 females (85.7%) (median age: 66 years). Median time between referral and surgery was 0 days (mean: 0.86 days). Median follow‐up was 12 months. All patients showed immediate relief from symptoms, with no recurrences of ADSLE. Complete success was achieved in 20 of 21 (95.2%) cases; the only failure was recorded in a patient who had previously undergone radio‐iodine treatment. In this case also revision endoDCR was not successful. The only perioperative complication was an epistaxis requiring revision surgery under general anesthesia. The definitive success rate was 95.2% after primary and revision surgery.Conclusions:EndoDCR enables rapid solution of ADSLE with a very high success rate. Immediate surgery minimizes the risk of skin fistulization and/or orbital complications; DCR shrinkage and lacrimal obstruction are unlikely since the procedure is performed on an enlarged sac. In comparison with external DCR, the absence of skin incision in an inflamed and infected field is the main advantage.
Disparities in Chronic Rhinosinusitis Outcomes and Income
Authors: Park Renee E. , Smith Timothy L. 
Published: August 2013

Objectives:Chronic rhinosinusitis (CRS) is prevalent with high burden of disease. Both general health and disease‐specific quality of life (QOL) measures have been found to significantly improve after endoscopic sinus surgery (ESS). It is also well known that social disparities in health are significant predictors for health outcomes. This study aimed to test the association between income and QOL outcomes in CRS.Methods:Patients were selected from a multicenter prospective cohort of adult CRS patients undergoing ESS (N=302). Outcomes included SF‐36 general health QOL and disease‐specific QOL as measured by the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey (CSS). Linear regression was applied to test the association of income with QOL outcomes, controlling for significant covariates.Results:Multivariable regression demonstrated better QOL in the high‐income group in all SF‐36 domains (p=0.000‐0.037) except mental health. There was no significant change in RSDI or CSS between income groups. Further, non‐white patients in the low‐income group demonstrated worse SF‐36 QOL after ESS in comparison to their white counterparts.Conclusions:Within the general health domains, low‐income minorities fared worse than their white counterparts in all SF‐36 domains. Low‐income minorities reported worse QOL after ESS in the SF‐36 domains of physical function, physical role, and emotional role. These domains focus on limitations of work effectiveness or activities, which may disproportionately impact this population. Income is not significantly associated with disease‐specific QOL. Low‐income is associated with worse general health QOL in most domains. CRS‐specific QOL surveys may fail to measure some important health outcomes.
Do the Material and Time of Nasal Packing Influence the Prognosis of Septomeatal Plasty?
Authors: Huang Tzu‐Chin , Hsu Ying‐Chieh 
Published: August 2013

Objectives:The purpose of this retrospective, randomized study was to analyze the influence of the material and time of nasal packing on the prognosis of Septomeatal plasty (SMP).Methods:We collected 120 patients who received SMP and randomly adopted Merocel (non‐resolvable) or Nasapore (biodegradable) as nasal packing during January to July 2012. Forty‐five cases (group N) adopted Nasapore, which was left in the nasal cavity and resolved spontaneously without manipulation. Those who used Merocel were further divided into 3 subgroups by the time of packing removal. The Merocel was randomly removed after the surgery on day one (M1:20 cases), day two (M2:39 cases) or day three (M3:16 cases). We compare these 4 groups in two aspects: 1) Medical resource consumptions, including the duration of medication, times of follow‐up, and period of treatment; 2) Postoperative complications, including bleeding, adhesion formation, subsequent septal hematoma, and septal perforation.Results:The Kruskal‐Willis Test was adopted to analyze the medical resource consumption items: duration of medication (weeks): N (2±0.6), M1 (2±0.3), M2 (2±0.7), M3 (2±0.6), P= 0.899; times of follow‐up: N (3.5±0.9), M1 (3.7±1.1), M2 (3.5±1), M3 (3.2±1), P= 0.585; period of treatment (weeks): N (4.3±1.4), M1 (4.8±1.7), M2 (4.8±1.4), M3 (4.2±1.6), P= 0.225. There were no significant differences among these 4 groups. We used Chi‐square test to analyze the incidence of postoperative complications, and there were no significant differences among these 4 groups either (p>0.05).Conclusions:The material and time of nasal packing seem to make no differences on the prognosis of SMP. Since prolonged nasal packing may cause more discomfort, we should consider shortening the packing time to provide higher patient satisfaction.
Doxycycline for Recurrent Chronic Rhinosinusitis with Nasal Polyps
Authors: Bezerra Thiago , Soter Ana C. , Abdo Tatiana , Pilan Renata , Pezato Rogerio , Pinna Fabio , Voegels Richard L. 
Published: August 2013

Objectives:Evaluate factors related to improvement after doxycycline treatment for patients with recurrent chronic rhinosinusitis with nasal polyps.Methods:We conducted an open label study from 2012 to 2013 on 32 patients with difficult‐to‐treat chronic rhinosinusitis with nasal polyps uncontrolled after endoscopic sinus surgery and long‐term low‐dose clarithromycin treatment. Patients received doxycycline 100mg per day for 12 weeks after a three‐month wash‐out period. The main outcome measure was a meaningful improvement in SNOT‐20 (>0.80). Other outcome measures were the SNOT‐20, NOSE, and Lund‐Kennedy scores. The following parameters were analyzed: asthma, rhinitis, DREA, and blood testing before treatment for C3, C4, IgG, IgA, IgE, IgM, ANCA, and blood eosinophil count.Results:53.1% (17/32) of patients showed a clinically significant improvement in SNOT‐20 (>0.8) score after treatment. The patients also showed a statistically significant improvement in SNOT‐20 (p<0.001), Lund‐Kennedy (p<0.001), and NOSE (p<0.004) scores. Presence of asthma (p<0.001), AERD (p<0.008), increased level of blood eosinophil count, and increased serum IgE (p<0.018) were factors associated with a worse prognosis after treatment.Conclusions:Our group of patients showed a positive result after treatment with doxycycline, especially in patients without asthma, DREA, andincreased serum levels of IgE and eosinophil counts.
The Effect on Health Status in Patients with Aspirin‐Exacerbated Respiratory Disease
Authors: Kumar Rohit 
Published: August 2013

Objectives:Assess the impact of aspirin desensitization therapy on the quality of life in patients suffering from chronic rhinosinusitis with nasal polyposis and aspirin‐exacerbated respiratory disease.Methods:We used the Glasgow Benefit Inventory (GBI) to establish the change in health status in all patients who underwent aspirin desensitization therapy in our unit between January 2009 and December 2012. The GBI was chosen because it is a well‐validated post‐intervention questionnaire that allows a direct comparison between other otorhinolaryngology interventions.Results:Twenty‐one patients were referred for ADT, from which 10 patients were suitable, of which 5 were male and 5 were female. The mean age was 44 years old, and the median follow‐up interval was 16 months. An average of 3.6 +/‐1.4 surgical procedures had been undertaken. Sustained symptom relief was achieved in 6 patients. 2 patients completed the treatment but gained no perceived benefit, and 2 were unable to tolerate the treatment. Average GBI scores for those who benefitted were 38.2 +/‐ 13.9 (general), 0 (social), and 30.5 +/‐ 9.9 (physical health). For those who failed to improve, the score was 0 for all categories.Conclusions:GBI outcomes for aspirin desensitization therapy are comparable to middle ear surgery for hearing and BAHAs, which show a significant improvement in quality of life. Although some patients gained no benefit, no patients reported any negative outcomes.
Repair of Parotidectomy Defects Using Layered Meshed Allogenic Grafts
Authors: Lerrick Andrew J. 
Published: August 2013

Objectives:Cervicofacial deformities following parotidectomy are commonly repaired using autologous tissue and allogenic grafts. Using two layers of allogenic material, oriented perpendicularly after meshing, and accented by eccentric spindle‐shaped gaps, affords a more favorable outcome with respect to appearance and healing.Methods:Following parotidectomy, the defect is measured and the allogenic tissue cut to size, using sterile paper as a template, if desired. A duplicate graft is prepared using either the first graft or the template. Each graft is oriented with ink, then meshed 1.5:1. The critical step is to orient the second graft on the mesher platform by 90 degrees. This maneuver creates spindle‐shaped holes oriented perpendicularly once each graft is placed. The meshed grafts are thinner and more pliable than the original material, facilitating in‐setting. The deep and superficial grafts are placed, taking into account the orientation of the spindles. Both grafts are trimmed in situ. The spindle sizes are altered by varying the tension, achieved by peripheral trimming. The superficial graft is tacked down beyond the deeper graft to provide a smoother transition zone. A suction drain is placed superficial to the grafts.Results:The integrity of each graft protects the facial nerve, affords precise contouring, and avoids donor site morbidity. Graft porosity facilitates drainage, expediting healing. Fibrinous in‐growth exceeds that of non‐porous tissue. The overlapping spindles inhibit neural in‐growth, reducing the likelihood of gustatory sweating.Conclusions:Allogenic grafts with eccentrically‐overlapping spindles provide an optimal setting for healing following parotidectomy.