bluuebunny/crossref_metadata_2025_split huggingface dataset:
Otoacoustic Emission in Noise‐Exposed Normal Hearing Workers
Authors: Sampaio Andre L.L. , Boger Marlene E. , Oliveira Carlos A.C.P. 
Published: February 2015

ObjectiveOtoacoustic emission test is useful in monitoring hearing changes and cochlear damage by noise still not detectable in pure‐tone audiometry.The aim was to evaluate amplitude of the signal and signal/noise ratio of distortion product otoacoustic emissions (DPOAE) in normal hearing workers exposed to different noise doses.MethodThis is a cohort prospective study performed in metalworking industries, in 3 groups of normal hearing workers, GI not exposed (n = 50), GII sporadically exposed (n = 50), and GIII often exposed to occupational noise (n = 50). DPOAE were performed after 14 hours of hearing rest. “Pass‐fail” criterion was employed for analyses.ResultsSix hundred eight workers underwent hearing thresholds, and 150 of them matched the inclusion criteria and had DPOAE recorded. DPOAE alterations in amplitude of signal and signal to noise ratio were found in groups II and III bilaterally, and the higher the frequency tested the lower were the results in GII and GIII (P <. 05). The greater the exposure to noise dose the lower the results (P <. 05). GI showed better results according to pass and fail criterion and higher amplitude of the signal and signal/noise ratio than GII and GIII (P <. 05).ConclusionDPOAE results are worse in the exposed groups according to occupational noise dose. It is important to search for undetectable hearing changes in all workers exposed to occupational noise even sporadically, and to encourage the use of hearing protectors, in order to prevent possible irreversible damage.
Microtia Reconstruction
Authors: Amali Amin , Yazdi Alireza Karimi , Sazgar Amir Arvin , Sadeghi Mohammad , Langeroudi Maziar Motiee , Firoozi Farzad , Emami Hamed 
Published: February 2015

ObjectiveReconstruction of microtia is a challenging issue in otology and reconstruction surgery. Autogenous costochondral reconstruction is the most widely accepted approach; however, it is time‐consuming and has some limitations. Irradiated homograft costal cartilage has been proposed as a suitable alternative. In this study we present our experience with this approach.MethodA total of 19 ears were treated with irradiated homograft costal cartilage prepared from 18‐ to 40‐year‐old cadavers under a standardized processing method. The reconstruction was achieved by a 2‐stage procedure with at least 3 months’ interval.ResultsStudy population included 9 (56.25%) males and 7 (43.75%) females with the mean age of 13.7 ± 5.1 years. Microtia was bilateral in 3, right‐sided in 8, and left‐sided in 5 subjects. Subjects were followed for 36.0 ± 9.9 months. Short‐term and long‐term complications were negligible.ConclusionIrradiated homograft costal cartilage resulted in relatively high satisfaction and low complication rates for auricular reconstruction. Aesthetic appearances of the reconstructed auricle were acceptable. The advantages of this approach are the elimination of additional incisions for graft harvesting and donor site morbidity.
Unilateral Enlarged Vestibular Aqueduct in Children
Authors: Provenzano Matthew , Greinwald John H. , de Alarcon Alessandro , Uwiera Trina , Meinzen‐Derr Jareen , Cohen Aliza 
Published: February 2015

Objective1) Describe the likelihood of contralateral hearing loss (HL) in patients with unilateral enlarged vestibular aqueduct (UEVA). 2) Detemine the positve predictive value of genetic testing in patients with UEVA. 3) Determine the correlation of temporal bone measurements in patients with UEVA.MethodPatients were identified from a database of children with sensorineural hearing loss (HL) and enlarged vestibular aqueduct (EVA) between 1998 and 2010. A group of patients with unilateral HL without EVA was also identified. Outcomes measured were HL phenotype, laterality of EVA, midpoint and operculum measurements, and genetic tests.ResultsFifty‐five percent of patients with UEVA had HL in the contralateral ear. There was no difference in the rate of HL progression in patients with bilateral and unilateral EVA (P =. 1). However, both EVA groups had higher rates of progression compared to patients with unilateral HL alone. A correlation was shown for the presence of HL at 250 Hz and the risk of more severe HL and progressive HL. Patients with bilateral EVA and SLC26A4 mutations had a higher rate of progression than patients who had no mutations (P =. 02). No patients with UEVA had Pendred syndrome.ConclusionChildren with unilateral EVA have a significant risk of HL progression. Hearing loss in the contralateral ear is common, suggesting that unilateral EVA is a bilateral process. Temporal bone measurements, HL severity, and HL at 250 Hz were correlated with the risk of progressive HL.
CT vs MRI to Evaluate Hearing Loss in Children
Authors: Dedhia Kavita , Chi David , Pike Francis 
Published: February 2015

Objective1) To report the findings of both computed tomography (CT) and magnetic resonance imaging (MRI) in children with hearing loss. 2) To find if there is a significant difference between these 2 radiographic modalities and between hearing loss groups.MethodRetrospective review of 120 children diagnosed with sensorineural hearing loss from 2005 to 2011 with both CT and MRI at a tertiary care center. Patients were divided into an asymmetric vs symmetric population and a mild/moderate hearing loss vs severe/profound hearing loss group. Radiographic findings were obtained via chart review.ResultsAsymmetric hearing loss was found in 55% of patients, while 45% had symmetric loss. Group 1 (mild and moderate loss) accounted for 60%,while group 2 (severe and profound loss) was found in 40% of patients. More abnormalities were found in the asymmetric compared to symmetric population on both CT (P =. 0001) and MRI (P =. 02). A significant difference was noted between the number of anomalies in group 2 vs group 1 hearing loss on the MRI (P =. 0002), but not CT (P =. 19). No significant difference was found between MRI and CT within any of the groups.ConclusionBoth radiographic tests found more abnormalities in the asymmetric population. Only MRI found more abnormalities in group 2 vs group 1 with statistical significance. The decision to use CT vs MRI remains controversial because they are complementary. However, obtaining an MRI in severe and profound hearing loss may be beneficial.
Prelamination of Radial Forearm Free Flap with Buccal Mucosa
Authors: Kim Grace G. , Halvorson Eric G. , Hackman Trevor G. 
Published: February 2015

Objective1) To describe a new technique for prefabricating a fasciomucosal flap on the forearm. 2) To report initial outcomes of reconstruction using this technique for small oral defects. 3) To learn how to apply and customize the prelaminated radial forearm fasciomucosal flap for reconstruction of the head and neck.MethodThis is a case series of 3 patients who underwent reconstruction with a prelaminated radial forearm fasciomucosal flap for small lip or oropharyngeal defects at a tertiary referral center from September 2011 to December 2011. Initial clinical outcomes are described and patient photographs are shown.ResultsWe prelaminated and successfully transferred 3 flaps in 3 male patients ranging in age from 46 to 53 years. These patients required reconstruction of a lip (n = 1) or oropharyngeal (n = 2) defect after removal of a head and neck arteriovenous malformation (n = 2) or cancer (n = 1). All flaps were prelaminated utilizing morcelized buccal mucosa grafts. Second stage transfer typically occurred approximately 2 to 3 weeks after prelamination. There were no intraoperative complications and no postoperative bleeding, infection, or flap failures. Reconstruction was stable and satisfactory at a range of 2‐5 months following surgery.ConclusionThe prelaminated radial forearm fasciomucosal flap using morcelized buccal mucosa for aerodigestive defects minimizes donor site morbidity and allows for mucosal restoration. A larger multisite study will provide more information on clinical outcomes.
Epidemiology of Chronic Rhinosinusitis in Children
Authors: Smith David F. , Arnaoutakis Demetri , Ishman Stacey L. , Boss Emily F. 
Published: February 2015

ObjectiveAlthough chronic rhinosinusitis (CRS) is common in children, the role of race/socioeconomic status (SES) has not been evaluated. We describe the epidemiology of children with CRS in an urban pediatric otolaryngology clinic and evaluate demographic differences compared to a group representative of the general pediatric otolaryngology population.MethodObservational study (retrospective cohort with comparison group) of all new/consult patients (March 3, 2008, to July 1, 2011) in an urban tertiary pediatric otolaryngology clinic with diagnosis of CRS. The comparison group consisted of all new/consult patients seen in the same clinic over a 3‐month period. Records were evaluated for demographics/insurance. Characteristics were compared between groups using Mann‐Whitney and Fisher’s exact tests.Results177 children with CRS were compared to 430 control patients. Compared to the general pediatric otolaryngology population, children with CRS were younger (5.9 ± 4.8 vs 8.2 ± 4.4, P <. 0001) and more commonly male (62% vs 52%, P =. 025). Compared to controls, more children with CRS were white (CRS 77% white; 10% black; 13% other vs control 47% white; 33% black; 20% other, P <. 0001). Likewise, children with CRS were less commonly insured with Medical Assistance (CRS 14% vs control 43%, P <. 0001).ConclusionCompared to the general population of children seen in this setting, children with CRS were more likely to be white/privately insured. This study is the first to evaluate race/SES in relation to pediatric CRS. Future research should employ nationally representative data to assess true variation of demographic factors in children with CRS.
Hearing Evaluation for Pediatric Cochlear Implant with ASSR
Authors: Beck Roberto , Tsuji Robinson K. , Ramos Henrique F. , Brito Neto Rubens V. , Almeida Edigar R. , Grasel Signe S. , Rossi Amanda C. 
Published: February 2015

ObjectiveThe aim of this study was to evaluate Auditory Steady‐State Responses (ASSR) at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral test responses.MethodThis prospective study evaluated 54 children with severe‐to‐profound hearing loss, aged from 3 to 72 months, between January and December 2011. All had absent ABR and OAE responses. ASSR were evoked using binaural single frequency stimuli at 110 dBHL with a 10 dB‐down seeking procedure. ASSR and behavioral test results were compared.ResultsForty‐two subjects completed both ASSR and behavioral evaluation. In 13 children behavioral tests were not available, 1 had inconclusive ASSR. Among 42 children with absent ABR and OAE, 11 (26.1%) had bilateral ASSR, 10 correlated well to behavioral results. Four (9.5%) showed unilateral responses in at least 2 frequencies, all confirmed by behavioral results. Among 27 subjects with absent ASSR, 8 had no behavioral responses; 12 had responses only in low frequencies >110 dBHL, 7 showed behavioral responses at all frequencies in medium to high intensities. No spurious ASSR responses were observed at 100 or 110 dBHL in any frequency.ConclusionASSR is a valuable tool to detect residual hearing in young children with absent ABR and OAE. No false‐positive ASSR results were observed, but in 7 cases with absent ASSR, the test underestimated residual hearing as compared to the behavioral responses.
Otoendoscopy in the Management of Congenital Cholesteatoma
Authors: Kanotra Sohit P. , James Adrian L. 
Published: February 2015

ObjectiveTo evaluate the use of otoendoscopy in the surgical management of congenital cholesteatoma.MethodsAll patients with congenital cholesteatomas were reviewed from a 10‐year prospective pediatric otological database. Otoendoscopy was primarily used to identify and remove any intraoperative residual disease after otomicroscopic excision of cholesteatoma.ResultsA total of 27 patients with congenital cholesteatoma were included. The mean age of the population was 6.9 years (range 3‐15 years); 39.2% of the cases were stage I with 35.7% stage II and 25% stage III. After surgical resection of the cholesteatoma under otomicroscopy, 4 (14.8%) were found to have involvement of the sinus tympani on endoscopy while 1 had involvement of the anterior epitympanum. The overall rate of detection of intraoperative residual cholesteatoma using the otoendoscope was 18.5%. In 2 cases the otoendoscope helped in preservation of the ossicles by facilitating dissection in the attic.ConclusionThis is the first study to define the role of otoendoscopes in congenital cholesteatoma. The enhanced access to the medial epitympanum and recesses of the mesotympanum provided by endoscopy are ideally suited to the typical locations of congenital cholesteatoma. We have found it especially beneficial in identifying and removing cholesteatoma left after otomicroscopic resection and in preserving the integrity of the ossicular chain. Consequently, lower residual disease rates and better hearing results can be anticipated as a result of endoscopic surgery.
Outcomes of Cartilage Tympanoplasty in Pediatric Patients
Authors: Friedman Adva B. , Dornhoffer John L. 
Published: February 2015

ObjectiveTo determine whether a relationship exists between successful outcomes of cartilage tympanoplasty and age at repair.MethodA retrospective chart review of patients between ages 4 and 13 who underwent cartilage tympanoplasty for tympanic membrane perforations from August 2005 to November 2011 was preformed. Demographics, complication data, and auditory outcomes were collected.ResultsPatients were subdivided into 3 age groups. Group 1 consisted of patients less than 7 years of age (n = 43), group 2 ages 7 to 10 (n = 40), and group 3 ages 10 to 13 (n = 36). Mean follow‐up was 595 days (range = 48‐1742). Complication rates respective to the 3 groups were as follows: Eustachian tube dysfunction (ETD) or fluid causing a conductive hearing loss (9.3%, 10%, 5.6%), need for tympanostomy tubes (4.7%, 2.5%, 0%), remnant perforation (7%, 5%, 2.8%), and revision tympanoplasty (2.3%, 2.5%, 0%). Resolution of ETD or fluid on subsequent visits precluded tube placement. A 1‐way analysis of variance (ANOVA) was performed to evaluate complication rates between groups. No significant differences were found (remnant perforation, P =. 70, repeat tympanoplasty, P =. 64, tympanostomy tubes, P =. 42, and ETD or fluid, P =. 76). Improvement in pure tone average was 10.23, 12.5, and 3.95, respectively.ConclusionA trend for slight increase in complications in children under the age of 10 was found but was not statistically significant. There were significant group differences in hearing improvement with younger patients demonstrating better outcomes. The implications for these findings will be discussed. These data suggest cartilage tympanoplasty can be performed effectively in young children when appropriate conditions exist.
Shape Fidelity of Human Nasal Septal Neocartilage Constructs
Authors: Reuther Marsha S. , Briggs Kristen K. , Sah Robert L. , Watson Deborah 
Published: February 2015

Objective1) To show that human septal neocartilage constructs possess comparable shape fidelity to native human septal tissue. 2) To demonstrate that the biochemical properties of human septal neocartilage constructs are unaffected by imposed bending and are equivalent to those of free‐swelling controls.MethodHuman septal chondrocytes from 9 donors were used to create 12‐mm constructs. These were cultured for a total of 10 weeks and subjected to bending for 6 days. Free‐swelling controls and native tissue were used for comparison. Shape retention, photo documentation, live‐dead staining, and biochemical properties were measured.ResultsLive‐dead staining showed no difference in cell survival between shaped constructs and free‐swelling controls. The immediate shape retention of the constructs was 39.0% versus 23.5% for native tissue (P =. 06). After 2 hours of relaxation, the constructs possessed similar shape retention to native tissue (26.9% and 20.6%, respectively; P =. 073). There was a significant decrease in shape retention from immediately after release to 2 hours of relaxation (23.5% and 18.9%, respectively; P =. 01). However, the retention did not change significantly between 2 and 24 hours of relaxation (18.9%; P =. 11). There was no significant difference in biochemical properties between shaped constructs and free‐swelling controls.ConclusionThe shape retention properties of human septal neocartilage constructs are similar to human native septal cartilage. In addition, bending of neocartilage constructs does not adversely affect cell viability or biochemical properties. This study demonstrates that neocartilage constructs possess adequate shape fidelity for use as septal cartilage graft material.
Prevalence of MT‐RnR1 in the General Population
Authors: Ibekwe Titus Sunday , Bhimrao Sanjiv K. , Westerberg Brian D. , Kozak Frederick K. 
Published: February 2015

ObjectiveReview the prevalence of MT‐RNR1 genetic mutation and assess the need for neonatal screening prior to gentamicin therapy. A comprehensive search of MEDLINE, EMBASE, Cochrane Library, Clinical Evidence, and Cochrane Central Register of Trials was performed. The reference lists were cross‐referenced. Review was restricted to human studies in English language.MethodStudies describing the prevalence/incidence of MT‐RNR1 gene mutations (A1555G, C1494T, A7445G) in the population. Relevant studies screening for presence for MT‐RNR1 in patients receiving aminoglycoside therapy were included.ResultsTwenty‐two articles out of 67 full papers and 206 abstracts from 1948 to November 2011 met the inclusion criteria. These included 9 prospective case‐control studies, 12 case series, and a case report. There is weak evidence that MT‐RNR1 is globally prevalent with racial bias especially in Chinese and Spanish populations. The prevalence/incidence ranged from 0.09%‐2.9% in general population to 17% in the high‐risk population. Weak evidence of neonatal sensorineural hearing loss following aminoglycoside exposure was also seen.ConclusionThere is a need for large national epidemiological studies to assess the prevalence of MT‐RNR. Some evidence of a global prevalence of MT‐RNR1 with racial bias and link between aminoglycoside exposure and NSHL among at risk group. It is difficult to justify routine screening of patients for MT‐RNR1 with the available literature.
Specific versus Generic Outcome Measure in Adeno‐Tonsil Pathology
Authors: Awad Zaid , Rennie Catherine E. 
Published: February 2015

Objective1) Compare the disease specific T14 outcome measure score to the generic quality of life CHQPF28 score in children with adenotonsillar pathology. 2) Investigate the relation of number of episodes of tonsillitis and presence of sleep apnea to both scores.MethodCross‐sectional study carried out in 2011. Parents of 146 children undergoing tonsillectomy or adenotonsillectomy at 3 London hospitals completed both T14 and CHQPF28 questionnaires. We also inquired about the number of episodes of acute tonsillitis a child suffers from each year and whether they have obstructive sleep apnea (OSA). Their scores were analyzed to measure the relation between the 2 tests and investigate the usefulness of the T14 as a measure of the impact of adenotonsillar pathology on children’s health.ResultsThe T14 infective and total score correlated well with the number of episodes of tonsillitis children have (Spearman rs = 0.5 and rs = 0.64). The obstructive element differentiated between children with OSA and no OSA (t test P <. 001). However, the overall T14 score, its infective and obstructive components, did not correlate well with the children CHQPF28 scores (rs = −0.01, P =. 95; rs = −0.08, P =. 53; rs = −0.09, P =. 47; respectively).ConclusionThe T14 performs well in predicting patients with significant adenotonsillar pathology with its infective and obstructive component and is a good outcome measure for treatment. It is not a good indicator of the impact of adenotonsillar disorder on the child’s overall well‐being as a static measure when compared to a generic quality of life test.
Use of Endoscopic Vascularized Nasoseptal Flap in Children
Authors: Giannoni Carla , Whitehead William 
Published: February 2015

Objective1) Determine ability to achieve 100% coverage of sellar skull base defects with the vascularized nasal septal flap in pediatric patients. 2) Identify the rate of residual CSF leaks following this repair technique in these pediatric patients. 3) Review the demographics and perioperative course in these children.MethodStudy design: Retrospective case series. Study conducted: January 1, 2006, to January 1, 2012. Condition studied: Repair of skull base defects after resection of sellar lesions. Subjects: Children. Setting: Children’s hospital. Intervention: Endonasal repair of skull base defects with a vascularized nasoseptal flap. Outcome measurement(s): 1) Complete coverage of defect. 2) Postoperative CSF leak.ResultsDemographics: Ten children were identified, and 11 flaps were performed. The average patient age was 12.6 years old (range of 5.1‐17.4 years). Total coverage was achieved in all cases. The technique was particularly challenging in the younger patients. A brisk CSF leak was observed during closure in 3 cases, but no CSF leaks were observed after balloon packing removal (day 5). No lumbar drains were used. Only minor complications were observed. A second look with debridement of packing material due to poor cooperation with office endoscopy was done in 7 children (70%).ConclusionThe endonasal vascularized nasal septal flap is a feasible and reliable method of repair of dural defects after resection of sellar lesions in children. Despite active CSF leak in 3 children, there were no residual CSF leaks. Unlike adult patients, children may require operative nasal debridement after repair has healed.
Turbinate Surgery in Rhinoplasty: Randomized Clinical Trial
Authors: Lavinsky‐Wolff Michelle , Camargo Humberto L. , Barone Carolina , Rabaioli Luisi , Petersen Sara , Dolci Jose E. L. , Polanczyk Carisi A. 
Published: February 2015

ObjectiveEvaluate the role of turbinate reduction during rhinoplasty in quality‐of‐life outcomes and nasal airway cross‐sectional area.MethodAdults with nasal obstruction, functional and aesthetics primary rhinoseptoplasty candidates were randomized to rhinoseptoplasty with or without inferior turbinate reduction. Study was conducted from December 2010 through January 2011 at the facial plastic clinic of a tertiary center in Brazil. Changes in Nasal Obstruction Symptom Evaluation (NOSE) and WHOQOL‐bref scores and acoustic rhinometry (AR) were assessed.ResultsFifty were included, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32 ± 12 years. Baseline characteristics were similar between groups. Rhinoseptoplasty improved specific and general quality‐of‐life scores irrespective of turbinate intervention group (P <. 001). There was no difference in relative change of NOSE score (–75% vs –73%; P =. 893); WHOQOL‐bref score domains (Physical: 7% vs 6% [P =. 10]; Psychological: 6% vs 7% [P =. 158]; Social: 0% vs 0% [P =. 99]; Environment 7% vs 5% [P =. 77]), NO‐VAS (–88% vs –81%; P =. 89), and all AR recordings (P >. 05) between turbinate reduction and no turbinate reduction groups, respectively.ConclusionTurbinate reduction during primary rhinoplasty did not improve short‐term general and specific quality‐of‐life outcomes or acoustic rhinometry recordings.