bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Suction Holder Clips for Endolaryngeal Laser Surgery
Authors: Manickavasagam Jaiganesh , Jebreel Ala’eddin 
Published: February 2015

ObjectiveSince the introduction of lasers in laryngeal surgery, a number of technological advances, as well as an improved understanding of disease pathogenesis, have enabled major evolutions in surgical techniques. Continuous smoke evacuation improves visualization. We have devised new simple and efficient suction clip holders for enolaryngeal surgery.MethodClip design and technical specifications are explained.ResultsWe have devised suction clip holders which have the following distinct advantages over other types of suction holders. These clips can hold various sucker sizes as they feature an expandable slit. With this clip, the placement of the sucker in the proximal end of the laryngoscope and the position of the sucker tip at the distal end are both easily adjustable for optimal suction. It also clips easily into any laryngoscope without obscuring visual field. Furthermore, in the instance of any bleeding, this sucker is easily detachable and can be used for suction.ConclusionWe routinely use these sucker clips to perform all endolarygneal surgery and overall, feel they are simple, easy to use, and extremely efficient in suctioning fumes.
Pulmonary Papillomatosis: HPV11 Mutation and Vorinostat Therapy
Authors: Woo Jennifer A. , Yuan Hang , Liu Xuefeng , Schlegel Richard , Grant Nazaneen , Harley Earl , Myers Scott 
Published: February 2015

Objective1) Report isolation of HPV‐11 with viral genome duplication in the lung tumor lesions of a 23‐year‐old man with a 20‐year history of recurrent respiratory papillomatosis (RRP). 2) Describe pulmonary RRP response to vorinostat therapy, following previous disease progression on alpha‐interferon, intralesional cidofivir, and oral methotrexate.MethodFollowing RUL segmentectomy to remove a 4‐cm RRP lesion and laser ablation of laryngeal papillomas, HPV viral genome was isolated and sequenced. Lung tumor cells were screened for in vitro sensitivity to multiple therapies, including vorinostat. Success of vorinostat therapy was measured by radiologic evaluation of lung lesions.ResultsHPV‐11 DNA was isolated from laryngeal and pulmonary lesions. Genomic sequencing identified a 2kB duplication of the HPV‐11 genome in the lung lesions only, including a novel duplication of the upstream promoter and the E6/E7 oncogenes. Lung tumor cells demonstrated in vitro sensitivity to vorinostat. After 12 weeks of vorinostat therapy (tolerated at 400 mg/daily for 21 days q 4 weeks), repeat CT revealed significant reduction of most lung lesions compared to baseline. Pulmonary and laryngeal diseases remained stable after 12 months follow‐up on vorinostat.ConclusionWe present the first documented case of progressive, chemoresistant pulmonary RRP responsive to vorinostat. Our data suggest a link between the duplication of HPV‐11 promoter and viral oncogenes and aggressive clinical phenotype. Use of novel cell‐culture technology and in vitro chemosensitivity screening may improve long‐term prognosis of this notoriously recalcitrant disease.
Severe Laryngomalacia: Management of 10 Cases with CO2 Laser
Authors: Pinto José A. , Kohler Rodrigo , Wambier Henrique , Mizoguchi Elcio I. , Ribeiro Renata C. , Gomes Leonardo M. 
Published: February 2015

Objective1) Be able to quantify the prevalence of severe laryngomalacia in our department and evaluate the impact of postoperative CO2‐laser supraglottoplasty. 2) Determine if CO2‐laser supraglottoplasty laser is beneficial for patients with severe laryngomalacia.MethodRetrospective study. Ten patients diagnosed with severe laryngomalacia in our service from October 2001 to September 2011 who underwent unilateral or bilateral CO2‐laser supraglottoplasty. The main outcome measures were: type of laryngomalacia, resolution of clinically significant laryngomalacia, development of major complications, andlength of post‐operative hospital stay.ResultsA total of 10 pediatric patients aged 1 month to 14 years were enrolled. The mean age was 20.8 months. There were 6 men (60%) and 4 women (40%). Inspiratory stridor was the main clinical symptom (90%) and all children had significant relief of symptoms. Most common type of LM was the type I (60%). About 3 patients (30%) underwent a new surgery. None of them needed tracheotomy nor had major complications.ConclusionThe majority of patients undergoing supraglottoplasty do not present complications. CO2‐laser supraglottoplasty is a secure and effective treatment option for severe laryngomalacia. Furthermore the postoperative clinical follow‐up is an important factor for the successful treatment of laryngomalacia.
Supraglottic Function in Unilateral Vocal Fold Paralysis
Authors: Van Deusen Mark B. , Gruss Calvin , Cleveland Thomas , Garrett C. G. , Francis David O. 
Published: February 2015

ObjectiveSupraglottic hyperfunction is a compensatory behavior that occurs in patients with glottic incompetency. It is pronounced in unilateral vocal fold immobility (UVFI), where false vocal folds (FVF) can obfuscate evaluation of the true vocal folds. We sought to characterize supraglottic hyperfunction patterns in post‐surgical UVFI patients.MethodVideostroboscopy examinations of 10 consecutive post‐surgical patients with complete UVFI diagnosed within 3 months of surgery were reviewed by 2 blinded, independent reviewers. Characteristics of supraglottic hyperfunction were scored for direction (AP or lateral) and whether laterality was asymmetric relative to UVFI (primary outcome). Kappa tests measured interrater reliability.ResultsThe UVFI cohort was evaluated a median of 63.5 days postsurgery. UVFI was left‐sided in 6 out of 10 patients. All patients had asymmetric lateral FVF hyperfunction with predominant medial excursion by the FVF contralateral to the immobile vocal fold (kappa = 1, P <. 01). AP hyperfunction occurred in 1 out of 2 of cases, with its significance less agreed upon by reviewers (kappa = 0.4, P =. 09). Petiole deviation toward the immobile vocal fold occurred in 70% of cases (kappa = 1, P <. 01).ConclusionSupraglottic hyperfunction was universal in patients with UVFI. The most common pattern was 1) asymmetric lateral FVF hyperfunction with maximum medial excursion of the contralateral FVF, and 2) petiole deviation toward the side of UVFI. Understanding fiberoptic examinations of UVFI may aid our diagnostic accuracy in lesser vocal fold pareses.
Symptoms in Eosinophilic Esophagitis: A Longitudinal Study
Authors: Larsson Helen M. , Knutsson Karin H. , Bergquist Henrik , Bove Mogens 
Published: February 2015

ObjectiveEvaluate dysphagia and health‐related quality of life (HRQL) in adults newly diagnosed with eosinophilic esophagitis (EoE) at diagnosis, after 2 months of treatment with topical corticosteroid, and at least 1 year later.MethodBetween February 2008 and November 2010, 39 consecutive patients were prospectively included at a university hospital and a secondary referral hospital. The questionnaires used for evaluation were the Watson Dysphagia Scale (WDS), the EORTC QLQ‐OES18 and the Short Form‐36 (SF‐36). The Wilcoxon signed‐rank test was used to compare scores.ResultsAt inclusion, the mean scores of the WDS, the EORTC QLQ‐OES18 dysphagia scale and eating scale and the SF‐36 global health score were 19.1, 14.5, 35.1, and 71.2, respectively. After treatment the scores improved to 9.4 (P. 0004), 4.9 (P. 02), 18.9 (P. 01), and 74.4 (ns). At the second follow‐up (mean 2.5 years after inclusion), the corresponding scores, 12.9 (P. 01), 7.6 (P. 08), 20.4 (P. 02), and 76.0 (ns), were still improved compared to at inclusion. While 16 patients had a history of hospitalization due to esophageal bolus impaction, no such event occurred during the study period.ConclusionNewly diagnosed, untreated adult EoE is associated with a substantial burden of symptoms and impaired HRQL, which improve significantly after treatment. A partial remission is still noted more than two and a half years after diagnosis.
3D Anatomy of the Cochlea for Cochlear Implant
Authors: Tanioka Hisaya , Kaga Kimitaka 
Published: February 2015

ObjectiveThis study aimed to create a 3‐dimensional anatomy of the round window to hook region to identify the optimal site for cochleostomy in cochlear implantation and other endocochlear surgical procedures.MethodTen normal ears were studied. To develop 3‐dimensional reconstructed inner ear image based on high‐resolution temporal bone images obtained by a spiral CT. The axial data were applied to create 3‐dimensional images on the CT work station for post‐processing with the use of current workstation software (GE Advantage Navigation).ResultsThe anatomy of the round window to hook region is complex, and spatial relationships can be difficult to evaluate using 2‐dimensional CT images. Three‐dimensional models of the round window membrane (RWM), cochlear duct, scala vestibule, scala tympani, ductus reuniens, and surrounding structures were generated. The relationship between these structures and the round window membrane (RWM) and adjacent otic capsule was easily identified.ConclusionThis 3‐dimensional model has implications for surgical procedures to the inner ear that aim to minimize insertional trauma and decrease operation time. We can know the anatomic information before cochlear implant.
A Novel Volumetric Model of Vestibular Schwannomas
Authors: Prendes Brandon L. , Groppo Eli R. , Reynolds Catherine , Parsa Andrew T. , Cheung Steven W. 
Published: February 2015

ObjectiveEvaluate an ellipsoid model of vestibular schwannoma (VS) tumor volume based on linear dimensions.MethodMRI scans from 97 patients with VS from 2003 to 2011 were analyzed. Linear measurements of major axes defining an ellipsoid within the cistern and a cone within the internal meatus were made. From those dimensions, geometrically based conformational models of tumor volume were evaluated.ResultsModel estimates of tumor volume were compared to measurements made using software utility in Brainlab. Seventy‐two MRI scans were used for model optimization and 25 scans to validate model predictions and performance. Optimal model selection was determined based on the best trade‐off between time required to obtain measurements and the model’s ability to capture volumetric variance. Analyses showed the optimal tumor model as one where the cisternal component was modeled as an ellipsoid and the canalicular portion was modeled as a cylinder (r = 0.96, P <. 001). This model was robust for a broad range of tumor sizes.ConclusionExpected outcomes following treatment of vestibular schwannomas are dependent on tumor size, which has been variably described throughout the literature both by tumor volume and linear dimension of canalicular and cisternal components. Our model can be used to invert volumetric data to linear indices of volume. This tool will enable meta‐analysis of disparate data sets.
Auditory Tube Dysfunction Occurring after Plastic Surgery
Authors: Aoki Hideaki 
Published: February 2015

ObjectiveSome patients with jaw anamorphosis symptom who underwent plastic surgery for lower jaw complain of earache, feeling of obstruction, and hearing disorders.By conducting auditory tube function tests before and after plastic surgery for the lower jaw, we studied pathophysiology, incidence, causes and treatment of auditory tube dysfunction.MethodThis study was carried out between 2000 and 2010. The 290 patients were divided into 4 groups(A to D) and compared for the rate of aggravation of auditory tube function and duration for the function to recover.ResultsApproximately 30% of patients with TM aggravation complained of ear symptoms. Among subjective ear symptoms, the most prevalent was feeling of ear obstruction, followed, in the order, by discuses. The number of patients who complained of ear symptoms was 23.9% in group A, 17.1% in group B, 6.7% in group C, and 9.1% in group D. Aggravation of auditory tube function (was determined by TM in 62.7% in group A, 44 (53.7%) in group B, 14 (46.7%) in group C, and 12 (54.5%) in group D.ConclusionPostoperative auditory tube dysfunction recovered spontaneously in an average of 3.48 days without providing ventilation treatment while patients were placed under observation. Patients with postoperative auditory tube dysfunction that lasted longer than 4 days or with complaints of subjective symptoms were given ventilation treatment. All cases were cured within 14 days.
Canal Wall‐up Tympanomastoidectomy: Recurrence Factors
Authors: Pereira Sonia , Baptista Sara , Barros Ezequiel 
Published: February 2015

ObjectiveCanal wall‐up tympanomastoidectomy is gaining popularity in the treatment for cholesteatoma. The choice remains controversial because of the significant recurrence rate of this disease. We aimed to analyze tympanomastoidectomy success rate, to establish eventual predictive factors for failure, and to evaluate the computed tomography (CT) scan’s value in this pathology.MethodWe performed a retrospective cohort study regarding all patients submitted to tympanomastoidectomy for cholesteatoma at the otolaryngology department of Hospital São José, Lisbon, from January 1, 2005, to December 31, 2009. Clinical and demographic data were obtained from medical records.ResultsOne hundred nineteen patients were submitted to tympanomastoidectomy. In most cases, preoperative CT scans showed cholesteatoma in the attic (50%) and large extension of the disease (tegmen, semicircular or fallopian canal erosion in 51%), not always confirmed during surgery (75%). Sixty percent had a canal wall‐down procedure. The overall postoperative air‐bone gap was within 20 dB in 44%. Second‐look surgery was performed in 24 patients: the overall recurrence rate was 23%, with conversion to canal wall‐down procedure in 67%. Factors identified as related to failure: cholesteatoma in the sinus tympani (33%), scutum erosion (29%), and large extension of disease (40%).ConclusionThe recurrence rate was significant, despite the high percentage of canal wall‐down procedures. Factors for failure remain uncertain and CT scans presented limited value in the diagnosis and evaluation of cholesteatoma, especially postoperatively. In the absence of better diagnostic procedures, we recommend second look surgery to control cholesteatoma’s recurrence.
Cartilage Tympanoplasty for Retraction Pockets
Authors: Gulia Joginder S. , Yadav Samar Pal S. , Singh Balwan 
Published: February 2015

ObjectiveTo see the efficacy of cartilage tympanoplasty in retraction pockets of tympanic membrane.MethodProspective study conducted from 2009 to 2010. Disease studied: Retraction pockets in tympanic membrane. Subjects studied: Twenty. Setting: Tertiary care center. Interventions: The retraction pockets were excised and cartilage tympanoplasty using tragal cartilage and perichondrium was performed. Graft take‐up, hearing improvement was noted and statistical significance was calculated.ResultsPatients were followed up for a period of 6 months. Graft take‐up was seen in 16 (80%) cases with residual perforation in 2 cases and recurrence of retraction pockets in 2 cases. The average preoperative hearing loss was 39.50 + 1.44 decibels, while the average postoperative hearing loss was 26.75 + 1.86 decibels, with a gain of 12.75 decibels (P value less than. 01).ConclusionRetraction pockets management by excision and cartilage tympanoplasty provides the tympanic membrane with greater strength and greatly increases the rate of tympanic membrane closure without affecting audiometric results. Graft take‐up and improvement in hearing was noted in 80% of the cases (P <. 01).
Catabolism of Mannosidase and Fucosidase in Cholesteatoma
Authors: Olszewska Ewa , Jakimowicz‐Rudy Joanna , Rogowski Marek 
Published: February 2015

ObjectiveTo determine the level of glycoconjugates catabolism by marking α‐mannosidase (MAN) and α‐fucosidase (FUC) activity in cholesteatoma and serum.MethodMiddle ear cholesteatomas (Chol), normal skin specimens (C) and serum of cholesteatoma patients and serum from healthy volunteers were included in the study. The concentration of lysosomal exoglycosidases activity was assessed on the basis of p‐nitrophenol release from the derivatives of the substrate (MAN from mannose and FUC from fucose).ResultsMean concentration of MAN activity in Chol was 8.31112 pKat/mL in comparison with C (2.621048 pKat/mL). Pearson correlation (MAN activity) was r = 0.26321. Mean activity concentration of FUC in Chol was 10.03288 pKat/mL in comparison with C: 2.723152 pKat/mL. The average concentration of MAN activity in serum from cholesteatoma patients was 3.05712 pKat/mL, compared to the concentration of MAN activity in the control serum 2.73244 pKat/mL. The average concentration of FUC activity in serum of cholesteatoma patients was 5.40336 pKat/mL and significantly higher in comparison with the FUC activity concentrations in C 3.51976 pKat/mL.ConclusionThere is an increase of glycocojugates catabolism due to the significantly higher concentration of MAN and FUC activity in cholesteatoma. The increased concentration of MAN and FUC activity in serum of cholesteatoma patients might suggest the role of those enzymes in the pathogenesis of chronic otitis media with cholesteatoma.
Central Obesity Is Related to Age‐Related Hearing Loss
Authors: Kim Tae Su , Chung Jong Woo , Kim Do Yeon , Kim Eon Bin 
Published: February 2015

Objective1) Test the the hypothesis that central adiposity measured by computed tomography is a better predictor of the risk of age‐related hearing loss (ARHL) than is body mass index (BMI), or waist circumference (WC). 2) Determine whether the visceral/subcutaneous fat ratio (VSR) is a significant risk factor for age‐related hearing loss.MethodWe performed a retrospective review of medical records from 235 adult subjects, either normal or symmetric sensorineural hearing loss, who visited the ASAN Health Promotion Center between July 2010 and June 2011. All subjects underwent fat measurement abdominal CT. The mean individual subject thresholds of 500 Hz, 1 kHz, 2 kHz. and 4 kHz were averaged to obtain the average pure tone hearing level (PTA). Glucose, lipid profile, BMI, and WC were measured after an overnight fast.ResultsVSR, WC, and age were positively associated with PTA score. But in men, VSR showed a positive association with borderline significance with PTA score. With backward stepwise multivariate linear regression analysis, VSR, but not WC, showed significant positive association with PTA score in females. When age, systemic disease, and other variables were adjusted using logistic regression analysis, WC and VSR showed significant positive correlation with hearing loss in males. However in women, VSR, but not WC, showed a significant positive correlation with hearing loss.ConclusionThe VSR is an independent risk factor for ARHL. The VSR which is measured by CT is a better predictor of the risk of ARHI than is BMI or WC, especially for women.
Cholesteatoma: Long‐term Follow‐up in Romanian Patients
Authors: Cosgarea Marcel , Necula Violeta , Maniu Alma 
Published: February 2015

ObjectiveCholesteatoma is an abnormal destructive growth of squamous epithelium in middle ear and mastoid. The presence of cholesteatoma requires surgical intervention and the main goal is to achieve a safe, dry ear and to improve hearing. The extension of surgery depends on the size of the cholesteatoma.MethodA total of 875 patients were treated for cholesteatoma in our department between 2001 and 2010, 213 pediatric patients. We performed both open and closed and technique, depending on disease extension, bone erosion, and complications, followed by second‐look surgery in most of the closed‐technique cases.ResultsThe closed technique was the treatment of choice in 69.2% cases, most of them uncomplicated cholesteatomas. In 30.6% we performed open technique for different reasons. Second look surgery was done in 57.3% of cases after 1.5 or 2 years. A total of 27.1% of patients were lost to the follow‐up program after the first years. Residual cholesteatomas were noticed in 17% of the cases and the recurrent cholesteatomas were operated in 32% of the cases. After surgery the air‐bone gape improved in 67.1% of the cases because of tympanoplasty with autologous graft or different types of prosthesis. In some cases we used the BAHA prosthesis.ConclusionCholesteatoma is a serious condition which needs surgical treatment. Second‐look control in closed technique should be done after one‐one and a half year. Closed technique is recommended in order to restore the function of the ear which is very important for a proper development and a good quality of life.
Clinical Analysis of 22 Cases of Automastoidectomy
Authors: Lee Sun Kyu , Jeung JiHyeon , Byun Jae Yong , Yeo Seung‐Geun , Park Moon‐Suh 
Published: February 2015

ObjectiveAutomastoidectomy is a destructive condition of the mastoid and middle ear cavity about which very little has been reported. 1) Know the clinical features and severities of automastoidectomy caused by chronic otitis media. 2) Evaluate the results of its surgical outcomes.MethodRetrospective study. Patients who visited outpatient clinic and were diagnosed with COM with automastoidectomy state by temporal bone CT from January 2003 to December 2011 were included in this study. All patients underwent surgery. Their postoperative states were evaluated at the outpatient clinic at least 6 months after surgery.ResultsTwo patients complained of facial palsy, 7 hearing disturbance, 10 otorrhea, and 3 otalgia. At physical examination, attic destruction and retracted tympanic membrane (TM) were observed in 12 patients, EAC destruction in 8, TM perforation in 4, and 1 had intact TM. All pathologic results were cholesteatoma. A total of 19 had canal wall down mastoidectomy, 2 had canal wall‐up mastoidectomy, and 1 had subtotal petrosectomy. One had tympanoplasty type 1, 3 had columella over stapes head, 10 had interposition or columella over stapedial footplate and, 1 had tympanoplasty type 3. Overall hearing improvement rate was 9.0%. There was no recurrence.ConclusionAutomastoidectomy is a relatively rare condition of middle ear diseases. It could be caused by cholesteatomatous COM and non‐cholesteatomatous COM. Hearing reconstructive procedures are generally not effective compared with other conditions. This study may be helpful to know the clinical features and surgical outcomes of this condition.
Clinical Value of VEMP in Ménière’s Disease
Authors: Youm Hye‐Youn , Kim Min Beom , Choi Jeesun , Byun Ha‐Young , Park Ga‐Young , Chung Won‐Ho 
Published: February 2015

Objective1) To find clinical value of cervical vestibular evoked myogenic potential (VEMP) in Ménière’s disease (MD). 2) To evaluate whether the VEMP results can be useful in assessing the stage of MD. 3) To evaluate the clinical effectiveness of VEMP in predicting hearing outcome.MethodThe amplitude, peak latency and interaural amplitude difference ratio (IAD ratio) was obtained using cervical VEMP. The VEMP results of MD were compared with normal subjects and MD stages were compared with IAD ratio. Finally, the hearing changes were analyzed according to their VEMP results.ResultsIn clinically definite unilateral MD (n = 41), the prevalence of cervical VEMP abnormality in IAD ratio was 34.1%. Compared with healthy subjects (n = 33), the VEMP profile showed low amplitude and similar latency. The mean IAD ratio in MD was 23%, and was significantly different from healthy subjects (P =. 01). As the stage increased, IAD ratio was significantly increased (P =. 078). After stratification by initial hearing level, stage I and II subjects (hearing threshold, 0‐40 dB) with abnormal IAD ratio showed a decrease in hearing over time compared to those with normal IAD ratio (P =. 065).ConclusionVEMP parameters have an important clinical role in MD. Especially, IAD ratio can be used to assess the stage of MD. An abnormal IAD ratio may be used as a predictor of poor hearing outcomes in subjects with early stage MD.