bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis
Authors: Francis David O. , Williamson Kelly , Hovis Kristen , Gelbard Alexander , Merati Albert L. , Penson David F. , Netterville James L. , Garrett C. Gaelyn 
Published: July 2015

Objectives/HypothesisTo determine whether injection augmentation reduces the likelihood of ultimately needing definitive framework surgery in unilateral vocal fold paralysis (UVFP) patients.Study Design: Retrospective cohort study.MethodsAll patients diagnosed with UVFP (2008–2012) at the academic center were identified. The time from symptom onset to presentation to either community otolaryngologist and/or academic center, as well as any directed treatment(s), were recorded. Stepwise, multivariate logistic regression analysis was used to determine whether injection augmentation independently affected odds of needing definitive, framework surgery among patients who were seen within 9 months of symptom onset and had not undergone any prior rehabilitative procedures.ResultsCohort consisted of 633 patients (55% female, 80% Caucasian, median age 60 years) with UVFP. The majority of etiologies were either surgery (48%) or idiopathic (37%). Duration to presentation at community otolaryngologist was shorter than to the academic center (median 2 vs. 6 months). Overall, less than half of UVFP patients had any operation (46%). Multivariate logistic regression found that earlier injection augmentation did not affect odds of ultimately undergoing framework surgery (odds ratio 1.13; confidence interval, 0.92–1.40; P = 0.23).ConclusionNearly half of UVFP patients do not require any rehabilitative procedure. When indicated, early injection augmentation is effective at temporarily alleviating associated symptoms but does not reduce likelihood of needing a definitive framework operation in patients with UVFP. Understanding practice patterns and fostering early detection and treatment may improve quality of life in this patient population.Level of Evidence4. Laryngoscope, 126:128–134, 2016
Nasolabial cysts: A systematic review of 311 cases
Authors: Sheikh Ahmed B. , Chin Oliver Y. , Fang Christina H. , Liu James K. , Baredes Soly , Eloy Jean Anderson 
Published: July 2015

Objectives/HypothesisNasolabial cysts are rare nonodontogenic cysts arising commonly in the nasal alar region. Intraoral sublabial resection of nasolabial cysts is considered the standard treatment modality. In the past 16 years, transnasal endoscopic marsupialization has emerged as an alternative approach for these lesions. A systematic review on this entity was performed to evaluate management and outcomes.Data SourcesPubMed/MEDLINE Database.MethodsA search of literature including nasolabial cysts, nasoalveolar cysts, and Klestadt's cysts was performed using the PubMed/MEDLINE database. Parameters regarding presentation, treatment, imaging, histology, and complications were extracted and subsequently analyzed.ResultsSeventy‐nine articles with 311 patient cases were included in this analysis. In cases reporting location, nasolabial cysts occurred 46.9%, 37.5%, and 10.9% on the left, right, and bilaterally, respectively. The most common presenting complaint was facial swelling in 168 out of 237 patients (70.9%). Computed tomography was the most commonly employed imaging study (n = 170). Surgical excision of nasolabial cysts was performed using an intraoral sublabial approach in 184 patients. Seventy‐nine patients underwent endoscopic transnasal marsupialization. The most common complication following surgical treatment of nasolabial cysts was postoperative facial/perinasal swelling. Three and two recurrences were reported in the sublabial excision group and transnasal marsupialization group, respectively. Mean follow‐up time was 20.0 months.ConclusionsEndoscopic transnasal marsupialization is a relatively new alternative to intraoral sublabial resection of nasolabial cysts, with similar efficacy. The rates of postoperative swelling, pain, and recurrence are similar in both groups. Laryngoscope, 126:60–66, 2016
Improving skills development in residency using a deliberate‐practice and learner‐centered model
Authors: Bhatti Nasir I. , Ahmed Aadil 
Published: July 2015

Objectives/HypothesisWork‐hour restrictions, increased workload, and subjective assessment of competency are major threats to the efficacy of the traditional apprenticeship model of surgical training in modern surgical practice. In response, medical educators are developing time‐ and resource‐efficient competency‐based models of surgical training. The purpose of our project was to develop, implement, and measure the outcomes of such objective and structured programs in otolaryngology. We also investigated factors affecting the learning curve, especially deliberate practice, formative feedback, and learners' autonomy.Study DesignProspective, longitudinal study.MethodsTo measure the surgical skills of residents, we first developed and tested objective tools for otolaryngology procedures. Based on these instruments, we identified milestones of the procedures. Training on a virtual‐reality simulator was validated to shorten the learning curve. We also studied a learner‐centered approach of training, factors affecting the learning curve, and barriers to a competency‐based model.ResultsThe objective tools were found to be a feasible, reliable, and valid opportunity for measuring competency in both the laboratory and operating room. With the formative assessment from these tools, residents had a remediation target to be achieved by deliberate practice. The milestones helped identify the threshold of competency, and deliberate practice on the simulator gave an opportunity for improving skills. The learner‐centered approach allowed flexibility and personalized learning by shifting the responsibility of the learning process to the learners.ConclusionThe competency‐based model of residency, based on the principles of deliberate practice and a learner‐centered approach, is a feasible model of residency training that allows development of competent surgeons and hence improves patient outcomes. Despite these advantages, challenges to this model require a concerted effort to overcome and fully implement these principles of training beyond just technical skills, ultimately creating well‐rounded medical professionals and leaders in the surgical field.Level of EvidenceN/A. Laryngoscope, 125:S1–S14, 2015
The role of radiation therapy in the management of sialorrhea: A systematic review
Authors: Hawkey Nathan M. , Zaorsky Nicholas G. , Galloway Thomas J. 
Published: July 2015

PurposeUp to 80% of patients with Parkinson disease and 30% of patients with amyotrophic lateral sclerosis (ALS) suffer from sialorrhea. Patients who fail medical and surgical therapy should be considered for external beam radiation therapy (EBRT). In this study, we conduct a systematic review to determine the dose and techniques used that result in greatest efficacy and lowest toxicity for the administration of EBRT in patients with Parkinson disease or ALS‐associated sialorrhea.Methods and MaterialsThis review included 216 patients from four prospective and six retrospective studies published from 1998 to 2014, with ALS or Parkinson disease who were treated with electron or photon EBRT for sialorrhea.ResultsA total of 216 patients were treated with EBRT from 10 studies. The indication for EBRT was failure of alternative medical treatment in all ALS patients. For patients with Parkinson disease, EBRT was the primary mode of treatment in 68% of cases. Overall, 176 (81%) of 216 patients treated with EBRT for sialorrhea reported symptomatic improvement from baseline. The most common target was the inferior two‐thirds of the bilateral parotid glands and the entire bilateral submandibular glands. The total number of patients who experienced short‐term toxicity was 86 of 216 patients (40%). The total number of patients who experienced long‐term toxicity was 24 of 207 (12%).ConclusionsEBRT is an effective treatment for sialorrhea in patients suffering from ALS or Parkinson disease. Treatment to the bilateral submandibular glands and caudal parotid glands is the most common field arrangement.Level of EvidenceNA Laryngoscope, 126:80–85, 2016
Seasonal affective disorder in patients with chronic tinnitus
Authors: Kim Young H. 
Published: July 2015

Objectives/HypothesisTo investigate the point prevalence of SAD, degrees of anxiety/depression/sleep disturbance, and characteristics of tinnitus in patients with chronic tinnitus.Study DesignCross‐sectional survey study.MethodsFrom December 2012 to February 2014, 100 patients with chronic persistent or intermittent tinnitus (>3 months) were enrolled. Audiograms, tinnitograms, and Visual Analogue Scales (VAS) were used to assess tinnitus. Tinnitus Handicap Inventory (THI) assessment and questionnaires about anxiety/depression/sleep disturbance/SAD were administered.ResultsThe male:female ratio was 48:52, and the mean age was 55.0 years. The numbers of patients with suspected SAD and subsyndromal SAD (S‐SAD) were nine (9.0%) and 11 (11.0%), respectively. Winter was the most uncomfortable season. Nine patients had a catastrophic THI score >76 (11.1% in the SAD group, 27.3% in the S‐SAD group, and 6.3% in the control group), suggesting a significant correlation between SAD/S‐SAD and THI (P = .042). Audiogram, tinnitogram, VAS assessment, and sleep disturbance testing revealed no significant differences among the three groups. Anxiety tests yielded more abnormal findings in the SAD group than in the control group (State Anxiety Inventory score: 33.3% vs. 3.3%, respectively, P = .012; Trait Anxiety Inventory score: 22.2% vs. 1.3%, respectively, P = .002). Depression test scores were significantly higher in the SAD/S‐SAD groups than in the control group (35.0% vs. 21.3%, respectively; P = .005).ConclusionsSuspected SAD and/or S‐SAD in chronic tinnitus patients were correlated with THI, anxiety, and depression. Understanding SAD in tinnitus patients may be important to manage these patients effectively.Level of Evidence4 Laryngoscope, 126:447–451, 2016
Cognitive load in distributed and massed practice in virtual reality mastoidectomy simulation
Authors: Andersen Steven Arild Wuyts , Mikkelsen Peter Trier , Konge Lars , Cayé‐Thomasen Per , Sørensen Mads Sølvsten 
Published: July 2015

Objectives/HypothesisCognitive load theory states that working memory is limited. This has implications for learning and suggests that reducing cognitive load (CL) could promote learning and skills acquisition. This study aims to explore the effect of repeated practice and simulator‐integrated tutoring on CL in virtual reality (VR) mastoidectomy simulation.Study DesignProspective trial.MethodsForty novice medical students performed 12 repeated virtual mastoidectomy procedures in the Visible Ear Simulator: 21 completed distributed practice with practice blocks spaced in time and 19 participants completed massed practice (all practices performed in 1 day). Participants were randomized for tutoring with the simulator‐integrated tutor function. Cognitive load was estimated by measuring reaction time in a secondary task. Data were analyzed using linear mixed models for repeated measurements.ResultsThe mean reaction time increased by 37% during the procedure compared with baseline, demonstrating that the procedure placed substantial cognitive demands. Repeated practice significantly lowered CL in the distributed practice group but not in massed practice group. In addition, CL was found to be further increased by 10.3% in the later and more complex stages of the procedure. The simulator‐integrated tutor function did not have an impact on CL.ConclusionDistributed practice decreased CL in repeated VR mastoidectomy training more consistently than was seen in massed practice. This suggests a possible effect of skills and memory consolidation occurring over time. To optimize technical skills learning, training should be organized as time‐distributed practice rather than as a massed block of practice, which is common in skills‐training courses.Level of EvidenceN/A. Laryngoscope, 126:E74–E79, 2016
United States multicenter clinical trial of the cochlear nucleus hybrid implant system
Authors: Roland J. Thomas , Gantz Bruce J. , Waltzman Susan B. , Parkinson Aaron J. ,   The Multicenter Clinical Trial Group
Published: July 2015

Objectives/HypothesisTo evaluate the safety and efficacy of acoustic and electric sound processing for individuals with significant residual low‐frequency hearing and severe‐to‐profound high‐frequency sensorineural hearing loss.Study DesignProspective, single‐arm repeated measures, single‐subject design.MethodsFifty individuals, ≥ 18 years old, with low‐frequency hearing and severe high‐frequency loss were implanted with the Cochlear Nucleus Hybrid L24 implant at 10 investigational sites. Preoperatively, subjects demonstrated consonant‐nucleus‐consonant word scores of 10% through 60% in the ear to be implanted. Subjects were assessed prospectively, preoperatively, and postoperatively on coprimary endpoints of consonant‐nucleus‐consonant words, AzBio sentences in noise, and self‐assessment measures.ResultsSignificant mean improvements were observed for coprimary endpoints: consonant‐nucleus‐consonant words (35.8 percentage points) and AzBio sentences in noise (32.0 percentage points), both at P < 0.001. Ninety‐six percent of subjects performed equal or better on speech in quiet and 90% in noise. Eighty‐two percent of subjects showed improved performance on speech in quiet and 74% in noise. Self‐assessments were positive, corroborating speech perception results.ConclusionThe Nucleus Hybrid System provides significant improvements in speech intelligibility in quiet and noise for individuals with severe high‐frequency loss and some low‐frequency hearing. This device expands indications to hearing‐impaired individuals who perform poorly with amplification due to bilateral high‐frequency hearing loss and who previously were not implant candidates.Level of Evidence2b. Laryngoscope, 126:175–181, 2016
Factors important in laryngology fellow and laryngology fellowship selection
Authors: Yung Katherine C. , Courey Mark S. 
Published: July 2015

Objectives/HypothesisTo determine factors that laryngology fellowship directors believe are most important in choosing a fellow and that laryngology applicants believe are most important in choosing a program.The number of laryngology fellowship programs and the number of laryngology fellowship applicants have been increasing in recent years. Selection criteria in choosing a fellow or fellowship program have not been studied.MethodsSurvey study using anonymous online questionnaires of laryngology fellowship directors and recent laryngology fellowship applicants. Directors were asked to rate qualities for judging the strength of a fellowship applicant. Applicants were assessed for the importance of various factors in choosing a fellowship.ResultsSixteen of 27 fellowship directors (59%) and 33 of 53 fellowship applicants (62%) contacted responded to the survey. Program directors listed interview performance, letters of recommendation, and personal knowledge of applicant as the most important factors. Gender or ethnicity, previous research in laryngology, and likelihood that the applicant will rank the director's program highly were ranked as least important factors. Applicants ranked personal rapport with fellowship mentor(s), large experience in endoscopic surgeries, and reputation of mentor(s) as most important, whereas call schedule, salary, and having more than one fellow per year were ranked as least important factors.ConclusionInterview performance, trusted colleague's recommendation, and personal knowledge were ranked as the most important factors in fellow selection. These criteria are consistent with previous research on otolaryngology residency and pediatric otolaryngology fellow selection. When selecting a fellowship, laryngology fellowship applicants choose based on personal rapport with mentor, opportunity to learn endoscopic surgeries, and mentor reputation.Level of EvidenceN/A. Laryngoscope, 125:2543–2546, 2015
Endoscopic cochlear implantation: Call for caution
Authors: Tarabichi Muaaz , Nazhat Omar , Kassouma Jamal , Najmi Murtaza 
Published: July 2015

Objectives/HypothesisTo assess whether transcanal endoscopic access to the basal turn of the cochlea for cochlear implantation is appropriate.Study DesignCase series study.MethodsWe reviewed 100 consecutive computed tomographic studies of the sinuses and temporal bone in our institution. We excluded studies that demonstrated evidence of congenital anomalies, chronic ear disease, or inadequate visualization of the cochlea. On axial sections, the angles of the basal turn of the cochlea and of the ear canal in reference to the sagittal plane were recorded as a function of age.ResultsEighty‐four studies were included and 16 were excluded. There was significant variability in the relationship between the ear canal and the basal turn of the cochlea in reference to the sagittal plane. A clear majority of images demonstrated the basal turn of the cochlea to align with a more posterior angle than that of the ear canal.ConclusionThe trajectory provided by posterior tympanotomy aligns more favorably with the basal turn of the cochlea than transcanal access. Endoscopic technique, primarily an ear canal intervention, may not be useful in cochlear implant surgery.Level of Evidence4. Laryngoscope, 126:689–692, 2016
Triple‐positive pathologic findings in oral cavity cancer are related to a dismal prognosis
Authors: Lin Yu‐Tsai , Chien Chih‐Yen , Lu Cheng‐Tung , Lou Sheng‐Dean , Lu Hui , Huang Chao‐Cheng , Fang Fu‐Min , Li Shau‐Hsuan , Huang Tai‐Lin , Chuang Hui‐Ching 
Published: July 2015

Objectives/HypothesisPerineural invasion (PNI), lymphovascular invasion (LVI), and extracapsular spread (ECS) of lymph nodes are adverse histopathologic factors among patients with oral cancer. We analyzed the clinical impact of the combination of PNI, LVI, and ECS among patients with oral cancer.Study DesignRetrospective analysis of patients with oral cancer that was treated primarily with surgery with at least 5 years of follow‐up data in a tertiary referral center.MethodsIn total, 554 patients diagnosed with oral cavity squamous cell carcinoma who underwent operations consecutively between 2006 and 2008 in our hospital were enrolled. Clinical characteristics, 5‐year survival rates, and local/regional control rates were analyzed.ResultsThere were 41 females and 513 males. Patients with PNI, LVI, or ECS presented pathologically had 5‐year overall survival rates of 58.4%, 50.4%, and 31.4%, respectively. Patients with both ECS and PNI or both ECS and LVI presented had 5‐year overall survival rates of 31.5% and 22.2%, respectively. Patients presenting with triple‐positive status (PNI, LVI, and ECS) had only a 20.0% 5‐year overall survival rate. The 5‐year local/regional control rate for patients with both ECS and PNI or both ECS and LVI was 26% and 44.4%, respectively; for all three factors, it was 26.7%.ConclusionPatients with triple‐positive status (PNI, LVI, ECS), ECS and PNI, or ECS and LVI experienced very low 5‐year local/regional control rates, 5‐year overall, and disease‐specific survival rates. Novel interventions are necessary to improve these clinical outcomes.Level of Evidence4. Laryngoscope, 125:E300–E305, 2015
Mycobacterial cervicofacial lymphadenitis in human immunodeficiency virus–infected individuals after antiretroviral therapy initiation
Authors: Ablanedo‐Terrazas Yuria , Alvarado‐de la Barrera Claudia , Ruiz‐Cruz Matilde , Reyes‐Terán Gustavo 
Published: July 2015

Objectives/HypothesisMycobacterial infections are the leading cause of morbidity and mortality among human immunodeficiency virus (HIV)‐infected individuals worldwide. Cervical lymph nodes are the most frequently affected extrapulmonary sites. Despite the substantial reduction in complications of HIV–tuberculosis coinfection, a proportion of individuals develop immune reconstitution inflammatory syndrome (IRIS), a term used for a clinical deterioration following initiation of antiretroviral therapy (ART). The objective of this study was to describe mycobacterial‐associated IRIS in cervical lymph nodes of HIV‐infected individuals receiving ART.Study DesignRetrospective cohort study, set in a tertiary referral center in Mexico City.MethodsWe included ART‐naive subjects who had at least one follow‐up ear, nose, and throat examination, and were diagnosed with lymph node mycobacterial infection before or during the first 3 months of ART initiation. Mycobacterial‐associated IRIS in cervical lymph nodes was determined retrospectively through clinical case definition and medical chart review.ResultsThirty‐three subjects who initiated ART were diagnosed with cervical lymph node mycobacteriosis; 24 had Mycobacterium tuberculosis infection and nine had nontuberculous disease.ConclusionsM. tuberculosis was the most common pathogen isolated from cervical lymph nodes. The only factor associated with IRIS was infection with a nontuberculous mycobacteria. The unexpectedly high incidence of mycobacterial‐associated IRIS underlines the relevance of head and neck examination before ART initiation.Level of Evidence4 Laryngoscope, 125:2498–2502, 2015
Anticounterfeiting Strategies and Their Influence on Attitudes of Different Counterfeit Consumer Types
Authors: Herstein Ram , Drori Netanel , Berger Ron , Barnes Bradley R. 
Published: July 2015

ABSTRACTThis article reports the findings of two studies that were designed to determine the effectiveness of several anticounterfeiting strategies on the counterfeit purchasing behavior of the participants, through a mixed methods research approach. In Study 1, in‐depth interviews were conducted with 50 consumers of counterfeit brands in order to investigate their attitudes. Drawing on the results, which revealed four different consumer types (struggle, spurious, indifferent, and liberated), Study 2 was undertaken with a further 128 consumers (32 from each type) to further define each group's type and identify the best anticounterfeit strategies suited to each. The findings suggest that counterfeit purchasing may be reduced if a specific strategy is adapted to suit each typology. Overall, positive rather than negative strategies were found to be more effective for the struggle and spurious consumers compared with indifferent and liberated consumers. The findings also reveal that the acquisition of affordable genuine merchandise may be the key to preventing counterfeit purchasing.
Toward Understanding Persuasion Expressions: The Activation of Attitudes
Authors: Whittler Tommy E. , Manolis Chris 
Published: July 2015

ABSTRACTIn response to sales representatives’ closing expressions, consumers’ stored attitudes are activated spontaneously from memory and influence product evaluations. Studies 1a and 1b examined the levels of favorability associated with several persuasive expressions. Study 2 then examined whether a sales representative's use of a more (Authority) or a less (Scarcity) favorable persuasive expression would affect consumers’ subsequent product and advertisement evaluations. The expressions were found to work differently depending upon two moderator variables: Need for Cognition and argument quality. The effect of Scarcity heightened subsequent product evaluation as Need for Cognition decreased, whereas the effect of Authority heightened subsequent product evaluation as Need for Cognition increased. The Scarcity statement did not affect product evaluations given strong or weak message claims in the advertisement, whereas the Authority statement produced more favorable product evaluations given strong versus weak messages claims. Cognitive response analyses and mediation patterns also indicated that the two persuasive expressions were distinct based upon individuals’ Need for Cognition. Implications for both sales representatives and consumers are drawn from these findings.