bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous middle cranial fossa cerebrospinal fluid otorrhea in adults
Authors: Rao Neela , Redleaf Miriam 
Published: August 2015

Objectives/HypothesisThe goals of this study are to: 1) investigate the urgency for repair of middle cranial fossa spontaneous cerebrospinal fluid (CSF) leaks in adults, and 2) review the literature and treatment recommendations for adult spontaneous CSF otorrhea.Data Sources1) All patients who were referred to a tertiary center with spontaneous CSF otorrhea, exposed middle cranial fossa dura, or encephalocele from 2004 to 2015; and 2) landmark references on spontaneous CSF leaksReview MethodsElectronic medical records of patients with a documented spontaneous CSF leak, exposed dura, or encephalocele were reviewed. Subjects were excluded if they had a congenital, traumatic, or iatrogenic CSF leak. Main outcome measure was duration of CSF leak and development of meningitis after clinical presentation.ResultsTwenty‐two patients (27 ears) who were at risk for meningitis from spontaneous CSF otorrhea, encephalocele, or a dural breach with or without mastoiditis were evaluated. Duration of CSF leaks in patients who refused repair or who continued to have CSF leak after repair or prior to successful repair ranged from 4 months to 11 years. Duration of encephaloceles and dural exposure in an uninfected mastoid ranged from 24 months to 6 years. Only one patient presented with meningitis. None of these 22 patients developed meningitis during the time periods they were under our care.ConclusionShould patients with CSF otorrhea, exposed dura, or encephalocele refuse operation, it may be reasonable to follow them with close observation and education about warning signs for meningitis. Laryngoscope, 126:464–468, 2016
Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus: A Prospective Study
Authors: van Zon Alice , Smulders Yvette E. , Ramakers Geerte G. J. , Stegeman Inge , Smit Adriana L. , Van Zanten Gijsbert A. , Stokroos Robert J. , Hendrice Nadia , Free Rolien H. , Maat Bert , Frijns Johan H. M. , Mylanus Emmanuel A. M. , Huinck Wendy J. , Topsakal Vedat , Tange Rinze A. , Grolman Wilko 
Published: August 2015

Objectives/HypothesisTo determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation.Study DesignProspective study.MethodsThirty‐eight adult patients were included in this prospective study, as part of a multicenter randomized controlled trial investigating the benefits of bilateral cochlear implantation versus unilateral cochlear implantation. Pre‐ and postoperative tinnitus perception scores were evaluated, before and 1 year after implantation on three tinnitus questionnaires; the Tinnitus Handicap Inventory (THI), the Tinnitus Questionnaire (TQ), and a visual analogue scale for tinnitus burden.ResultsBefore implantation, the tinnitus prevalence was 42.1% (16 of 38) in the whole study group. One year after implantation, the tinnitus questionnaire scores had decreased in 71.4% according to the TQ and 80.0% according to the THI. Tinnitus was induced after cochlear implantation in six patients, five in the bilateral and one in the unilateral group.ConclusionsOur study shows that cochlear implantation is effective in the reduction of tinnitus in patients with bilateral sensorineural hearing loss who suffered from preoperative tinnitus. Conversely, tinnitus may also increase or even be induced by the cochlear implantation itself. Cochlear implant candidates should be well informed about these possible consequences before undergoing surgery.Level of Evidence2b Laryngoscope, 126:956–961, 2016
Clinical analysis of drug‐induced sleep endoscopy for the OSA patient
Authors: Golbin Dina , Musgrave Brandon , Succar Eric , Yaremchuk Kathleen 
Published: August 2015

Objectives/HypothesisTo determine if the use of drug‐induced sleep endoscopy (DISE) and transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea (OSA) is associated with improved outcomes and acceptable complication rates when compared to uvulopalatopharyngoplasty (UPPP) with or without tonsillectomy (± T).MethodsA retrospective cohort review was performed comparing 40 patients who had previously undergone UPPP ± T with 64 patients who had DISE, UPPP ± T, and possible TORS base‐of‐tongue resection and/or partial epiglottectomy. Apnea‐hypopnea index (AHI), Epworth Sleepiness Scale (ESS), body mass index, sex, hospital length of stay, hospital charges, hospital readmissions, emergency department visits, and major complications were compared for both groups.ResultsThe 40 patients who underwent UPPP ± T without DISE showed a significant reduction in AHI of −20.1 (P = 0.001) and a complication rate of 3% (P = 0.001). There was no significant change in ESS (−2.2; P = 0.734). The 64 patients who underwent DISE and subsequent procedures showed a significant reduction in AHI of −21.4 (P = 0.001) and a complication rate of 34.7% (P = 0.001). There was no significant difference in the ESS (+0.1; P = 0.734) or AHI (P = 0.092) between the two groups.ConclusionPatients who underwent UPPP ± T without DISE did not show a statistically significant difference in outcomes compared to the patients who underwent DISE with other procedures, including TORS. The TORS patients had increased total costs and length of stay that were statistically significant and had increased complications that were not statistically significant.Level of Evidence4. Laryngoscope, 126:249–253, 2016
Adenosquamous carcinoma of the head and neck: Molecular analysis using CRTC‐MAML FISH and survival comparison with paired conventional squamous cell carcinoma
Authors: Kass Jason I. , Lee Steve C. , Abberbock Shira , Seethala Raja R. , Duvvuri Umamaheswar 
Published: August 2015

Objectives/HypothesisAdenosquamous carcinoma (ASC) is a rare variant of head‐and‐neck squamous cell carcinoma (HNSCC) generally thought to be uniformly aggressive with poor prognosis. However, it remains unknown how overall survival compare with conventional HNSCC. Here we report for the first time that ASC does not necessarily indicate a worse prognosis than conventional HNSCC.Study DesignCase‐control retrospective study.MethodsForty‐two primary tumors of the head and neck, treated with curative intent, were identified. Next, 2:1 matching of HNSCC was performed using the following matching criteria: gender, site, pathologic tumor stage, and pathologic node stage. Successful matching was performed for 32 of 42 tumors. Additionally, 20 samples were sent for break‐apart FISH testing to evaluate for the presence of the CRTC1‐MAML2 translocation.ResultsThere was a 1.8:1 male to female ratio, with a mean age of 62 years (range 38–84). The layrnx was the most common site (26%), followed by oropharynx (24%), oral cavity (19%), and sinonasal (17%). Kaplan‐Meier analysis of adenosquamous and matched HNSCC showed similar survival curves. Median survival times for ASC and HNSCC were 4 and 6 years, respectively. A random‐effects Cox model with Gamma frailty revealed no statistical difference between the two groups (P = 0.25). All cases of ASC were negative for the CRTC1‐MAML2 translocation.ConclusionThis study directly compares primary ASC with HNSCC. No difference in overall survival was detected in contradistinction to the previously thought uniformly poor prognosis. We also highlight the importance of the CRTC1‐MAML2 translocation in distinguishing ASC from mucoepidermoid carcinoma.Level of Evidence3b. Laryngoscope, 125:E371–E376, 2015
The effects of treadmill running on aging laryngeal muscle structure
Authors: Kletzien Heidi , Russell John A. , Connor Nadine P. 
Published: August 2015

Objectives/HypothesisAge‐related changes in laryngeal muscle structure and function may contribute to deficits in voice and swallowing observed in elderly people. We hypothesized that treadmill running, an exercise that increases respiratory drive to upper airway muscles, would induce changes in thyroarytenoid muscle myosin heavy chain (MHC) isoforms that are consistent with a fast‐to‐slow transformation in muscle fiber type.Study DesignRandomized parallel group controlled trial.MethodsFifteen young adult and 14 old Fischer 344/Brown Norway rats received either treadmill running or no exercise (5 days/week/8 weeks). Myosin heavy chain isoform composition in the thyroarytenoid muscle was examined at the end of 8 weeks.ResultsSignificant age and treatment effects were found. The young adult group had the greatest proportion of superfast‐contracting MHCIIL isoform. The treadmill running group had the lowest proportion of MHCIIL and the greatest proportion of MHCIIx isoforms.ConclusionThyroarytenoid muscle structure was affected both by age and treadmill running in a fast‐to‐slow transition that is characteristic of exercise manipulations in other skeletal muscles.Level of EvidenceNA. Laryngoscope, 126:672–677, 2016
The Chronic Obstructive Sialadenitis Symptoms Questionnaire to assess sialendoscopy‐assisted surgery
Authors: Aubin‐Pouliot Annick , Delagnes Elise A. , Eisele David W. , Chang Jolie L. , Ryan William R. 
Published: August 2015

Objectives/HypothesisIntroduce the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire to quantify chronic sialadenitis symptoms and assess the impact of sialendoscopic‐assisted salivary duct surgery (SASDS).Study DesignRetrospective outcome symptoms questionnaire study.MethodsThe COSS questionnaire assesses the severity of sialadenitis symptoms from 0 to 100. Patients who underwent SASDS from April 2006 to December 2013 completed the COSS questionnaire and the ShortForm8 Health Survey (SF‐8) based on current symptoms, and reported whether they had complete, partial, or no symptomatic response to SASDS.ResultsSixty‐six of the 156 (43%) contacted patients completed the questionnaires who had had symptoms in 26 submandibular ducts and 53 parotid ducts. The mean COSS score was higher for parotid ducts (12.0; interquartile range [IQR] 1.0–20.0) than for submandibular ducts (7.6; IQR 0.5–15.0) but not significantly so (P = 0.20). Thirty‐eight (60%) patients reported complete resolution of symptoms, with a mean COSS score of 4.5 (IQR 0–7). Twenty‐one (33%) patients reported partial resolution, with a mean COSS score of 18.5 (IQR 11.3–22.8). Five (8%) patients reported no improvement, with a mean COSS score of 25.1 (IQR 15.2–35). Thirty‐six (46%) ducts with sialoliths had a significantly lower mean COSS score (5.8; IQR 0−9.5) compared to those without sialoliths (14.2; IQR 4.5−21.5, P = 0.0004). There was no significant difference in SF‐8 survey scores between these groups.ConclusionThe COSS questionnaire is a novel survey instrument to measure obstructive sialadenitis symptom severity that could be helpful in defining outcomes of SASDS. COSS scores under 10 correlate with complete resolution of symptoms, whereas scores between 10 and 25 correlate with partial resolution.Level of Evidence4. Laryngoscope, 126:93–99, 2016
Does quality of life depend on speech recognition performance for adult cochlear implant users?
Authors: Capretta Natalie R. , Moberly Aaron C. 
Published: August 2015

Objectives/HypothesisCurrent postoperative clinical outcome measures for adults receiving cochlear implants (CIs) consist of testing speech recognition, primarily under quiet conditions. However, it is strongly suspected that results on these measures may not adequately reflect patients' quality of life (QOL) using their implants. This study aimed to evaluate whether QOL for CI users depends on speech recognition performance.Study DesignTwenty‐three postlingually deafened adults with CIs were assessed.MethodsParticipants were tested for speech recognition (Central Institute for the Deaf word and AzBio sentence recognition in quiet) and completed three QOL measures—the Nijmegen Cochlear Implant Questionnaire; either the Hearing Handicap Inventory for Adults or the Hearing Handicap Inventory for the Elderly; and the Speech, Spatial and Qualities of Hearing Scale questionnaires—to assess a variety of QOL factors. Correlations were sought between speech recognition and QOL scores. Demographics, audiologic history, language, and cognitive skills were also examined as potential predictors of QOL.ResultsOnly a few QOL scores significantly correlated with postoperative sentence or word recognition in quiet, and correlations were primarily isolated to speech‐related subscales on QOL measures. Poorer pre‐ and postoperative unaided hearing predicted better QOL. Socioeconomic status, duration of deafness, age at implantation, duration of CI use, reading ability, vocabulary size, and cognitive status did not consistently predict QOL scores.ConclusionFor adult, postlingually deafened CI users, clinical speech recognition measures in quiet do not correlate broadly with QOL. Results suggest the need for additional outcome measures of the benefits and limitations of cochlear implantation.Level of Evidence4. Laryngoscope, 126:699–706, 2016
Upper airway stimulation for obstructive sleep apnea: The surgical learning curve
Authors: Murphey Alexander W. , Baker Andrew B. , Soose Ryan J. , Padyha Tapan A. , Nguyen Shaun A. , Xiao Christopher C. , Gillespie M. Boyd 
Published: August 2015

Objectives/HypothesisTo determine the effect of surgeon experience with an upper airway stimulation (UAS) system on surgical time and complication rates.Study DesignRetrospective review.MethodsSurgical procedure times and complication rates observed in patients implanted at 22 study centers as part of a phase III, multicenter surgical trial of upper airway nerve stimulation therapy for obstructive sleep apnea were reviewed.ResultsThe study included 126 subjects who were predominantly male (83%), with a mean age of 54.5 years (range = 31–80 years), and the mean body mass index was 28.4 ± 2.6. There were an average of 5.7 (range = 1–22) surgical implants per site, with an average surgical time of 2.52 ± 0.98 hours (range = 1.08–6.0 hours). The surgical implant time decreased significantly with surgeon experience, from 2.98 ± 1.18 hours for a surgeon's first implant (n = 22) to 2.08 ± 0.55 hours for the fifth implant (n = 10, P = .025). Surgical time was inversely correlated with the site implant number (rho = −0.334, P < .001). Procedure‐specific complications were uncommon and self‐limited and did not decrease appreciably with increasing experience.ConclusionsSurgical time for implantation of the UAS system decreased significantly after the first five implants and then stabilized. The rate of surgical complications did not decrease with surgeon experience, although this may be attributable to the low overall rate of serious surgical complications and low number of implants at some centers.Level of Evidence4 Laryngoscope, 126:501–506, 2016
Recurrent laryngeal nerve reinnervation in children: Acoustic and endoscopic characteristics pre‐intervention and post‐intervention. A comparison of treatment options
Authors: Zur Karen B. , Carroll Linda M. 
Published: August 2015

Objectives/HypothesisTo establish the benefit of ansa cervicalis‐recurrent laryngeal nerve reinnervation (ANSA‐RLN) for the management of dysphonia secondary to unilateral vocal cord paralysis (UVCP) in children. Children treated with ANSA‐RLN for the management of dysphonia secondary to unilateral vocal fold immobility will have superior acoustic, perceptual, and stroboscopic outcomes compared to injection laryngoplasty and observation.Study DesignRetrospective case‐series chart review.MethodsLaryngeal, perceptual, and acoustic analysis of dysphonia was performed in 33 children (age 2–16 years) diagnosed with UVCP. Comparison of pre‐post function for treatment groups (no treatment, injection laryngoplasty, ANSA‐RLN) with additional comparison between gestational ages, age at initial evaluation, and gender were examined. Perceptual measures included Pediatric Voice Handicap Index (pVHI) and Grade, Roughness, Breathiness, Asthenia, Strain (GBRAS) perceptual rating. Objective measures included semitone (ST) range, jitter%, shimmer%, noise‐to‐harmonic ratio, voicing, and maximum phonation time.ResultsPost‐treatment, pVHI, jitter%, and ST were significantly improved for ANSA‐RLN subjects compared to injection subjects. Improved function (laryngeal diadochokinesis, pVHI, GRBAS, and/or acoustic) was observed in all ANSA‐RLN subjects who had vocal fold paralysis as the only laryngeal diagnosis.ConclusionsThis study presents one of the largest studies of pediatric vocal fold paralysis diagnosis and treatment. The study looks at the spectrum of function in patients with UVCP and looks at the outcomes of options: no treatment, injection laryngoplasty, and ANSA‐RLN. Although surgical outcomes vary, both injection laryngoplasty and ANSA‐RLN show benefit in laryngeal function, voice stability, voice capacity, perceptual rating, and pVHI scores. Both injection laryngoplasty and ANSA‐RLN showed improvements post‐treatment, and should be considered for management of pediatric UVCP. However, the ANSA‐RLN group showed better and longer‐lasting perceptual and acoustic parameters in comparison with the injection and control groups. Reinnervation, even long term after the onset of vocal fold paralysis, should be considered a viable permanent treatment for pediatric UVCP.Level of Evidence4 Laryngoscope, 125:S1–S15, 2015
Novel mouse model for simulating microsurgical tumor excision with facial nerve preservation
Authors: Lim Jae H. , Boyle Glen M. , Panizza Benedict 
Published: August 2015

Objectives/HypothesisTo determine the feasibility of using a mouse tumor model as a microsurgical training tool for otolaryngology‐head and neck surgery (OHNS) trainees.Study DesignAnimal study.MethodsWe injected athymic nude mice with human cutaneous squamous cell carcinoma (A431 cell line) deep to the parotid region overlying the masseter muscle. We sacrificed the animals 1 to 3 weeks postinjection, once a visible tumor growth was confirmed. We then asked 10 OHNS trainees to excise the tumor with preservation of the facial nerves under a high‐magnification dissecting microscope. The trainees graded the tasks in several areas of specific measures using a visual analogue scale (VAS) including 1) tumor texture, 2) surgical realism, 3) usefulness, and 4) difficulty of the task.ResultsNoticeable tumor growth occurred within 5 days following A431 cell injection and reached measureable size (0.5–1.5 cm) within 1 to 3 weeks. The tumor displaced the facial nerve laterally and medially, with few demonstrating infiltration of the nerve. VAS scores (± standard deviation) were 8.1 (±1.7), 7.7 (±2.5), 9.0 (±0.9) and 6.6 (±1.9) for tumor texture, surgical realism, usefulness, and the difficulty of the task, respectively.ConclusionsWe demonstrate a novel, reliable and cost‐effective mouse model for simulating tumor extirpation microsurgery with preservation of important neural structures. OHNS trainees have found this simulation model to be realistic, useful, and appropriately challenging.Level of EvidenceNA Laryngoscope, 126:E1–E5, 2016
Hydrologic Implications of Post‐Fire Mulching Across Different Spatial Scales
Authors: Prats Sergio Alegre , Wagenbrenner Joseph W. , Martins Martinho A. S. , Malvar Maruxa Cortizo , Keizer Jan Jacob 
Published: August 2015

AbstractBesides direct damage, wildfires can produce striking direct and indirect impacts, including extreme runoff–erosion responses with serious negative consequences for land‐use sustainability and downstream values at risk. The best way to reduce post‐fire runoff is the rapid application of mulch: a protective cover of straw, needles, wood‐based material, or other ground cover. In this study, we assessed the efficacy of forest residue mulching for reducing post‐fire runoff across spatial scales on a logged and burnt eucalypt hillslope. Additionally, we assessed the underlying processes involved in the hydrologic responses of burnt areas in central Portugal during the first 2 years after a wildfire, with special focus on soil moisture, soil water repellency, and rainfall. Forest residue mulch reduced post‐fire runoff by 50% in both micro‐plots (0·25 m2) and hillslope scale silt fence plots (100 m2) during the first year after the wildfire. Runoff in the micro‐plots was tenfold higher than the larger plots, regardless of mulching. The main controlling factors for the volume of runoff were rainfall amount (direct correlation) and soil moisture (inverse correlation). Soil water repellency and soil moisture were not affected by the mulch but played a role in the hydrologic response. In contrast, there was no decrease in runoff rate within the first two post‐fire years. Forest residue mulching can be an effective post‐fire treatment for reducing runoff rates, and the consistent decrease in runoff rates between the two spatial scales suggests that the scaling of runoff was not affected by the mulch. Copyright © 2015 John Wiley & Sons, Ltd.
The “Melosira years” of Lake Baikal: Winter environmental conditions at ice onset predict under‐ice algal blooms in spring
Authors: Katz Stephen L. , Izmest'eva Lyubov R. , Hampton Stephanie E. , Ozersky Ted , Shchapov Kirill , Moore Marianne V. , Shimaraeva Svetlana V. , Silow Eugene A. 
Published: August 2015

AbstractWinter primary production in seasonally ice‐covered lakes historically has not been well studied, but it is increasingly recognized as an important component of lake metabolism. Lake Baikal in Siberia is not only the World's oldest, deepest, and most biologically diverse lake, but also where large under‐ice blooms of the diatom Aulacoseira baicalensis (formerly Melosira) occur in some years. The phenomenon of “Melosira years” is noteworthy both for the intensity of the diatom blooms, in which total under‐ice production can be a majority of total annual production, and for the enigmatic regularity of their occurrence every 3–4 yr. The degree to which these episodic blooms might be controlled by external forcing and endogenous lake processes has been debated for decades. We used a 50‐yr time series of phytoplankton observations to statistically model the occurrence of Aulacoseira blooms as a function of meteorological and climatological predictor variables. The results support the hypothesis that a confluence of meteorological conditions in the preceding fall season, which favor clear ice formation with minimal snow cover, also favor Aulacoseira blooms in the following spring. Further, we observe that this confluence of factors is related to relatively strong states of the Siberian High which, while not strictly periodic, do explain a significant fraction of the interannual bloom pattern. Finally, our analyses show that the timing of the peak abundance of A. baicalensis shifted 1.6 months later across the 50‐yr time series, corresponding with the delay in ice‐on timing that has been associated with climate change.