bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Cholesteatoma: Congenital versus Acquired
Authors: Shim Byoung Soo , Shim Myung Joo , Lim Hyun Woo , Yoon Tae Hyun 
Published: February 2015

Objective1) To compare the characteristics of congenital and acquired pediatric cholesteatoma. 2) To investigate the risk factors influencing recidivism after initial surgery to propose a guided therapeutic approach.MethodRetrospective analysis was made on pediatric cholesteatoma cases under the age of 18 years. A total of 163 patients (92 of congenital and 71 of acquired cholesteatoma) were operated by the same surgeon from 1993 to 2011. We analyzed the symptoms, physical findings, computed tomography, operative findings, hearing, and recurrence.ResultsThe ages at diagnosis and operation in congenital cholesteatoma were significantly younger than acquired. The chief complaint of congenital was mainly the incidental mass (74%), whereas the otorrhea (66%) in acquired. Mass shadow behind the intact tympanic membrane was observed in 95% of congenital cholesteatoma. The main tympanic membrane abnormalities of acquired cholesteatoma were attic retraction and pars tensa perforation (56% and 56%). Invasion of epitympanum and ossicular erosion were more frequently found in the acquired cholesteatoma (P <. 05). There was no difference in recurrence rate between congenital and acquired cholesteatoma. Statistically significant factors at high risk of recurrence were pars tensa perforation, diploic pneumatization, incus erosion. On the other hand, lowering risk factors were sclerotic mastoid on CT and no mastoidectomy.ConclusionThe congenital and acquired cholesteatoma showed very different clinical features. Careful eradication and continued follow‐up is recommended in the children with high risk of recurrence.
Effect of Work Hour Restriction on Residents’ Case Volume
Authors: Darrat Ilaaf , Thorne Marc C. 
Published: February 2015

Objective1) To determine the effect of the Accreditation Council for Graduate Medical Education (ACGME) 80‐hour work restriction on the total number of cases of graduating residents. 2) To determine the effect of the ACGME 80‐hour work restriction on the total number of key indicator cases of the graduating residents.MethodThe ACGME national data reports of case logs for graduating residents from 2004‐2011 were analyzed. Linear regression was used to evaluate for changes in total case numbers over time. Separate models were generated for total case volume, ACGME categories for resident participation (surgeon, assistant, supervisor), and ACGME key indicator categories.ResultsA statistically significant increase in total case volume was observed over the study period, with graduating residents on average performing 25.8 more cases per study year (95% CI = 6.5 to 44.9, P =. 018). This increase is primarily accounted for by an increase in the number of cases categorized as surgeon, with 19.8 more cases per study year (95% CI = 5.8 to 33.7, P =. 015). An increase of 4.1 cases per study year in the key indicator category of Head and Neck was observed (95% CI = 1.6 to 6.5, P =. 008).ConclusionDespite implementation of the 80‐hour duty restriction, case logs of graduating residents demonstrated an increase in case volume over calendar time. Further research will be necessary to determine if this finding reflects improved efficiencies in training programs or redistribution of resident activities away from other educational opportunities.
Procedure and Outcome in Simple Underlay Myringoplasty
Authors: Hashimoto Shigehisa , Takahashi Sugata 
Published: February 2015

ObjectiveTo assess tympanic membrane (TM) closure rates achieved by 3 operative procedures in simple underlay myringoplasty with fibrin glue (SUM) for TM perforation.MethodA SUM was performed under local anesthesia under a microscope in patients with perforated TM defects of 50% or less. In those with defects exceeding 50%, we chose a method allowing SUM to be conducted under general anesthesia. A SUM using an endoscope was performed in cases with curved EAC.ResultsA total of 158 ears were treated by SUM. There were 60 ears on which a SUM was performed using an operating microscope under local anesthesia, and complete closure was achieved in 54 (90%). Eighty‐four ears were treated by a SUM under general anesthesia, and closure was achieved in 74 (88%). Endoscopy (1.9 mm in diameter) was performed in 14 ears, of which 13 (93%) attained TM closure. There were no significant differences in closure rates among the surgical procedures selected, and neither enlargement of perforation nor decreased hearing acuity occurred, as compared to the preoperative condition, even in patients suffering reperforation.ConclusionThis operative procedure is simple and minimally invasive, and provides a satisfactory perforation closure rate. The present data indicate that selection of operative procedures appropriate to various disease states may permit greater extension of surgical indications.
Surgical Site Infections in Ear Surgery: Hair Removal Effect
Authors: Kattipattanapong Woraya , Isaradisaikul Suwicha 
Published: February 2015

Objective1) Compare the rate of surgical site infections in ear surgery between the groups with and without hair removal. 2) Study factors associated with surgical site infections.MethodA randomized clinical study was conducted in 136 patients who were planned for external or middle ear disease via postauricular approach at Chiang Mai University Hospital from May 2010 to May 2011. Demographic data, surgical site infection within 30 days after operations, and associated factors were recorded.ResultsFifty‐eight cases were men and 78 cases were women. Demographic data between the 2 groups—age, gender, the side of operated ear, types of anesthesia, emergency or elective setting, BMI, history of alcohol drinking or smoking, underlying diseases, operative time, and the length of stay in the hospital—showed no significant difference. A postoperative surgical site infection was developed in 5 patients: 3 in the group with hair removal (5%) and 2 in the group without hair removal (3%) (P =. 674, Fisher’s exact test). All infected cases had mastoidectomy surgery.ConclusionSurgical site infection rate between the groups with and without hair removal showed no difference. Hair removal in ear surgery via postauricular incision showed no effect on the surgical site infection.
Use of Embolization with Liquid Agent in Glomus Surgery
Authors: Rangel Gustavo , Araujo Marcio , Guimarães Luanda , Mury Isabelle , Tavares Diogo , Felix Felipe 
Published: February 2015

ObjectiveEvaluate the effects of embolization using liquid embolic agent (Onyx) in surgery for jugulotympanic tumors with regard to length of stay in hospital, duration of procedure, signs of facial palsy, intraoperative hemorrhage, and postoperative complications.MethodSix patients were admitted for evaluation therapeutic options. Two patients were treated with radiotherapy and 4 proceeded to surgery. The selection criteria for the therapeutic choice were staging of the lesion, intraoperative risks of the procedure and patient expectations. The embolization with liquid material was performed 2 days prior to surgery by the radiology department in the operative cases. The evaluation was done retrospectively using medical data.ResultsFour patients underwent surgery and 2 patients maintained follow‐up after radiotherapy. In comparison with the literature, a reduction of days in the hospital without requiring intensive care a reduction in (average time of 3 days) and a reduction in duration of surgery time (average length of 150 minutes) was noted. There was no need for hemotransfusion, neither facial palsy nor infection of wound was reported after the surgery in patients that underwent preoperative embolization.ConclusionWe have a shorter duration of surgery and reduced bleeding and reduced length of hospitalization days with a secure embolization, and as a consequence, less postoperative complications.
Vibrant Soundbridge vs BAHA: Outcomes Comparison
Authors: Rivas Jose A. , Rivas Adriana , Rincon Luz A. , Tamayo Cesar A. , Forero Victor H. , Rivas Alejandro 
Published: February 2015

Objective1) Evaluate results of the implant Vibrant Soundbridge vs BAHA in conductive or mixed deafness. 2) Compare audiological and satisfaction outcomes.MethodRetrospective study of 50 patients with mixed or conductive deafness. Twenty‐five patients using VSB, 25 using BAHA.ResultsWith VSB 46% were men, and the age at implantation was 39 years (SD, 15 years). A total 96% of cases FMT were placed on the round window. Mean postoperative pure tone average without VSB was 69 (±17) dB HL and with VSB in free‐field condition 33 (±17) dB HL. Mean hearing gain was 34 (±17) dB HL. When comparing with the BAHA users’ group, the hearing gain was 38 (±14), and there were no statistical differences, P =. 37.ConclusionVSB is an efficient alternative for patients with conductive‐mixed hearing losses, comparable to bone anchored hearing device. The use of the FMT on the round window has demonstrated to be effective in well‐selected cases.
Bupivacaine Infiltration Effect on Post‐Tonsillectomy Pain
Authors: Bakhshaee Mehdi , Bameshki Ali Reza , Khadivi Ehsan , Razavi Majid , Razban Marzieh 
Published: February 2015

ObjectiveTonsillectomy is one of the most frequent operations performed worldwide. Pain and hemorrhage are the most complications. Reduction in post‐operative pain prevents the dehydration from reduced oral intake. Peritonsillar infiltration of epinephrine with bupivacaine might have some role for this purpose.Method72 children who were candidates for adenotonsillectomy randomly were divided into three groups including: patients who injected by normal saline preoperation (placebo group); those injected by bupivacaine and epinephrine preoperation (group 2); and postoperation (group 3). Postoperative pain, hemorrhage and the time of oral intake were measured.ResultsOnly VAS pain score in 30 minutes post‐operation was significantly different between placebo and the group 2 (p=0.02). Swallowing pain in 6 hours after tonsillectomy was decreased in drug injection groups compared with placebo group (p< 0.05). The first time of oral intake was not different among groups, statistically. Immediate post‐tonsillectomy hemorrhage was significantly higher in placebo group compare to the other groups while delay hemorrhage did not show any difference.ConclusionPeritonsillar injection of epinephrine with bupivacaine before or after tonsillectomy will reduce immediate post‐operative hemorrhage and lead to reduction in the swallowing pain. Early feeding could be a factor for prevention of unwanted outcomes such as fever and secondary dehydration.
Cochlear Implantation in X‐linked Mixed Deafness
Authors: Prickett Kara K. , Todd Norman W. 
Published: February 2015

Objective1) Describe important points of consideration when planning cochlear implant surgery for patients at risk for cerebrospinal fluid (CSF) gusher on cochleostomy. 2) Report successful cochlear implantation in patients with X‐linked mixed deafness.MethodFraternal twins with X‐linked mixed deafness were enrolled in an observational study at a tertiary academic medical center from 2010 to 2011. Subjects underwent cochlear implantation and were followed during recovery and auditory rehabilitation. Main outcome measures included successful placement of electrode arrays into the cochlea, adequate control of leaking CSF, incidence of postoperative complications, and development of listening and speaking communication skills in children with implants.ResultsElectrode arrays were successfully placed despite challenging middle and inner ear abnormalities. Leaking CSF was controlled without the use of lumbar drains. No perioperative or postoperative complications occurred. Both patients progressed rapidly in the development of hearing, listening, and speaking skills after successful cochlear implantation. A new surgical instrument was designed and used to aid in electrode insertion into gushing CSF.ConclusionCochlear implantation in patients with X‐linked mixed deafness requires careful planning and execution, but may result in excellent communicative outcomes.
Congenital Familial Subglottic Stenosis
Authors: Manickavasagam Jaiganesh , Thevasagayam Ravi , Bateman Neil D. 
Published: February 2015

ObjectiveCongenital stenosis may be caused by either a small cricoid cartilage or a thick submucosa secondary to a failure of canalization of the subglottic lumen. Acquired subglottic stenosis is caused by trauma. Congenital subglottic stenosis is a well‐known cause of stridor in infancy. It usually occurs sporadically and familial occurrence is rare.MethodCase series. Pediatric tertiary referral center.Three children who presented with subglottic stenosis born to consanguineous parents were identified. For the literature research, reports published from 1950 to January 2012 were retrieved. We also screened bibliographies of the collected articles to identify pertinent reports.ResultsThree Asian children were born with congenital subglottic stenosis for closely related consanguineous parents. Their presentation, family tree, genetic tests, associated features, and treatment will be discussed. All patients underwent laryngotracheal reconstruction.ConclusionCongenital familial subglottic stenosis in unrelated parents has been reported previously but not in consanguineous parents. Family genetic work up is recommended. Further genetic research is needed to assess the mode of possible heritage in these cases.
Development of a Murine Model for CMV‐Induced Hearing Loss
Authors: Patel Rusha J. , Wang Yong , Park Albert H. 
Published: February 2015

Objective1) Illustrate phenotypical evidence of sensorineural hearing loss by showing elevation of auditory evoked brainstem response (ABR) thresholds and diminished distortion product otoacoustic emission (DPOAE) in newborn mice inoculated with murine cytomegalovirus (mCMV). 2) Demonstrate evidence of mCMV‐mediated pathology based on microscopic examination of infected cochleas.MethodBALB/c mice were injected at postnatal day 3 with 100 pfu of mCMV; controls received saline. Hearing thresholds were assessed using DPOAE and ABR at 4 weeks of age and onward. Histologic changes in temporal bones were compared between infected and control mice.ResultsMore than 50% of infected mice had significantly higher DPOAE and ABR thresholds at 4 weeks of age as compared to age‐matched controls (P <. 008). Five mice (45%) had profound hearing loss (≥80 dB) at 4 weeks of age; 7 mice (50%) progressed to profound hearing loss at 6 weeks. 40% of mice had asymmetric hearing loss. Temporal bone histology showed diffuse loss of outer hair cells in profoundly deaf mice as compared to controls.ConclusionIntracerebral injection of mCMV to newborn mice can cause hearing loss with high to low frequency ABR progression, and diminished DPOAE. This hearing loss is asymmetric and progressive, similar to human infection. Histologic examination shows loss of outer hair cells in mCMV infected mice, suggesting that CMV infection may target the outer hair cells. Further studies using this model should shed light on the mechanism underlying CMV‐mediated hearing loss and provide foundation for better managing and treatment of the condition.
Evaluation of the Function of Auditive Tube
Authors: Testa José Ricardo G. , Dos Santos Ana Carolina S. 
Published: February 2015

ObjectiveEvaluate the possibility of glucose test in assessing the function of the Eustachian tube.MethodProspective study included 20 subjects with chronic otitis media not cholesteatoma, presenting dry tympanic perforation for at least 30 days. These patients were subjected to instillation of ear drops of glucose solution in the ear with dry tympanic perforation. Later these patients were subjected to a audiologic evaluation with impedance and Eustachian tube function test.ResultsIn glucose test there was a statistical difference between the 2 responses of test, since it can be stated that there is a greater percentage of subjects with positive responses (80%). There was no statistical difference between the 2 responses in Eustachian tube function test. The test with the greater percentage of semipermeable was glucose test, with 80%, versus 45% of Eustachian tube function test. Consequently the Eustachian tube function test had a greater percentage of not permeable, with 50% versus 20% of glucose test. The glucose test has an excellent sensitivity (100%) and specificity is very low (33.3%).ConclusionThe glucose test gives informations about the function of the auditive tube.
General Otolaryngology Knowledge in Primary Care Residents
Authors: Error Marc E. , Wilson Kevin F. , Gale Derrick C. , Ward Preston D. , Meier Jeremy D. 
Published: February 2015

Objective1) Determine the amount of exposure to otolaryngology in medical training of nonotolaryngology residents (NOR). 2) Evaluate the general otolaryngology‐related knowledge in these residents.MethodA 10‐question multiple‐choice quiz was given to residents in family practice, pediatrics, emergency medicine, and internal medicine during scheduled educational conferences. Residents were also asked if they ever participated in an otolaryngology rotation during medical school or residency. Medical students and otolaryngology residents completed the quiz to act as controls.ResultsA total of 49 NOR and 44 medical students answered the questionnaire. Only 24% of the NOR had an otolaryngology rotation during medical school. The same amount (24%) had a rotation during residency. The average percentage correct on the quiz was 49%, 57%, and 91% for medical students, NOR, and otolaryngology residents respectively (P <. 05). Questions with surprising results included one with an endoscopic image of the middle turbinate, and examinees were asked to identify the structure (NOR = 18% correct). A laryngectomy stoma was also shown, and participants were asked what would happen if the stoma was occluded for 10 minutes (NOR = 20% correct).ConclusionIn this sample of nonotolaryngology residents, a minority experienced a clinical rotation in otolaryngology during medical school or residency. This nonvalidated questionnaire also suggested significant deficiencies in basic otolaryngology knowledge in these residents. Identifying mechanisms to improve exposure to otolaryngology in the medical training curriculum is needed.
Impact of Tonsillectomy Clinical Practice Guidelines
Authors: Setabutr Dhave , Adil Eelam , Chaikhoutdinov Irina , Carr Michele M. 
Published: February 2015

ObjectiveTo evaluate the effect of the recently published pediatric tonsillectomy and polysomnography clinical guidelines on current practice patterns.MethodAn anonymous 15‐question survey was sent to members of the American Academy of Otolaryngology–Head and Neck Surgery regarding their awareness of the Clinical Practice Guideline: Tonsillectomy in Children and Clinical Practice Guideline: Polysomnography for Sleep‐Disordered Breathing Prior to Tonsillectomy in Children and whether or not they have changed their practice as a result.ResultsA total of 93% of respondents read the guidelines. Most respondents had completed a pediatric otolaryngology fellowship (84%). A small majority of physicians (54%) continue to prescribe antibiotics within 24 hours after surgery. One‐third of respondents stopped prescribing antibiotics because of the new guidelines. Discord between severity of symptoms and tonsil size was the most common reason cited for ordering a polysomnogram prior to tonsillectomy (76%) in concordance with the guideline’s recommendations. A total of 45% of physicians prescribe NSAIDs for pain control despite its safety profile, and 23% reported that the guidelines influenced their use of NSAIDs postoperatively. Most respondents use intraoperative steroids (90%).ConclusionThe guidelines are intended to provide evidence‐ based direction in tonsillectomy practices and improve referral patterns for polysomnography prior to tonsillectomy. A majority of the surveyed otolaryngologists reviewed these guidelines. There is some evidence practice has changed secondary to the guidelines.
Model for Hearing Loss Identification in Belarus
Authors: Merkulova Elena P. , Levaya‐Smaliak Anastasia M. , Danilenko Nina G. 
Published: February 2015

Objective1) To analyze 35delG mutation rates in the large group of children with sensorineural hearing loss (SNHL); 2) To optimize the diagnosis of SNHL in children.MethodA total of 392 children with SNHL from moderate‐to‐profound hearing loss were examined. A screening for 35delG, pure tone audiometry, and family interviews were performed. A comparative analysis of hearing loss degree and risk factors in 3 groups of children, including 35delG heterozygous, 35delG homozygous, and without this mutation was performed.ResultsAmong children with SNHL, 45% are homozygous and 15% are heterozygous for 35delG GJB2. The frequency rate of perinatal pathology in the group of 35delG absence patients is significantly higher (P value =. 03) than in groups of 35delG homozygous and 35delG heterozygous. Our study shows a positive family history is present in 45% of cases with 35delG homozygous children, while for the group without this mutation the deafness of relatives is only 15%. On comparison of 35delG homozygous with 35delG absent patients, the prevalence of severe‐to‐profound hearing loss was significantly (P value =. 046) higher in the group of 35 delG associated SNHL patients.ConclusionOur study reveals mutation 35delG is the main genetic cause of SNHL in Belarus as it is detected in 60% of the patients with SNHL. All newborns despite presence or absence of risk factors should be given a molecular analysis for 35delG in cases of positive family history, severe‐ profound congenital hearing loss, and absence of perinatal risk factors.
Quality of Life in Childhood Hearing Loss: Systematic Review
Authors: Rachakonda Tara , Lieu Judith E. C. , Thorne Marc C. 
Published: February 2015

ObjectiveThough the functional performance of children with hearing loss (HL) has been assessed through audiometric and educational testing, quality of life (QOL) has not been as thoroughly addressed. This systematic review was undertaken to test the hypothesis that QOL in children with HL is worse than children with normal hearing.MethodMEDLINE, EBSCO, and EMBASE databases (end date 11/9/11) were searched for peer‐reviewed articles that examined QOL of children 0 to 18 years with HL using validated QOL surveys. Abstracts were reviewed by 2 reviewers. Articles were excluded if children had fluctuating/temporary HL (such as otitis media) and/or cognitive impairment.ResultsOf 963 articles initially located, 32 articles will be included for further evaluation using modified STROBE criteria: 2 case‐control studies, 11 observational cohort studies, and 19 cross‐sectional studies. Meta‐analysis will be performed to combine data from the studies, and sensitivity analysis will be performed to evaluate the effect of methodologic quality on the overall results. Tests of heterogeneity will be performed and the literature collected will be examined for evidence of publication bias.ConclusionWe expect that though children with HL may experience worse QOL than their normal hearing peers, hearing assistive devices, such as conventional hearing aids, bone‐anchored hearing aids, and cochlear implants, may provide QOL benefits to these children, above and beyond functional benefits.