bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microbial Flora and Antibiotic Resistance in Peritonsillar Abscesses in Upstate New York
Authors: Plum Ann W. , Mortelliti Anthony J. , Walsh Ronald 
Published: September 2014

Objectives:(1) Identify the most common bacteria in peritonsillar abscesses over the past decade. (2) Identify the prevalence of antibiotic resistance of pathogens responsible for peritonsillar abscesses to guide initial antibiotic treatment.Methods:This is a retrospective chart review looking at adult and pediatric patients who presented to a single tertiary academic center in upstate New York from 2002 through 2012 and underwent either incision and drainage or quincy tonsillectomy for a peritonsillar abscess (n = 69), during which cultures of the abscess were obtained. Cultures from the abscess were reviewed for bacteria and antibiotic sensitivities. Patient medical records were reviewed for age, medical comorbidities, prior episodes, immune‐compromised state, type of drainage procedure done and complications, and whether more than one procedure was needed.Results:Of the peritonsillar abscesses, 62.32% were polymicrobial and 34.78% were monomicrobial. The most common pathogens were beta hemolytic streptococcus (31.88%), alpha hemolytic streptococcus (21.74%), Neisseria (14.49%), and Streptococcus milleri (13.04%). Staphylococus was resistant to oxacillin (25%), erythromycin (25%), clindamycin (12.5%), and penicillin (12.5%). Alpha hemolytic streptococcus was resistant to clindamycin (6.67%) and erythromycin (6.67%). Streptococcus milleri was resistant to clindamycin (11.11%) and erythromycin (11.11%).Conclusions:Peritonsillar abscesses are most commonly polymicrobial, with beta and alpha hemolytic streptococci, Neisseria, and S milleri as the most prevalent pathogens. In addition, antibiotic resistance to clindamycin and erythromycin is common across streptococcal strains and staphylococcal strains, and methicillin resistance is also common in staphylococcal strains responsible for peritonsillar abscesses.
Myringotomy Ear Simulation Model
Authors: Ker Liang , Ng Chew Lip , Austin Felix , Foo Delane 
Published: September 2014

Objectives:Myringotomy and ventilation tube insertion is a common otolaryngologic surgical procedure with a steep learning curve for residents. Incorrect placement of incisions and external ear canal trauma are common complications when residents begin learning the procedure. With increasingly conservative guidelines on indications of myringotomy tubes, residents have less opportunities to refine this skill on real patients. The objective is to create a learner‐centric myringotomy simulator.Methods:Although the concept of simulation training in myringotomy is not new, we aim to reduce the learning curve by introducing learner‐guided features on a simulation model. Some of these include landmarks such as the handle of malleus, the anterior inferior quadrant guide, and modified instruments as part of the simulation. Working with the National University of Singapore, Division of Industrial Design team, a 3‐dimensional library of different variants of ear models, including modified ear canals for teaching, was created. We created a platform to house the different components including an auricle, an external ear canal, and a disposable tympanic membrane with landmarks.Results:The model is accurate with realistic consistency to mimic soft tissues encountered in the myringotomy procedure. The simulator allows for variance in anatomy between the side of the ear and also between adult and pediatric sizes.Conclusions:Our model can be used to train otolaryngology residents and will be employed as a proof‐of‐concept model for the purpose of simulation training.
A Randomized Controlled Trial Protocol for GeloRevoice Throat Lozenges as Adjunctive Analgesic in Post‐tonsillectomy Pain
Authors: Liu Zi Wei , Meghji Sheneen , Jayaraj Samuel 
Published: September 2014

Objectives:There has been recent controversy with regard to optimal postoperative pain control for tonsillectomy. Codeine is no longer recommended for children under the age of 12 years because of the risk of respiratory depression. Hence, identifying alternative/adjunct analgesia for post‐tonsillectomy pain is a high clinical priority. This is a protocol for a randomized controlled trial. The primary objective is to determine whether GeloRevoice throat lozenges (contain sodium hyaluronate) are effective as adjunct therapy to standard analgesia (paracetamol, ibuprofen, difflam spray) in post‐tonsillectomy pain.Methods:A total of 72 patients were randomized to 2 groups. Parents with children aged 6 to 18 years undergoing tonsillectomy were approached to participate in the study. The intervention group received GeloRevoice throat lozenges and the control group received a placebo. The study was subject to trust research and audit and safety reporting procedures, and ethical approval was applied for.Results:The primary endpoint was a pain score using a visual analog scale for pediatric populations. Pain scores were recorded on a diary card daily for 1 week postoperatively. Visual analog scale data were compared between 2 groups using a 2‐tailed t test where P <. 05 was considered to be statistically significant.Conclusions:This double‐blinded randomized controlled trial provides evidence on the safety and efficacy of GeloRevoice throat lozenges when used as adjunctive analgesia for post‐tonsillectomy pain.
Readability Assessment of Online Tracheostomy Care Resources
Authors: Hu Amanda , Kong Keonho (Albert) 
Published: September 2014

Objectives:(1) Assess the readability of online tracheostomy care resources. (2) Compare the readability of major versus minor websites and patient‐ versus professional‐oriented resources.Methods:A Google search was performed for “Tracheostomy care” in January 2014. The top fifty results were categorized into major versus minor websites, and patient‐ versus professional‐oriented resources. These websites were evaluated with the following readability tools: Flesch Reading Ease Score (FRES), Flesch‐Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (GFOG).Results:Readability scores for the 50 websites were FRES 57.21 ± 16.71 (possible range = 0 to 100), FKGL 8.33 ± 2.84 (possible range = 3 to 12), SMOG 11.25 ± 2.49 (possible range = 3 to 19), and GFOG 11.43 ± 4.07 (possible range = 3 to 19). There was no significant difference in all 4 readability scores between major (n = 41) and minor (n = 9) websites. Professional‐oriented websites (n = 19) had the following readability scores: FRES 40.77 ± 11.69, FKGL 10.93 ± 2.48, SMOG 13.29 ± 2.32, and GFOG 14.91 ± 3.98. Patient‐oriented websites (n = 31) had the following readability scores: FRES 67.29 ± 9.91, FKGL 6.73 ± 1.61, SMOG 10.01 ± 1.64, and GFOG scores 9.30 ± 2.27. Professional‐oriented websites had more difficult readability scores than patient‐oriented websites for FRES (P <. 00), FKGL (P <. 00), SMOG (P <. 00), and GFOG scores (P <. 00).Conclusions:Online tracheostomy care resources were written at a level more difficult than the recommended fourth‐ to sixth‐grade level for written health information. There was no significant difference in readability between major and minor websites. Professional‐oriented websites were more difficult to read than patient‐oriented websites.
Relation between Different Stages of Oral Cancer and Aberrant Methylation in Taiwan: Preliminary Report
Authors: Liu Chih‐Hsien , Wang Wen‐Hung , Wang Pa‐Chun , Lin Jia‐Cheng , Liu Fu‐Guo R. 
Published: September 2014

Objectives:During the past decade, oral cancer has become the fourth cause of death in Taiwan. After receiving treatment at the early stages of oral cancer (stage I and stage II), the 5‐year survival rate is up to 81.9%. However, as soon as cancer cells spread to the neighboring tissues accompanied with lymph node metastasis in the neck (stage III and stage IV), the 5‐year survival rate drops to 23‐25%. This indicates the importance of the early detection of carcinogenesis to high survival rate. Aberrant methylation in promoter regions of certain genes has long been noticed and evidenced as strongly correlative to carcinogenesis.Methods:The tissue samples were obtained from the patients of one medical center, and the tissue was divided into 3 parts: tumor, nearby tissue, and further (normal) tissue. Then, the tissue was deposited in liquid nitrogen for DNA and RNA extractions. Patient data were collected including age, sex, risk factors (alcohol/betelnut/cigarette use), clinical and pathological stage, and operation.Results:This study investigates the aberrant methylation level on seven genes, E‐cadherin, cyclinA1, cytoglobin, IGF2, MGMT, P16, and RARβ, in tissue samples of oral cancer.Conclusions:By means of the high sensitivity and accuracy technology, pyrosequencing, the methylation profiles of studied genes should be able to provide insight and evaluation of biomarkers of aberrant methylation in carcinogenesis.
Robot‐Assisted Sialolithotomy with Sialoendoscopy: A Novel Approach to Management of Large Submandibular Gland Stones
Authors: Razavi Christopher , Paschalis Celine , Samara Ghassan J. , Maroon Mark 
Published: September 2014

Objectives:(1) Describe robot‐assisted sialolithotomy with sialoendoscopy (RASS) for the management of large submandibular gland (SMG) stones. (2) Analyze symptom recurrence and lingual nerve damage following RASS in comparison to the combined transoral sialoendoscopic approach (CTA).Methods:A retrospective case series was performed on patients with large palpable SMG stones managed with RASS. Large stones were defined as >4 mm, the upper limit that can be removed via sialoendoscopy. Fourteen patients who presented between October 2012 and January 2014 with mean stone size of 11.9 mm were identified. Patients were questioned regarding symptom recurrence, symptoms of lingual nerve damage, and procedural satisfaction at mean follow‐up of 8 months. Procedural success was defined as absence of symptom recurrence in conjunction with gland preservation. These measures were compared to reported outcomes with CTA in the English literature.Results:Procedural success was 100% (14/14) for our series. No patients reported symptoms of lingual nerve damage at the time of follow‐up, while 2 patients reported transient lingual nerve paresthesia (mean duration 2.5 weeks). Mean patient satisfaction was 9.8 on a scale of 10. Literature review identified 137 patients who underwent CTA for large SMG stones between 2005‐2011. Procedural success rate for these patients was 75%. When commented on, lingual nerve damage was reported in 2% of patients.Conclusions:Preliminary data in management of large SMG stones with RASS shows improved procedural success in comparison to CTA. Furthermore, the morbidity of lingual nerve damage seen in CTA has yet to be encountered with RASS, likely due to improved visualization.
The Role of Psychological Factors in Burning Mouth Syndrome
Authors: Lee Yun Jae , Kwak Min K. , Ji Yong Bae , Song Chang Myeon , Lee Seung Hwan , Park Chul Won , Tae Kyung 
Published: September 2014

Objectives:Burning mouth syndrome (BMS) is characterized as a burning sensation in the mouth without definite oral pathology. Although BMS is not uncommon, the etiology and psychological profiles are not well established. The aim of this study is to evaluate the role of psychological factors in BMS patients.Methods:We prospectively compared the psychiatric symptoms using Symptom Checklist‐90‐Revised questionnaire (SCL‐90‐R) in 50 patients diagnosed with BMS and 52 controls who had no oral and pharyngeal disease from December 2012 to June 2013.Results:The mean age (56.8 vs 52.8 years, P =. 18) and male to female ratio (42% vs 46%, P =. 95) did not differ between the 2 groups. Somatization, obsessive‐compulsive, depression, anxiety, phobic anxiety, and psychoticism scores of SCL‐90‐R were significantly higher in the BMS group than in the control group (P <. 05). In the subgroup analysis according to sex, the male group showed similar patterns, whereas the BMS group showed higher somatization, anxiety, phobic anxiety, and psychoticism scores than the control group in the female group analysis. The psychiatric symptoms of SCL‐90‐R did not correlate with sex, age, and duration of symptoms in the BMS group. Comorbid disease such as hypertension, diabetes, rheumatoid disorder, or chronic hepatitis in BMS patients was significantly associated with higher somatization and obsessive‐compulsive scores compared with BMS patients without comorbidity.Conclusions:Based on the results of this study, it is suggested that psychosomatic factors may contribute to the development of BMS.
Sea‐Surface Simulator Device to Detect Motion Sickness Disease in Naval Personnel
Authors: Gurpinar Berk 
Published: September 2014

Objectives:This study aims to introduce a device, which has been widely used to train the personnel recruited for naval missions in frigates, used as a motion sickness detector in our study. We also compared the findings of the motion sickness patients to the normal population.Methods:Thirty adult male personnel were included. Sea intensity between level 1 and level 5 was simulated, and the parasympathetic and physical findings of the personnel were recorded.Results:The mean age was 22.6 ± 3.4. During level 2 intensity, 4 personnel (13.33%); level 3, 5 personnel (16.66%); level 4, 12 personnel (40%); and level 5, 9 personnel (30%) demonstrated motion sickness symptoms.Conclusions:Besides training purposes, these simulators could be helpful to identify motion sickness disease in the targeted personnel before naval missions.
Transoral Submandibular Gland Excision: A Review of 43 Patients
Authors: Fisher Michelle , Segel Jamie M. , Groves Michael , Brown Jimmy J. 
Published: September 2014

Objectives:(1) Review our experience with trans‐oral excision of the submandibular gland. (2) Compare outcomes of the transoral approach with the traditional transcervical approach.Methods:A retrospective chart review of prospectively collected data. Forty‐three patients with benign submandibular gland pathology who underwent trans‐oral excision of the submandibular gland from 2007‐2013 were identified. Data pertaining to patient demographics, conversion to open approach, recurrence of disease, length of operative procedure, length of hospital stay, and incidence of neurologic complications were collected.Results:Forty‐three patients underwent transoral excision of the submandibular gland over a 6‐year period. Of the 43 procedures performed, 1 transoral case required conversion to an open procedure, and therefore 98.6% of patients avoided a neck scar. Thirty‐four out of 42 (80%) of patients reported transient tongue parasthesias. No patient experienced hypoglossal or facial nerve dysfunction.Conclusions:Transoral submandibular gland excision is a safe and effective procedure. The approach allows for avoidance of an unsightly neck scar as well as lower rates of injury to the lingual, hypoglossal, and facial nerves when compared to a transcervical operation. This should become a routine part of the surgical armamentarium of the well‐trained otolaryngologist.
Comparative Finite‐Element Analysis for Defect Reconstruction with Rhomboid Flaps
Authors: Syamal Mausumi N. , Lovald Scott , Ochoa Jorge A. , Ghanem Tamer Abdel‐Halim 
Published: September 2014

Objectives:To view the utility of comparative 2D finite element analysis (FEA) of rhomboid flap models in analyzing how varying skin stiffness and directionality affects closure of a facial defect.Methods:Two‐dimensional (2D) finite element models based on prior validated 2D. Nonlinear hyperelastic human skin models of rhomboid surgical flaps were parameterized for reconstruction of a 2 × 2 cm facial defect. Skin stiffness and directionality were varied to simulate several real‐patient factors such as age, radiation, sex, etc. ANSYS 12.1 was used to compute the stress/strain and reaction force results.Results:The challenges of defect closure often include intrinsic factors of a patient's skin. As skin stiffness and directionality vary, the stress/strain patterns vary accordingly. FEA gives surgeons the ability to visually see how certain patient‐specific skin factors affect closure of a defect, allowing for anticipation of challenges such as dog‐earing or high strain fields near critical structures (eye, ear, and hairline).Conclusions:The utility of finite element models for analyzing and planning pre‐surgical endeavors has been well‐documented. Our study is the first of its kind for comparative surgical planning for varying skin conditions.
3D Assessment of Tongue Volume after Free Flap Reconstruction: Validation of Technique
Authors: Jeffery Caroline C. , Constantinescu Gabriela , O'Connell Daniel A. , Harris Jeffrey R. , Seikaly Hadi , Cote David 
Published: September 2014

Objectives:Use 3‐dimensional volumetric analysis of postoperative computed tomography (CT) scans to characterize tongue volume and correlate measured values with swallowing function.Methods:Retrospective chart review of prospectively collected data. Fifteen patients treated with surgical resection and free flap reconstruction of the oral and base of tongue with or without postoperative irradiation between 2010 to 2012 were included in the study. Mimics program was used to obtain measurements of the oral tongue and tongue base volume, tongue base to oropharyngeal volume ratio, and tongue base to posterior pharyngeal wall distance by analyzing the postoperative 6‐month and 1‐year CT scans. Prospectively collected functional outcomes data, including aspiration/penetration score, perceptual evaluation of intelligibility, and G‐tube dependence rates, were evaluated and correlated with dimensional analysis measures.Results:Adequate but not excessive tongue base volume correlated with reduced aspiration/penetration score and improved speech intelligibility. Oral tongue volume did not correlate with functional outcomes. Overall G‐tube dependence rate was low in this cohort (13.3%).Conclusions:Three‐dimensional analysis of tongue volume can be used to help predict postoperative swallowing outcomes.
4D‐CT for Localization of Nonlocalizing Parathyroid Adenomas in Primary Hyperparathyroidism
Authors: Hobbs Bradley A. , Fitzgerald Ryan , Bodenner Donald L. , Stack Brendan C. 
Published: September 2014

Objectives:(1) Present the application of 4‐dimensional (4D) computed tomography (CT) in preoperative localization of parathyroid adenomas that do not localize with technetium‐99 (Tc‐99) single‐photon emission computed tomography (SPECT)/CT or ultrasound. (2) Present indications for 4D‐CT use. (3) Understand radiologic dosimetry issues of 4D‐CT.Methods:A retrospective review of over 15 consecutive patients at an academic medical center with primary hyperparathyroidism who underwent preoperative 4D‐CT after nonlocalizing preoperative ultrasound and Tc‐99 SPECT‐CT scans between November 2013 and June 2014. This was a mixture of patients presenting for their first operations and others requiring revision surgery. Intraoperative radioguided parathyroidectomy results, excised gland weight, patient demographics, and parathyroid hormone levels were recorded. Sensitivity, specificity, and positive and negative predictive values of 4D‐CT for preoperative adenoma localization were calculated.Results:4D‐CT resulted in successful localization and biochemical cure in all primary or revision cases in which it was utilized. Radiation doses from 4D‐CT will be presented and compared to radiologic dosimetry from SPECT‐CT.Conclusions:4D‐CT offers a sensitive and specific modality for preoperative parathyroid adenoma localization which is useful in cases where ultrasound and SPECT‐CT sestamibi are nonlocalizing.
Analysis of Predisposing Factor for Pharyngocutaneous Fistula in Laryngeal Carcinoma Patients
Authors: Kong Hong , Wang Yanli , Zheng Jun , Zhang Xuhe 
Published: September 2014

Objectives:Pharyngeal fistula is the most common and troublesome postoperative complication after surgery of larynx, lower pharynx, and cervical esophagus carcinoma. This study aims to identify (1) the potential predisposing factors of pharyngeal fistula in laryngeal carcinoma patients after laryngectomy and (2) how nutritional support during treatment would contribute to improve prognosis.Methods:Retrospective review of 156 consecutive cases of laryngeal carcinoma patients who underwent laryngectomy from 2011 to 2013 at China‐Japan Union Hospital, Jilin University. Nutritional support and other potential predisposing factors were analyzed between patients with and without pharyngeal fistula.Results:Among the 156 cases studied, 6.4% of patients demonstrated postoperative pharyngeal fistula. Many predisposing factors showed statistical significance (P <. 05 or P <. 001) in this study, such as smoking history (P <. 05), neck dissection (P <. 001), duration of operation (P <. 05), postoperative serum albumin/total protein level (P <. 001and P <. 001, respectively), and body weight change after surgery (P <. 05). Other factors, such as age, sex, hemoglobin level, tumor stage, surgical option, and hypertension, did not show any statistical significance. Furthermore, patients with malnutrition have much higher risk of developing pharyngeal fistula.Conclusions:The occurrence of pharyngeal fistula in laryngeal carcinoma patients is highly associated with the duration of smoking, neck dissection, duration of operation, postoperative serum albumin/total protein level, and body weight change. By optimizing the patients’ general preoperation conditions and synchronous nutritional support, it would largely enhance the therapeutic response, reduce incidence, and improve prognosis.
Audit of Patients Undergoing Thyroid Surgery in an Attempt to Improve the Standard of Care
Authors: Farboud Amir , Chandra‐Mohan Alagar 
Published: September 2014

Objectives:Improve the standard of care for patients undergoing thyroid surgery. Recognized complications include hypocalcemia and recurrent laryngeal nerve (RLN) damage. We aimed to review our practice and improve it by adhering to the criteria set out by the National Institute of Clinical Excellence (NICE).Methods:Retrospective audit looking at patients undergoing thyroid surgery over a 6‐month period (09/2012). Pro forma methods were used to establish the adequacy of documentation including the use of nerve monitoring equipment, identification and stimulation of the RLN, and the recording of pre‐ and postoperative vocal cord checks (n = 18). Retrospective re‐audit after recommendations to complete the loop (n = 8) over a 4‐month period.Results:The first part of the audit cycle identified haphazard management of calcium levels in the postoperative period, incomplete documentation of vocal cord checks, and RLN identification and testing during surgery. Recommendations and guidance to staff, as well as a revised protocol on calcium management, resulted in improved care overall following re‐audit. In part 2 of the audit cycle; only 1 patient became hypocalcemic in the postoperative period and was managed successfully following the protocol. RLN detection, testing, and monitoring were documented in all patients. The 2nd loop showed that all patients were receiving documented RLN identification and stimulation intraoperatively; all patients had documented pre‐ and postoperative cord checks and use of a nerve monitor (n=10).Conclusions:The audit shows we were able to meet the criteria set out by NICE.