bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of High-Speed Digital Imaging with Stroboscopy for Laryngeal Imaging of Glottal Disorders
Authors: Patel Rita , Dailey Seth , Bless Diane 
Published: October 2014

Objectives: High-speed digital imaging (HSDI), unlike stroboscopy, is a frequency-independent visualization technique that provides detailed biomechanical assessment of vocal physiology due to increased temporal resolution. The purpose of this study was to investigate the clinical value of HSDI compared to that of stroboscopy across 3 disorder groups classified as epithelial, subepithelial, and neurologic disorders. Methods: Judgments of vibratory features of vocal fold edge, glottal closure, phase closure, vertical level, vibratory amplitude, mucosal wave, phase symmetry, tissue pliability, and glottal cycle periodicity from 252 participants were performed by 3 experienced raters. Results: The results revealed that 63% of the data set was noninterpretable for assessment of vibratory function on stroboscopic analysis because of the severity of the voice disorder (100% of participants with severe voice disorders and 64% of participants with moderate voice disorders), whereas HSDI resulted in analysis of 100% of the data. The neuromuscular group (74%) was the most difficult to analyze with stroboscopy, followed by the epithelial (58%) and subepithelial groups (53%), secondary to the severity of hoarseness. Conclusions: Because it is desirable in clinical examination to observe vocal fold vibrations, which cannot be done in cases of severe dysphonia, HSDI may aid in clinical decision-making when patients exhibit values exceeding 0.87% jitter, 4.4% shimmer, and a signal-to-noise ratio of less than 15.4 dB on acoustic analysis. These measures could serve as minimal indications for use of HSDI. The data suggest that HSDI can be viewed as augmentative to stroboscopy, particularly in cases of moderate to severe aperiodicity, in which HSDI may aid clinical decision-making.
Collagen Injection as a Supplement to Arytenoid Adduction for Vocal Fold Paralysis
Authors: Kimura Miwako , Nito Takaharu , Imagawa Hiroshi , Tayama Niro , Chan Roger W. 
Published: October 2014

Objectives: Dysphonia associated with vocal fold paralysis can persist even after successful medialization procedures, including arytenoid adduction. It is hypothesized that laryngeal collagen injection could improve phonation following arytenoid adduction in selected patients. Our objective was to evaluate how collagen injection could result in measurable improvements in vocal function and voice quality. Methods: Forty patients with unilateral vocal fold paralysis who had undergone arytenoid adduction underwent transoral injection of non—cross-linked bovine dermal collagen by means of indirect laryngoscopy and a curved injection device. A control group of 40 patients underwent arytenoid adduction but not collagen injection. The patients' voice quality was assessed perceptually with the GRBAS scale, and vocal function was assessed by acoustic and aerodynamic measures (maximum phonation time and transglottal DC flow). The relative glottal area was also assessed by videostroboscopy. Results: Significant improvements in vocal function and voice quality were observed with collagen injection for those patients who did not achieve satisfactory glottal competence with arytenoid adduction alone. Glottal area measurements revealed that glottic insufficiency was significantly reduced after arytenoid adduction as well as after collagen injection. Conclusions: The findings suggest that collagen injection could be an effective supplementary treatment for improving voice following arytenoid adduction. It has the advantage of being a minimally invasive outpatient office procedure. The long-term efficacy of the procedure should be explored.
Assessment of Trends in Antimicrobial Resistance in Chronic Rhinosinusitis
Authors: Bhattacharyya Neil , Kepnes Lynn J. 
Published: October 2014

Objectives: We performed a cross-sectional review of a prospective database to determine the contemporary incidence and temporal patterns of antimicrobial resistance in chronic rhinosinusitis (CRS). Methods: A microbiological database was retrospectively reviewed to extract all endoscopically obtained paranasal sinus cultures from 2001 through 2005 in adult patients with CRS. The culture data were tabulated according to bacterial species and representative antibiotic resistances for methicillin, erythromycin, clindamycin, gentamicin, tetracycline, sulfamethoxazole, and levofloxacin. The data were analyzed to determine whether increasing rates of antibiotic resistance developed over the study years. Further analysis was conducted for methicillin-resistant Staphylococcus aureus (MRSA) species to determine prevalence trends and antibiotic resistance trends for MRSA versus other species. Results: We analyzed 701 bacterial isolates among 392 culture samples. Staphylococcus aureus was the most commonly isolated organism (19.0%). Antibiotic resistance significantly increased for erythromycin over the study (maximum resistance rate, 69.7% in 2005; p = .009), remained unchanged for methicillin, clindamycin, levofloxacin, and sulfamethoxazole (p = .366 to p = .397), and trended downward for gentamicin (p = .180) and tetracycline (p = .120). Nineteen percent of S aureus species were found to be MRSA, but MRSA-specific antibiotic resistance rates did not change over the course of the study (all p ≥ .222). In aggregate, MRSA species exhibited statistically significant higher rates of resistance to each antibiotic tested than did non-MRSA bacteria. Conclusions: Antibiotic resistance seems to be emerging for erythromycin at a rate higher than for other antibiotics. Although not increasing in prevalence, MRSA maintains a significant presence in CRS with associated increased levels of antibiotic resistance.
Regeneration of the Trachea Using a Bioengineered Scaffold with Adipose-Derived Stem Cells
Authors: Suzuki Teruhisa , Kobayashi Ken , Tada Yasuhiro , Suzuki Yukie , Wada Ikuo , Nakamura Tatuo , Omori Koichi 
Published: October 2014

Objectives: Our group has developed and clinically applied an artificial graft made from a collagen sponge scaffold for the regeneration of tracheal tissue. However, the artificial graft requires about 2 months for epithelial regeneration. The purpose of the present study was to accelerate the regeneration process of the trachea through the effective use of a bioengineered scaffold. Adipose-derived stem cells (ASCs) with multilineage differentiation capability were used. In our study, we implanted a bioengineered scaffold that included autologous ASCs into tracheal defects in rats. Methods: Collagen gel, including ASCs labeled with monomeric yellow fluorescent protein, was layered onto the surface of the collagen sponge to form a bioengineered scaffold. This scaffold was implanted into the tracheal defects in rats. A control scaffold without ASCs was also implanted. Results: On day 14 after implantation, a pseudostratified columnar epithelium with well-differentiated ciliated and goblet cells and neovascularization was observed in rats that received the implant with the bioengineered scaffold that included ASCs. Conclusions: These results suggested that implanted ASCs accelerated neovascularization and epithelialization on the regenerated trachea. Thus, our newly developed bioengineered scaffold contributes to tracheal regeneration.
Effect of Infliximab on Experimentally Induced Otitis Media in Rats
Authors: Lee Dong-Hee , Yeo Sang-Won , Chang Ki-Hong , Park So-Young , Oh Jeong-Hoon , Seo Jae-Hyun 
Published: October 2014

Objectives: We performed a prospective randomized and controlled animal study to investigate the effects of infliximab on experimental otitis media in rats. Methods: Seventy-two Sprague-Dawley rats were randomly allocated to 3 study groups and 1 control group. Infliximab was injected intravenously. Histopathologic changes were determined by hematoxylin-eosin staining. Fluorescence microscopy was performed to examine the leakage of the exudates. Vascular permeability was measured by the Evans blue dye technique. Results: In comparison with the control group, we found significant differences in the extent of middle ear mucosa without active inflammation and the presence of reparable lesions in all study groups treated with infliximab. A significant reduction of extravasated Evans blue dye in all study group animals was found as compared with the control group animals. Conclusions: This study suggests that the monoclonal tumor necrosis factor α antibody, infliximab, can reduce inflammatory activity in experimental otitis media in rats.
Hearing Impairment in Genotyped Wolfram Syndrome Patients
Authors: Plantinga Rutger F. , Pennings Ronald J. E. , Huygen Patrick L. M. , Bruno Rocco , Eller Philipp , Barrett Timothy G. , Vialettes Bernard , Paquis-Fluklinger Veronique , Lombardo Fortunato , Cremers W. R. J. 
Published: October 2014

Objectives: Wolfram syndrome is a progressive neurodegenerative syndrome characterized by the features “DIDMOAD” (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). We sought to study the audiometric data of genotyped Wolfram syndrome patients with sensorineural hearing impairment. Methods: Pure tone threshold data of 23 Wolfram syndrome patients were used for cross-sectional analysis in subgroups (age less than 16 years or between 19 and 25 years, gender, and origin). Results: All subgroups, with 1 exception, showed a fairly similar type of hearing impairment with, on average, thresholds of about 25 dB (range, 0 to 65 dB) at 0.25 to 1 kHz, gently sloping downward to about 60 dB (range, 25 to 95 dB) at 8 kHz. The subgroup of Dutch women, which was excluded from the calculations of the average hearing thresholds, showed a higher degree of hearing impairment. Only the latter subgroup showed progression; however, contrary to the previous longitudinal analysis, progression was not significant in the present cross-sectional analysis, presumably because of the high degree of cross-subject variability. Conclusions: This unique collection of audiometric data from genotyped Wolfram syndrome patients shows no substantial progression in sensorineural hearing impairment with advancing age, no relation to the types of WFS1 mutations identified, and, with exclusion of the subgroup of Dutch female patients, no significant sex-related differences.
Two Sites of Head and Neck Squamous Cell Carcinoma: Utility of Loss of Heterozygosity
Authors: Sharma Arun , Wayne Sigrid , Nikiforova Marina N. , Johnson Jonas T. , Walvekar Rohan R. 
Published: October 2014

Objectives: The prevalence of distant metastasis and second primary tumors is increasing with improved locoregional control in patients with head and neck squamous cell carcinoma. Traditionally, clinicopathologic evidence has been the gold standard used to distinguish distant metastasis from second primary tumors. We report a case in which loss of heterozygosity testing was used to clarify the clonal relationship between the 2 sites of head and neck squamous cell carcinoma. Methods: A patient with squamous cell carcinoma in the larynx and mandible underwent loss of heterozygosity testing. Results: The loss of heterozygosity testing confirmed that the mandibular cancer was a metastatic presentation of the laryngeal squamous cell carcinoma. Conclusions: We conclude that loss of heterozygosity testing can be useful in differentiating distant metastasis from second primary cancers in patients with 2 sites of head and neck squamous cell carcinoma, consequently providing important prognostic and staging information.
Preoperative Laryngeal Nerve Screening for Revision Anterior Cervical Spine Procedures
Authors: Paniello Randal C. , Martin-Bredahl Katherine J. , Henkener Lori J. , Riew K. Daniel 
Published: October 2014

Objectives: Anterior cervical spine procedures carry an inherent risk of recurrent laryngeal nerve (RLN) injury. Patients with persistent RLN paresis may be asymptomatic because of compensation from the opposite side. If such patients undergo an opposite-side anterior approach for revision surgery, they are at risk for a second RLN injury, creating the potential for bilateral vocal fold paresis and possible need for tracheotomy. A program of routine screening for laryngeal paresis was implemented for these patients. This retrospective study reviews the results of this screening process. Methods: Patients referred for preoperative laryngeal nerve screening were identified. Their charts were reviewed for the results of the videolaryngoscopic examination, and for any recommendations made based on the findings. Relevant history and other physical findings were recorded. Results: Fifty screening laryngeal examinations were performed in 47 patients, of whom 31 (66%) had previously undergone a single anterior cervical approach procedure, and 16 (34%) had undergone more than one. Thirteen of the examinations (26%) revealed abnormal laryngeal findings, including paresis or paralysis in 11 cases (22%), of which 5 were asymptomatic. The findings resulted in a recommendation of a cervical approach from the already-involved side. None of the revision procedures resulted in bilateral vocal fold paralysis. The risk of laryngeal nerve injury appears to increase as higher cervical levels are approached. Conclusions: Minimally symptomatic injuries of the laryngeal nerves from prior neck surgery create a potential serious risk of bilateral vocal fold paralysis with subsequent procedures. Preoperative laryngeal screening is a simple and effective method for reducing this risk.
Evaluation of Functional Recovery of Recurrent Laryngeal Nerve Using Transoral Laryngeal Bipolar Electromyography: A Rat Model
Authors: Tessema Belachew , Pitman Michael J. , Roark Rick M. , Berzofsky Craig , Sharma Sansar , Schaefer Steven D. 
Published: October 2014

Objectives: We developed a standardized method of minimally invasive transoral laryngeal (ToL) bipolar electromyography (EMG) for evaluation of recurrent laryngeal nerve (RLN) recovery after a controlled crush injury in a rat model. Methods: Ten 200- to 250-g Sprague-Dawley rats underwent a controlled crush injury to the left RLN performed with 60 seconds of use of a calibrated aneurysm clamp with a closing force of 0.61 N. Serial ToL bipolar EMG was performed on adductor muscles and the posterior criocoarytenoid muscle during spontaneous vocal fold motion under anesthesia. Each animal underwent ToL EMG immediately after surgery and 1, 3, and 6 weeks after surgery. Results: The EMG signals showed normal motor unit potentials and recruitment patterns 3 weeks after crush injury. Endoscopic evaluation of vocal fold mobility yielded consistently normal findings 6 weeks after crush injury. Conclusions: We have developed a standardized method of crush injury to the rat RLN model and a minimally invasive transoral bipolar spontaneous EMG technique to serially evaluate and follow nerve injury and recovery in rats. This model is intended to simulate intraoperative RLN injury, to elucidate the electrophysiological events that occur during nerve recovery, and to form the basis for studying agents to enhance such recovery.
Injection of Botulinum Toxin into External Laryngeal Muscles in Pediatric Laryngeal Paralysis
Authors: El-Hakim Hamdy 
Published: October 2014

Objectives: I undertook to demonstrate the effect of injecting botulinum toxin type A (BTA) into cricothyroid, sternothyroid, and sternohyoid muscles in cases of bilateral laryngeal paralysis (BLP). Tracheostomy remains the consistently reproducible and accepted method to salvage the airway obstruction in BLP. The bypass, however, acknowledges the current lack of knowledge and consensus on the pathogenesis. Methods: I performed a retrospective chart review of BLP cases treated with BTA in a tertiary care pediatric center. The injections were performed under direct vision through an open transcervical approach. The main outcome measures used were improvement of airway symptoms and endoscopic findings, tracheostomy requirement, and incidence of recovery of function. Results: In total, 24 patients with BLP were identified. Over a 2-year period, 7 patients were treated with BTA. Six patients had congenital idiopathic BLP. One of these had trisomy 7. One patient acquired the paralysis after cardiac surgery. No patients required a tracheostomy, except for the infant with trisomy 7. Six patients recovered function completely, and the seventh recovered it partially (range, 4 weeks to 12 months). Conclusions: Injection of BTA into external laryngeal muscles may be an alternative to tracheostomy in BLP. It is proposed that the toxin relaxes the glottic aperture by paralyzing the cricothyroid and strap muscles and that it may aid in appropriate reinnervation of the larynx via mechanisms beyond the neuromuscular junction.
Interleukin-10 is an Essential Modulator of Mucoid Metaplasia in a Mouse Otitis Media Model
Authors: Tsuchiya Katsuyuki , Komori Masahiro , Zheng Qing Yin , Ferrieri Patricia , Lin Jizhen 
Published: October 2014

Objectives: Inflammatory cytokines are involved in the development of mucous cell metaplasia and hyperplasia (MCM) in otitis media (OM). However, which cytokines play an essential role in the MCM of OM is not clear at the moment. Methods: In this study, we hypothesized that interleukin-10 (IL-10) played an indispensable role in the MCM of bacterial OM, and we used IL-10 knockout mice to test this hypothesis. Results: In wild-type mice, both Streptococcus pneumoniae and Haemophilus influenzae triggered the development of MCM in the middle ear mucosa. In IL-10 knockout mice, the number of goblet cells and mucin-producing cells in the middle ear was significantly reduced after bacterial middle ear infection compared with that in wild-type mice. Conclusions: We conclude that IL-10 plays an essential role in the MCM of bacterial OM. Interleukin-10 is a potential target for the treatment of MCM in OM.
Novel Technique for Peritonsillar Abscess Drainage
Authors: Chang Eugene Hanyoung , Hamilton Grant S. 
Published: October 2014

Objectives: We propose a novel technique for peritonsillar abscess (PTA) drainage in which the patient is lying in the Trendelenburg position. We provide evidence that this novel technique is relatively safe and effective in PTA drainage. Methods: We queried otolaryngology training programs in regard to techniques of PTA drainage after receiving Institutional Review Board approval. Respondents were asked to rate their own level of success in draining PTAs, as well as the perceived satisfaction and comfort of the patient. These were rated on a scale of 1 (never successful or comfortable) to 5 (always successful or comfortable). Results: We collected 138 responses. The respondents included residents (67%), faculty (30%), and medical students (3%). The overwhelming majority of respondents placed the patient in a seated position (97%); only 4 respondents used the Trendelenberg position. On average, physicians who drained PTAs in the Trendelenberg versus the seated position had a higher success rating (5 versus 4.37) and a higher patient comfort rating (4.75 versus 3.31). Conclusions: We propose a novel PTA drainage technique in which the patient is in the Trendelenburg position. We provide evidence that our technique is rarely used in otolaryngology, and provides success rates and patient comfort levels that are greater than those of the current standard of the seated position.
Incapacitating Unilateral Tinnitus in Single-Sided Deafness Treated by Cochlear Implantation
Authors: Van de Heyning Paul , Vermeire Katrien , Diebl Martina , Nopp Peter , Anderson Ilona , De Ridder Dirk 
Published: October 2014

Objectives: Tinnitus is a well-known, difficult-to-treat symptom of hearing loss. Users of cochlear implants (CIs) have reported a reduction in tinnitus following implantation for bilateral severe-to-profound deafness. This study assessed the effect of electrical stimulation via a CI on tinnitus in subjects with unilateral deafness and ipsilateral tinnitus who underwent implantation in an attempt to treat tinnitus with the CI. Methods: Twenty-one subjects who complained of severe intractable tinnitus that was unresponsive to treatment received a CI. Tinnitus loudness was measured with a Visual Analog Scale; loudness percepts were recorded with the device activated and deactivated. Tinnitus distress was measured with the Tinnitus Questionnaire before and after implantation. Results: Electrical stimulation via a CI resulted in a significant reduction in tinnitus loudness (mean ± SD; 1 year after implantation, 2.4 ± 1.8; 2 years after implantation, 2.5 ± 1.9; before implantation, 8.5 ± 1.3). With the device deactivated, tinnitus loudness was still reduced to between 6.1 and 7.0 over 24 months. The Tinnitus Questionnaire revealed a significant positive effect of CI stimulation. Conclusions: Unilateral tinnitus resulting from single-sided deafness can be treated with electrical stimulation via a CI. The outcomes of this pilot study demonstrate a new method for treatment of tinnitus in select subjects, perhaps an important new indication for cochlear implantation.
Dexmedetomidine Sedation for Laryngeal Framework Surgery
Authors: Jense Ryan J. , Souter Karen , Davies Jo , Romig Christopher , Panneerselvam Ashok , Maronian Nicole 
Published: October 2014

Objectives: Sedation for laryngeal framework surgery has lacked easy modulation between appropriate pain control, airway protection, and the alertness appropriate for vocal testing. Our objective was to determine whether dexmedetomidine hydrochloride could safely and effectively be used as the sole intravenous anesthetic agent in conjunction with local anesthesia for laryngeal framework procedures. Methods: We undertook a prospective review of 14 patients who underwent laryngeal framework surgery with dexmedetomidine anesthesia in 2004 and 2005. All dexmedetomidine doses, sedation levels, and vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation level, were recorded every 15 minutes by the anesthesiologist throughout the duration of the procedures. Operative conditions were noted by the surgeon, focusing special attention on airway protection, patient arousability, and patient comfort. Results: Dexmedetomidine sedation produced hemodynamic and respiratory values that were maintained near preoperative values, and overall pharyngeal-laryngeal integrity provided superior operating conditions for the patient and the operating surgeon. Conclusions: We believe that dexmedetomidine provides excellent sedative and operative conditions for awake laryngeal framework procedures. Coupled with local anesthesia, dexmedetomidine produced virtually no undesirable hemodynamic or respiratory effects, while allowing for adequate sedation the majority of the time. The operative conditions were markedly improved over those of previous standard monitored anesthesia regimens.