bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Canine Vocal Fold Function after Injection of a New Biomaterial Designed to Treat Phonatory Mucosal Scarring
Authors: Karajanagi Sandeep S. , Lopez-Guerra Gerardo , Park Hyoungshin , Kobler James B. , Galindo Marilyn , Aanestad Jon , Mehta Daryush D. , Kumai Yoshihiko , Giordano Nicholas , d'Almeida Anthony , Heaton James T. , Langer Robert , Herrera Victoria L. M. , Faquin William , Hillman Robert E. , Zeitels Steven M. 
Published: October 2014

Objectives: Most cases of irresolvable hoarseness are due to deficiencies in the pliability and volume of the superficial lamina propria of the phonatory mucosa. By using a US Food and Drug Administration–approved polymer, polyethylene glycol (PEG), we created a novel hydrogel (PEG30) and investigated its effects on multiple vocal fold structural and functional parameters. Methods: We injected PEG30 unilaterally into 16 normal canine vocal folds with survival times of 1 to 4 months. High-speed videos of vocal fold vibration, induced by intratracheal airflow, and phonation threshold pressures were recorded at 4 time points per subject. Three-dimensional reconstruction analysis of 11.7 T magnetic resonance images and histologic analysis identified 3 cases wherein PEG30 injections were the most superficial, so as to maximally impact vibratory function. These cases were subjected to in-depth analyses. Results: High-speed video analysis of the 3 selected cases showed minimal to no reduction in the maximum vibratory amplitudes of vocal folds injected with PEG30 compared to the non-injected, contralateral vocal fold. All PEG30-injected vocal folds displayed mucosal wave activity with low average phonation threshold pressures. No significant inflammation was observed on microlaryngoscopic examination. Magnetic resonance imaging and histologic analyses revealed time-dependent resorption of the PEG30 hydrogel by phagocytosis with minimal tissue reaction or fibrosis. Conclusions: The PEG30 hydrogel is a promising biocompatible candidate biomaterial to restore form and function to deficient phonatory mucosa, while not mechanically impeding residual endogenous superficial lamina propria.
Activation of the Transforming Growth Factor Beta Pathway in Bacterial Otitis Media
Authors: Lee Yun-Woo , Chung Yunju , Juhn Steven K. , Kim Youngki , Lin Jizhen 
Published: October 2014

Objectives: Granulation tissue is common in otitis media (OM), yet little is known about the signaling pathways in the formation of granulation tissue in response to infections. In this study, we sought to investigate the activation of the transforming growth factor beta (TGF-β) signaling pathway in the formation of granulation tissue in response to middle ear pathogens. Methods: Rat OM models were made by inoculating pneumococcus type 6A or nontypeable Haemophilus influenzae into the middle ear cavity or by obstructing the eustachian tube. Various pathway activities in the middle ear mucosa were analyzed with microarrays. Results: The TGF-β signaling pathway was highly regulated in the middle ear cleft with bacterial OM, but not in the ears with eustachian tube obstruction. In ears with bacterial OM, the TGF-β signaling pathway products were higher in Haemophilus-infected ears than in pneumococcus-infected ears. Conclusions: Bacterial OM triggers granulation tissue to thrive in the middle ear cleft of rats. Nontypeable H influenzae is more potent than pneumococcus type 6A in the formation of granulation tissue. Eustachian tube obstruction alone did not contribute to granulation tissue formation in the middle ear.
Prevalence of Insomnia and Impact on Quality of Life among Community Elderly Subjects with Tinnitus
Authors: Lasisi Akeem O. , Gureje Oye 
Published: October 2014

Objectives: We sought to determine the prevalence of insomnia and its impact on the quality of life (QoL) among community elderly subjects (at least 65 years of age) with subjective tinnitus. Methods: After household selection with multistage stratified area probability sampling, face-to-face interviews were used to obtain self-reports of subjective tinnitus and insomnia, and QoL was assessed with the WHOQoL-Bref instrument. Results: Among 1,302 elderly subjects, there were 183 subjects (109 female and 74 male) with tinnitus. Among those with tinnitus, insomnia was encountered in 95 (51.9%) and was found to be significantly more common among those with tinnitus than among those without (378 of 1,119, or 33.8%; p = 0.002). The insomnia symptoms included difficulty in maintaining sleep in 73.4% of subjects, difficulty in falling asleep in 70.0%, early morning wakefulness in 64.3%, non-restorative sleep in 35.1%, and daytime sleepiness in 34.7%. Univariate analysis revealed difficulty with falling asleep (p = 0.01) and early morning wakefulness (p = 0.05) to be significantly associated with tinnitus among the symptoms. Student's t-test and logistic regression analysis revealed significant deterioration in the total QoL and in the physical, psychological, social, and environmental QoL domains among elderly subjects who had tinnitus with insomnia as compared with those without insomnia. Conclusions: We believe that insomnia is significantly more common among elderly subjects with tinnitus than among those without, and that its presence further depreciates the QoL in these elderly individuals.
Potential Nerve Damage following Contact with a Piezoelectric Device
Authors: Salami Angelo , Mora Renzo , Crippa Barbara , Gentile Raffaella , Dellepiane Massimo , Guastini Luca 
Published: October 2014

Objectives: The aim of the study was to assess the extent of the potential nerve damage following prolonged contact with a piezoelectric device. Methods: The study was conducted with 30 patients; all of the patients had cervical metastatic lymph nodes at levels II, III, and IV (N2b) and a negative evaluation for metastatic disease (M0). The patients underwent radical neck dissection. After its skeletonization, the spinal nerve was exposed directly to ultrasonic activation with a piezoelectric device for various times (5, 10, and 20 seconds) and with different inserts (OP3 insert and OT7 insert). The axonal damage was graded from 0 to 3 as follows: 0, no damage; 1, minor axonal damage; 2, severe axonal damage but not covering the entirety of the nerve fascicles; 3, severe axonal damage covering the entirety of the nerve fascicles. Results: Histologic examination showed no evidence of damage to the perineurium and axons after 5 and 10 seconds of exposure to ultrasonic activation with each insert. Conclusions: Our histologic data highlight the selective action of the piezoelectric device, which reduces the risk of accidental nerve damage in otolaryngological bone surgery.
Olfactory Ensheathing Cells in a Rat Model of Laryngeal Reinnervation
Authors: de Corgnol Anne-Christine , Guérout Nicolas , Duclos Célia , Vérin Eric , Marie Jean-Paul 
Published: October 2014

Objectives: Olfactory ensheathing cells have been used successfully for recovery of nervous system lesions. The aim of our study was to determine whether olfactory ensheathing cells from the olfactory bulb or olfactory mucosa were able to improve functional recovery in a laryngeal reinnervation animal model. Methods: Fifty-nine rats were divided into 6 groups. A group without nerve section (group 1; n = 10) and a group without anastomosis (group 2; n = 11) served as controls. Right vagus nerve section and immediate anastomosis (nonselective reinnervation) was performed in 4 other groups, as follows. In group 3 (n = 10), there was selective reinnervation without any addition of substance; groups 4 (n = 10), 5 (n = 10), and 6 (n = 8) received, on the section and anastomosis site, and at the same time, cultivated olfactory bulb, cultivated olfactory mucosa, and noncultivated olfactory mucosa from inbred rats, respectively. Three months later, videolaryngoscopy with vocal fold movement measurements, electromyography, and histologic examination were performed. Results: The best right vocal fold angular movement (3.05° ± 1.14°) was observed in group 5 with cultivated olfactory mucosa, versus group 3 (–0.28° ± 1.51°; p = 0.06). The relative angular vocal fold movement was better in group 5 (p = 0.05). The mobility score was 0.6 ± 0.27 for group 3 and 1.4 ± 0.31 for group 5 (p = 0.07). Less synkinesis was observed in the reinnervated groups with cell addition, particularly with noncultivated olfactory mucosa (group 6; p = 0.05). Conclusions: Olfactory ensheathing cells obtained from olfactory mucosa cultures seem to improve functional laryngeal reinnervation in a rat model of nonselective vagus nerve section and anastomosis.
Long-Term Effects of Hearing Aids on Word Recognition Scores
Authors: Song James E. , Tanaka Sara M. , Pinto Jayant M. , Rasmussen Beth , Ferro Lia M. , Saadia-Redleaf Miriam I. 
Published: October 2014

Objectives: The purpose of this study was to retrospectively examine how monaurally fitted hearing aids affected word recognition scores in patients with bilateral symmetric sensorineural hearing loss. Methods: Sixty-six patients from 2 separate institutions were included in this study. In addition to having bilateral symmetric sensorineural hearing loss due to presbycusis, each patient had to have worn a single hearing aid for at least 5 months and have valid pre-aid and post-aid audiograms. Word recognition scores were analyzed with a table of confidence levels generated by Thornton and Raffin that determined the probability of differences between word recognition scores. Results: Hearing aids did not improve or preserve word recognition scores to the degree that has been previously reported in the literature. The unaided (control) ear demonstrated a decrease in word recognition scores over time, as was expected from previous studies. The aided ears demonstrated a similar decline in word recognition scores when compared to the unaided ears. When the conventional confidence level of 0.05 was used, the aided ears showed no advantage over the unaided (control) ears. Conclusions: These findings are not consistent with the acclimatization first reported by Silman et al in 1993. Such a discrepancy in the results calls for further studies to evaluate just how effective unilateral hearing aids are in patients with bilateral symmetric sensorineural hearing loss.
Effect of Type I Tympanoplasty on the Quality of Life of Children
Authors: Habesoglu Tulay Erden , Habesoglu Mehmet , Deveci Ildem , Kulekci Semra , Kalaycik Cigdem , Gokceer Tanju , Egeli Erol 
Published: October 2014

Objectives: Quality-of-life issues related to chronic otitis media (COM) include physical symptoms, emotional symptoms, hearing loss, speech symptoms, social symptoms, and parents' emotional symptoms. In this study we evaluated the effects of tympanoplasty on the quality of life of pediatric patients. Methods: In a questionnaire-based outcome study, we reviewed 56 of 78 pediatric patients with COM who were treated with type I tympanoplasty at our institution between December 2008 and February 2010. All patients were asked to fill out the COM-5 questionnaire with their parents, before operation and 6 months after operation. Preoperative and postoperative total ear scores, preoperative and postoperative ear scores with an intact tympanic membrane, preoperative and postoperative ear scores with a perforated tympanic membrane, and preoperative and postoperative audiological results were assessed. Results: After type I tympanoplasty, 45 patients (80.3%) had successful closure of the tympanic membrane, but 11 patients (19.7%) had unsuccessful closure of the tympanic membrane. There was a significant decrease in physical suffering, hearing loss, emotional distress, activity limitations, and caregiver's concerns scores in patients with intact tympanic membranes after operation (p < 0.01). Conclusions: Children with COM had a significant increase in their quality of life after successful tympanoplasty. Our results also suggested that tympanoplasty was successful in pediatric patients with COM.
Incremental Health Care Utilization and Expenditures for Chronic Rhinosinusitis in the United States
Authors: Bhattacharyya Neil 
Published: October 2014

Objectives: I determined incremental increases in health care expenditures and utilization associated with chronic rhinosinusitis (CRS). Methods: Patients with a reported diagnosis of CRS were extracted from the 2007 Medical Expenditure Panel Survey medical conditions file and linked to the consolidated expenditures file. The patients with CRS were then compared to patients without CRS to determine differences in health care utilization (office visits, emergency facility visits, and prescriptions filled), as well as differences in health care expenditures (total health care costs, office visit costs, prescription medication costs, and self-expenditures) by use of demographically adjusted and comorbidity-adjusted multivariate models. Results: An estimated 11.1 ± 0.48 million adult patients reported having CRS in 2007 (4.9% ± 0.2% of the US population). The additional incremental health care utilizations associated with CRS relative to patients without CRS for office visits, emergency facility visits, and number of prescriptions filled were 3.45 ± 0.42, 0.09 ± 0.03, and 5.5 ± 0.8, respectively (all p ≥ 0.001). Similarly, additional health care expenditures associated with CRS for total health care expenses, office-based expenditures, prescription expenditures, and self-expenditures were $772 ± $300, $346 ± $130, $397 ± $88, and $90 ± $24, respectively (all p ≥ 0.01). Conclusions: Chronic rhinosinusitis is associated with a substantial incremental increase in health care utilization and expenditures due to increases in office-based and prescription expenditures. The national health care costs of CRS remain very high, at an estimated $8.6 billion per year.
Melatonin: Can it Stop the Ringing?
Authors: Hurtuk Agnes , Dome Claudia , Holloman Christopher H. , Wolfe Kelly , Welling D. Bradley , Dodson Edward E. , Jacob Abraham 
Published: October 2014

Objectives: We sought to report the efficacy of oral melatonin as treatment for chronic tinnitus and to determine whether particular subsets of tinnitus patients have greater benefit from melatonin therapy than others. Methods: This was a prospective, randomized, double-blind, crossover clinical trial in an ambulatory tertiary referral otology and neurotology practice. Adults with chronic tinnitus were randomized to 3 mg melatonin or placebo nightly for 30 days followed by a 1-month washout period. Each group then crossed into the opposite treatment arm for 30 days. The tests audiometric tinnitus matching (TM), Tinnitus Severity Index (TSI), Self Rated Tinnitus (SRT), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI) were administered at the outset and every 30 days thereafter to assess the effects of each intervention. Results: A total of 61 subjects completed the study. A significantly greater decrease in TM and SRT scores (p < 0.05) from baseline was observed after treatment with melatonin relative to the effect observed with placebo. Male gender, bilateral tinnitus, noise exposure, no prior tinnitus treatment, absence of depression and/or anxiety at baseline, and greater pretreatment TSI scores were associated with a positive response to melatonin. Absence of depression and/or anxiety at baseline, greater pretreatment TSI scores, and greater pretreatment SRT scores were found to be positively associated with greater likelihood of improvement in both tinnitus and sleep with use of melatonin (p < 0.05). Conclusions: Melatonin is associated with a statistically significant decrease in tinnitus intensity and improved sleep quality in patients with chronic tinnitus. Melatonin is most effective in men, those without a history of depression, those who have not undergone prior tinnitus treatments, those with more severe and bilateral tinnitus, and those with a history of noise exposure.
Are Postural Restrictions Necessary for Management of Posterior Canal Benign Paroxysmal Positional Vertigo?
Authors: De Stefano Alessandro , Dispenza Francesco , Citraro Leonardo , Petrucci Anna Grazia , Di Giovanni Pamela , Kulamarva Gautham , Mathur Navneet , Croce Adelchi 
Published: October 2014

Objectives: An important component of management of benign paroxysmal positional vertigo (BPPV) has been the application of postural restrictions after use of a canalith repositioning maneuver (CRM) to prevent the return of otolithic debris into the posterior semicircular canal (PSC). This study was designed to explore the effectiveness of postural restrictions in patients with BPPV caused by otolithic debris in the PSC. Methods: Seventy-four adult patients with unilateral PSC BPPV were enrolled into this study. All patients were managed with a CRM — Either the modified Epley maneuver or the Semont maneuver. The patients were divided randomly into 2 groups: Group A, with postural restrictions, and group B, without postural restrictions. The statistical analysis was performed with χ2 tests and t-tests. Results: No patients in either group showed positional nystagmus in the posttreatment evaluation under infrared videonys-tagmoscopy. No patients had symptoms of vertigo after the therapy. The results of follow-up vestibular tests were normal in both groups. Conclusions: In our experience, postural restrictions do not enhance the beneficial effect of the CRMs. They do not seem to have any protective role and therefore should not be recommended as an adjunct to the treatment of PSC BPPV.
Removal of Tracheobronchial Foreign Bodies via Suspension Laryngoscope and Hopkins Telescope in Infants
Authors: Lei Wen-Bin , Su Zhen-Zhong , Zhu Xiao-Lin , Xiong Guan-Xia , Chai Li-Ping , Chen De-Hua , Chen Feng-Hong , Feng Xia , Liu Ke-Xuan , Wen Wei-Ping 
Published: October 2014

Objectives: Tracheobronchial foreign body aspiration is a life-threatening accident in infants, and is still a formidable clinical emergency to both otorhinolaryngologists and anesthesiologists. In this study, we attempted to assess the safety and ease of tracheobronchial foreign body removal in infants via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation. Methods: The retrospective clinical study from 2006 to 2010 included 50 infants with foreign body aspiration, of whom 35 underwent suspension laryngoscopy and Hopkins telescopy and the other 15 underwent rigid bronchoscopy. All of the procedures were under general anesthesia with endotracheal intubation. Results: All of the patients underwent temporary extubation. The foreign body was successfully removed in 46 cases and was not found in the other 4 cases. The mean operation time in the rigid bronchoscopy group was 13.20 ± 9.01 minutes, and that in the Hopkins telescopy group was 5.79 ± 3.54 minutes. The oxygen saturation level was below 90% in 17 cases, of which 7 were in the rigid bronchoscopy group and 10 were in the Hopkins telescopy group. The vital signs, including the partial pressure of carbon dioxide in expiratory gas and the heart rate, were stable in all cases. Conclusions: Foreign body removal in infants via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation should be promoted, since it is relatively safe and easy for both anesthesiologists and otorhinolaryngologists to perform and has a remarkable success rate.
Effects of Levobupivacaine versus Bupivacaine Infiltration on Postoperative Analgesia in Pediatric Tonsillectomy Patients: A Randomized, Double-Blind, Placebo-Controlled Study
Authors: Özmen Süay , Özmen Ömer Afşin , Kasapoğlu Fikret 
Published: October 2014

Objectives: We compared the effects of levobupivacaine hydrochloride, bupivacaine hydrochloride, and saline injections in alleviating posttonsillectomy pain. Methods: Between November 2009 and April 2010, we recruited 60 patients (36 male and 24 female) between 2 and 12 years of age into the study. After informed consent was obtained from the parents, patients admitted for tonsillectomy were randomized into 3 groups by means of sealed envelopes. Group 1 (20 patients; mean age, 6.45 ± 2.78 years) received 0.9% sodium chloride (saline solution), group 2 (20 patients; mean age, 5.60 ± 2.70 years) received 0.25% levobupivacaine hydrochloride, and group 3 (20 patients; mean age, 5.85 ± 2.43 years) received 0.5% bupivacaine hydrochloride infiltrated around each tonsil. Pain was evaluated with McGrath's face scale. Results: The postoperative pain scores at 1 and 5 hours were similar among the groups (p > 0.05). The pain scores in the levobupivacaine group were lower than those in the saline group at 13 hours (p < 0.017). The pain scores in the bupivacaine and levobupivacaine groups were significantly lower than those in the saline group from 17 to 21 hours until day 6 (p > 0.017). There was no difference between the levobupivacaine and bupivacaine groups (p > 0.017). Conclusions: Local infiltration of levobupivacaine is a relatively safe and effective method and is equivalent to use of bupivacaine for posttonsillectomy pain.
Prevalence and Significance of High-Frequency Hearing Loss in Subjectively Normal-Hearing Patients with Tinnitus
Authors: Kim Dong-Kee , Park Shi-Nae , Kim Hyung Min , Son Hye Rim , Kim Nam-Gyun , Park Kyoung-Ho , Yeo Sang Won 
Published: October 2014

Objectives: We investigated the incidences of high-frequency hearing loss (HFHL; above 2 kHz) and extended high-frequency hearing loss (EHFHL; above 8 kHz) in patients with tinnitus and subjectively normal hearing, and evaluated their effects on the clinical and audiological features of the patients. Methods: The sample included 85 patients with sensorineural tinnitus who had normal hearing sensitivity in the frequencies from 250 Hz to 2 kHz, and who had undergone extended high-frequency audiometry between July 2009 and February 2010. We investigated the incidences of HFHL and EHFHL in these patients and analyzed the significance of the hearing losses. Results: The incidence of HFHL or EHFHL was 88%. The proportion of patients with EHFHL, among the patients who had normal hearing sensitivity up to 8 kHz, was about 74%. The patients with normal hearing sensitivity at all test frequencies were significantly younger, had larger otoacoustic emissions, and had tinnitus that was less loud as measured by tinnitus matching than did the subjects with HFHL and/or EHFHL. However, other comparisons of clinical factors in the three groups did not show any differences. Conclusions: Even if patients with tinnitus do not have any subjective hearing impairment, most of them have HFHL and/or EHFHL. The effects on the clinical features of the patients are still vague.