bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracheocutaneous Fistula Closure in Pediatric Tracheostomy Patients: A Systematic Review
Authors: McCormick Michael E. , Preciado Diego A. 
Published: September 2014

Objectives:Compare success and complication rates of primary tracheocutaneous fistula closure compared with fistulectomy with secondary fistula healing.Methods:A systematic literature search was performed on PubMed. All prospective and retrospective studies of tracheocutaneous fistula (TCF) closure techniques in pediatric patients were included for initial analysis. The authors’ unpublished cohort of 13 fistulectomy patients was also included in the overall analysis. Primary outcomes were surgical success rate and major complication rate. Fisher exact test was used for statistical analysis.Results:Thirteen studies were identified for inclusion in the systematic review; 8 studies reported both success rates and complications. The total number of patients in all included studies was 259 (median, 19; range, 8‐98). Techniques included fistulectomy with multilayer closure (197), primary closure alone (2), and fistulectomy alone with healing by secondary intention (60). Success rates were comparable between fistulectomy alone (95.0%) and primary closure techniques (97.5%) (P =. 275). There was a statistically significant increased rate of reported major complications among patients treated with primary closure techniques compared to fistulectomy (0.0% vs 8.5%, P =. 038).Conclusions:While both primary closure techniques and secondary healing techniques for pediatric TCF closure have excellent success rates, fistulectomy with healing by secondary intent is associated with less reported major complications.
Comparison of Mometazon Furoate to Cetirizin for Symptom Severity Control and QOL in Allergic Rhinitis
Authors: Cetin Bilal , Saglam Omer , Dursun Engin , Karapinar Ugur 
Published: September 2014

Objectives:Evaluate and compare nasal symptom scores and quality of life (QOL) findings in allergic rhinitis patients.Methods:A total of 426 adult allergic rhinitis patients’ medical records were evaluated retrospectively. Group A consisted of 188 patients and received mometasone furoate nasal spray (100 mcg daily/nostril). Group B consisted of 238 patients receiving cetirizine (10 mg oral/daily) for 30 days. Nasal symptoms (watery discharge from the nose, nasal congestion, sneezing and nasal pruritus) and QOL (Short Form‐36) were recorded before and after treatment.Results:When compared before and after treatment, each group's total nasal symptom scores reduced significantly (Group A, P =. 001; Group B, P =. 002), and QOL scores improved significantly (Group A, P =. 001, Group B, P =. 001). But when compared between groups, Group A results were better than Group B (total nasal symptom scores P =. 001, QOL scores P =. 003).Conclusions:Although intranasal mometasone furoate is a better choice than oral cetirizine, both of these medicines can be used to control allergic rhinitis symptoms and improve patient QOL.
Inhibitory Effect of Prostaglandin E2 on the Migration of Nasal Fibroblasts
Authors: Shin Jae‐Min , Park Il‐Ho , Park Joo‐Hoo , Kim Jin Ah , Lee Heung‐Man 
Published: September 2014

Objectives:Fibroblast migration is crucial for normal wound repair after sinonasal surgery. Prostaglandin E2 (PGE2) is a potent inhibitor of fibroblast functions including chemotaxis, proliferation, and matrix production. The purpose of this study was to determine whether PGE2 affects the migration of nasal fibroblasts and to investigate the mechanism of action of PGE2 on nasal fibroblasts.Methods:Primary cultures of nasal fibroblasts were established from inferior turbinate samples. Fibroblast migration was evaluated with scratch assays. Reverse transcription‐polymerase chain reaction was performed for E‐prostanoid (EP)1, EP2, EP3 and EP4 receptors. EP receptor‐selective agonists and antagonists were used to evaluate receptor functions. Stimulatory G (Gs) proteins were activated to evaluate mechanisms. Intracellular cyclic adenosine monophosphate (cAMP) levels were measured by enzyme‐linked immunosorbent assay, and fibroblast cytoskeletal structures were visualized with immunocytochemistry.Results:PGE2 significantly reduced the migration of nasal fibroblasts. Agonists selective for the EP2 and EP4 receptors significantly reduced the nasal fibroblast migration. Antagonists of the EP2 and EP4 receptors inhibited the effect of PGE2 on nasal fibroblast migration. Activation of Gs protein and adenyl cyclase reduced nasal fibroblast migration.Conclusions:PGE2 inhibited the migration of nasal fibroblasts via the EP2 and EP4 receptors, and this inhibition was mediated by cAMP elevation. Targeting specific EP receptors could offer therapeutic opportunities for conditions such as delayed wound healing after nasal surgery.
Successful Endoscopic Dacryocystorhinostomy: What Factors Make Revision Surgery More Likely?
Authors: Liu Zi Wei , Jayaraj Samuel , Subak‐Sharpe Ian 
Published: September 2014

Objectives:Endoscopic dacryocystorhinostomy (DCR) is indicated for treatment of nasolacrimal duct obstruction, which manifests as a watery eye. Endoscopic techniques have gained popularity in recent years compared to open DCR, which leaves a facial scar. Success rates have been reported to be between 65‐95%. We report the success rate of endoscopic DCR at our institution and analyze factors leading to revision surgery.Methods:This is a retrospective analysis of endoscopic DCR performed at a district general hospital between August 2010 and December 2013. We perform this as a day case procedure using a DCR burr and leave silastic stents in situ. We do not routinely use anti‐mitotic agents. We collected and analyzed demographic data (age, co‐morbidity, medications), technical notes, rate of symptom resolution at follow‐up, and need for revision surgery.Results:A total of 33 endoscopic DCRs were performed in this time period. The overall success rate (satisfactory resolution of symptoms at minimum 3 months follow up) was 76%. Rate of revision surgery was 15%. In 50% of cases scar tissue obstructing the DCR opening was the cause of surgical failure. Previous surgery (external DCR/punctoplasty) was not associated with a higher rate of endoscopic DCR failure (P =. 616).Conclusions:Endoscopic DCR is a safe technique for treating nasolacrimal duct obstruction with local success rates of 76%. A common reason for failure is scar tissue obstructing the rhinostomy opening and greater attention is being given to surgical techniques that maintain wide patency of the opening, as this may reduce rates of failure.
Cardiopulmonary Coupling Analysis: Changes before and after Treatment with a Mandibular Advancement Device
Authors: Lee Woohyun , Ahn Jae‐Cheul , Rhee Chae‐Seo , Lee Chul Hee , Kim Jeong‐Whun 
Published: September 2014

Objectives:Evaluate the changes of sleep quality in patients using a mandibular advancement device (MAD) for obstructive sleep apnea (OSA) based upon cardiopulmonary coupling (CPC).Methods:A total of 52 patients (mean age, 53.7 ± 9.6 years; range, 33‐74 years) were included in this study. Of them, there were 47 males (90.4%). All subjects were diagnosed with OSA after in‐laboratory full‐night polysomnography and re‐evaluated after 3‐month use of a MAD. At baseline, apnea‐hypopnea index (AHI) was 33.6 ± 17.0. We compared CPC parameters at baseline with those after 3 month use of a MAD.Results:Low frequency coupling (59.5 ± 16.1 to 47.7 ± 14.8%, P <. 001) and elevated low frequency coupling (44.6 ± 18.4 to 32.6 ± 15.7%, P <. 001) significantly decreased. High frequency coupling (28.6 ± 16.0 to 36.5 ± 15.7%, P =. 004) and very low frequency coupling (11.7 ± 7.2 to 15.3 ± 6.6%, P =. 028) significantly increased. The change of AHI significantly correlated with changes of the CPC parameters: negatively correlated with high frequency coupling change (r = –0.572, P <. 001); positively correlated with low frequency and elevated low frequency coupling changes (r = 0.604 and 0.497, respectively; P <. 001 in both).Conclusions:Low frequency coupling decreased as AHI improved while high frequency coupling increased as AHI improved. The CPC parameters showed that the sleep quality was improved by MAD therapy.
Internet Usage and eHealth Literacy of Patients in an Otolaryngology–Head and Neck Surgery Clinic
Authors: Saffarzadeh Areo G. , Verma Sunil P. , Billimek Jon 
Published: September 2014

Objectives:(1) Investigate whether otolaryngology–head and neck surgery (OHNS) outpatients consult health‐related online resources and establish baseline levels of perceived eHealth literacy. (2) Determine which resources patients use to investigate their disease and research treating physicians. (3) Explore relationships between perceived eHealth literacy, demographic data, and internet usage.Methods:A questionnaire was administered to 79 patients in a tertiary care OHNS outpatient setting between December 2013 and February 2014. The questionnaire recorded (1) demographic data, (2) health‐related Internet use, and (3) eHealth Literacy Scale (eHEALS), a tool used to measure perceived eHealth literacy.Results:Seventy‐five of 79 patients completed the questionnaire. Seventy‐six percent (n = 57) of patients had consulted online resources regarding their disease. The most commonly used resources were prompted by search engine results such as Google (88%, n = 51) and health websites such as WebMD (71%, n = 41). Only 14% of this group used the American Academy of Otolaryngology—Head and Neck website. Fifty percent (n = 38) of patients consulted online resources regarding their otolaryngologist prior to their visit. The mean eHEALS score was 3.65/5.0 (95% confidence interval [CI], 3.46‐3.84). For patients who search for health‐related information online, the odds of using dedicated health websites were 90.8% lower for patients with an eHEALS score below the mean versus above the mean (P =. 017; 95% CI, 35%‐98.7%).Conclusions:The majority of patients in this study consulted online resources to learn about their disease and physician. In this cohort, the perceived eHealth literacy influenced the type of website consulted. Patients with lower perceived eHealth literacy were less likely to consult dedicated health websites.
The Patient's Perioperative Perspective during Treatment for Obstructive Sleep Apnea
Authors: Rudolph Megan , Zapanta Philip E. 
Published: September 2014

Objectives:(1) Describe each patient's preoperative and postoperative experience in the treatment of obstructive sleep apnea (OSA). (2) Understand how the patients’ perceptions may influence their postoperative outcome and satisfaction.Methods:To analyze the differences between quantitative and qualitative postoperative results, we developed a modified phenomenological qualitative study of OSA patients who failed continuous positive airway pressure use and underwent surgery. From May to August 2012, patients were interviewed using a semi‐structured approach until thematic saturation was reached (n = 17). Of these interviews, 13 were held in‐person while 4 were performed by phone. Through Moustakas’ analysis, the transcribed interviews were broken down into codes. These were grouped into overarching themes. Upfront debriefing, investigator triangulation, epoche, reciprocal coding, member checks, and thick, rich description ensured data trustworthiness. Additionally, the patient's preoperative sleep studies and postoperative sleep studies were analyzed and compared to the subjective results.Results:The study identified 5 themes relating to patients and their OSA surgery: (1) Importance of OSA on personal and professional life; (2) Motivating factors for choosing surgery; (3) Patient knowledge; (4) Postoperative challenges; (5) Impact of OSA surgery.Conclusions:Patients’ experiences going into the surgery can largely influence their perceived outcome and satisfaction. These experiences are individual and subjective, and the postoperative sleep studies do not capture the whole outcome of the patients’ response to surgery. This suggests when patient reported outcomes are combined with postoperative sleep studies, otolaryngologists can gain a much better perspective about their patients.
Sleep Surgery Variations: The Evolution of Surgery for Obstructive Sleep Apnea at an Academic Hospital
Authors: Russell Jonathon O , Anderson Jared , Bae Charles , Kominsky Alan 
Published: September 2014

Objectives:(1) Identify surgeon dependent and temporal variations in indications and surgical interventions for obstructive sleep apnea (OSA) at a tertiary academic hospital. (2) Clarify if volume of sleep surgeries performed affects outcomes. (3) Determine if surgical volume correlates with technical variation (ie, do surgeons who perform more surgeries for OSA perform additional procedures beyond uvulopalatopharyngoplasty [UPPP]).Methods:Retrospective chart review: Adult patients who had undergone UPPP since 2003 and had electronic medical records available were included. Quality of life (QOL) instruments included in the electronic medical record such as the Epworth Sleepiness Scale (ESS) and the Functional Outcomes of Sleep Questionnaire (FOSQ) were included. Pre‐ and postoperative results were compared using standard statistical analysis.Results:A total of 247 patients met inclusion criteria. Median AHI of all patients with available postoperative PSG decreased from 39.4 to 21.4. Patients of high‐volume surgeons (>10 UPPP per year) were more likely to have a lower preoperative Friedman score (P <. 02), complete a postoperative PSG (P <. 0001 by the 2‐tailed Fisher exact test), have a decreased postoperative ESS (P <. 01), and have a PSG completed sooner after surgery (P <. 01). Postoperative AHI and change in AHI did not differ between groups, however (P =. 21 and P =. 14, respectively).Conclusions:UPPP contributes to objective improvement in PSG measures and quality of life. Nuances in patient selection and patient management are apparent between high volume surgeons and others, and may contribute to quality of life variations. Standardization of patient selection, timing of postoperative PSG, and increased utilization of QOL instruments may improve QOL outcomes among surgeons who do not perform UPPP regularly.
Transversely Retropalatal Collapsibility Measured by Regular Endoscopy Is Associated with Position Independency and Apnea‐Hypopnea Index
Authors: Lee Li‐Ang , Chen Hung Chin , Hsin Li Jen , Li Hsueh‐Yu , Fang Tuan‐Jen 
Published: September 2014

Objectives:Investigate whether the retropalatal airway collapsibility defined by regular endoscopy with Müller's maneuver could be used for predicting position independency and apnea‐hypopnea index (AHI) in patients with obstructive sleep apnea (OSA).Methods:This was a retrospective study and a total of 77 polysomnographies (mean AHI = 25.75 ± 22.69) and 77 awake endoscopies with Müller's maneuver between January 2010 and October 2013 were reviewed from 45 OSA patients (40 men and 5 women; mean age, 40.7 ± 1.6 years). Transverse/longitudinal diameters and collapsibilities of the airway at the level of the uvular base were measured using a picture archiving and communication system. Intra‐ and interrater reliabilities were assessed. Associations among the retropalatal airway dimensions, AHI (total, supine, and lateral), and position independency (defined as a supine AHI of <2 times of the lateral AHI) were statistically analyzed.Results:Measurement of transverse diameters and transverse/longitudinal collapsibilities was highly reliable within and between raters (all intraclass correlation coefficients >0.8) but longitudinal diameters measurement was less reliable. Transverse collapsibility significantly correlated with position independency (r = 0.545, P =. 019). It was also independently significantly associated with total (beta = 0.522, P <. 001), supine (beta = 0.480, P =. 001), and lateral (beta = 0.412, P =. 006) AHI after multiple linear regression.Conclusions:Regular endoscopy with Müller's maneuver continues to be an important clinical tool to evaluate the upper airway among OSA patients and a high transversely retropalatal collapsibility is a hallmark of non‐positional and/or severe OSA.
Occurrence of Aerodigestive Foreign Bodies in Children Less Than 12 Years Old in Uganda
Authors: Nakku Doreen , Tamwesigire Imelda 
Published: September 2014

Objectives:(1) Determine the prevalence and common types of aerodigestive foreign bodies. (2) Determine the nonclinical factors that influence their occurrence among children under 12 years of age.Methods:A case control study between February and October 2012. The study population was all children between 6 months and 12 years old presenting to the ENT clinic at Mbarara Regional Referral Hospital. Consecutive and random sampling was used for cases and controls respectively. The cases were recruited after removal of the foreign body in theater. Information collected included biodata, circumstances surrounding the occurrence of the foreign body, the type of foreign body, and the family's socioeconomic status.Results:Prevalence was 6.6% with M:F = 2:1. The most common foreign bodies were seeds in the airway and coins in the esophagus. There was a strong association between the type of foreign body and activity of the child at the time of the incident (P =. 001). A middle level socioeconomic status had a significantly lower risk (odds ratio = 0.27, P =. 01). Older mothers’ children were protected. In multivariate analysis using the child's age and sex, mother's age, and socioeconomic status of the family, females had a risk of 39% compared with the males (P =. 03).Conclusions:The prevalence of aerodigestive foreign bodies is relatively high. Risk factors include age under 5 years, male sex, the child's activity at the time, and younger age of the mother. A higher socioeconomic status and female sex are protective. Therefore nonclinical factors influence the occurrence of aerodigestive foreign bodies among children.
Combined Endovascular and Surgical Treatment of Cervicofacial Arteriovenous Malformations
Authors: Colletti Giacomo , Mandala Marco , Moneghini Laura , Frigerio Alice , Melchiorre Fabio , Grimmer Fredrik J. 
Published: September 2014

Objectives:Arteriovenous malformations (AVMs) often cause disfigurement and severe functional disturbances. An improper approach can unlock an explosive growth in the AVM and present a very high risk of relapse. Recurrent AVMs are much harder to cure. Intraoperative massive bleeding is a tangible risk if AVMs are treated surgically without preparatory endovascular embolization. The study's aims were: (1) Recognize and clearly diagnose a cervicofacial AVM. (2) Describe the indications and techniques to treat cervicofacial AVMs. (3) Analyze the critical importance of a combined endovascular and surgical approach.Methods:The most accepted indications and techniques concerning head and neck AVMs are gathered from a review of the literature and compared with the personal experience of the authors with 10 AVMs of the soft tissues of the head and neck and 4 AVMs of the facial bones. All patients underwent preoperative endovascular embolization with n‐butyl cyanoacrylate followed by surgical removal of the malformation within 48 hours of the procedure.Results:One early case of AVM of the maxilla was complicated by massive intraoperative hemorrhage despite preoperative embolization. One maxillo‐mandibular AVM recurred 2 years after the treatment. In all patients an improvement in cosmetic appearance was documented. Smaller AVMs were easier to manage and had the best results.Conclusions:An aggressive combined endovascular‐surgical treatment seems to be the only “curing” strategy for head and neck AVMs. A thoughtful preoperative balance must be made within a multidisciplinary team and clearly discussed with the patient.
Tonsil Surgery in Sweden 2013: Indications, Surgical Methods, and Complication Rates
Authors: Stalfors Joacim , Odhagen Erik , Ericsson Elisabeth , Söderman Anne‐Charlotte Hessén , Hultcrantz Elisabeth , Sunnergren Ola , Hemlin Claes 
Published: September 2014

Objectives:Describe how tonsil surgery was performed in Sweden 2013.Methods:The National Tonsil Surgery Register in Sweden collects detailed information regarding indication, surgery, and complications for tonsil operations. The purpose of the register is primarily to provide a basis for the description of a clinic and stimulate quality improvement programs. Also, the data can be used for research. All clinics are encouraged to include all tonsil surgeries in Sweden in the register, and during 2013, over 80% of all tonsil surgeries are estimated to be included. Information registered through questionnaires is data regarding indication, surgery performed, and complications such as readmission or return to theater due to bleeding.Results:A total of 11,029 tonsil surgeries were registered in 2013. Surgical methods used were tonsillectomy (4726), tonsillectomy with adenoidectomy (1632), tonsillotomy (738), and tonsillotomy with adenoidectomy (3933). Tonsillectomy was mainly used for infectious indications while tonsillotomy was used for obstructive/sleep apnea indications. Tonsillectomy was performed with cold knife (3056) or diathermy scissor (1217). Tonsillotomy was performed with coblation (653). Primary bleeding was registered in 1.8% of the total cohort. Readmission due to secondary bleeding was registered in 5.9% of the total cohort, but 11.4% after tonsillectomy and 2.2% after tonsillotomy. Return to theater because of bleeding was registered in 2.1%.Conclusions:Detailed information regarding tonsil surgery can be assessed with the National Tonsil Surgery Register in Sweden. Data can be used for studies on a large population and provide new knowledge.
Trends in American and Canadian Contribution to the Otolaryngology Literature
Authors: Lin June Rui Jun , Gurberg Joshua , Akabari Elaheh , White Paul , Nunez Desmond A. 
Published: September 2014

Objectives:Assess the 2008‐2012 American and Canadian contribution to the world otolaryngology literature.Methods:All articles published from January 2008 to December 2012 in 8 otolaryngology journals were reviewed. Book reviews, letters, correspondence, and meeting abstracts were excluded. Nationality, author numbers, and study types were extracted. Nationality of the article was defined by the publishing department's country of origin. Articles were categorized into primary clinical research, primary basic science research, secondary research such as systematic reviews and meta‐analyses, and other articles that did not fit the aforementioned classifications. Articles originating from the United States, Canada, and the rest of the world were statistically compared using Mantel‐Haenszel Common Odds Ratio Estimate, Pearsons chi‐squared, and Fisher exact tests.Results:A total of 3635 articles published in the journals surveyed were analyzed. Canadian‐authored papers decreased from 12.8% in 2008‐2009 to 10.2% in 2011‐2012, whereas American‐authored papers increased from 27.9% in 2008‐2009 to 30.1% in 2011‐2012. These changes were statistically significant (P =. 031). Multiauthorship (≥5 authors) increased in Canadian papers (P =. 015), whereas this trend had not been observed in American papers (P =. 566). Study types from the United States and Canada had not significantly changed from 2008‐2009 to 2011‐2012 (P =. 137).Conclusions:There were significant changes in otolaryngology publishing trends in the United States and Canada. Increase in multiauthorship in Canadian‐authored papers possibly suggests increased collaboration with multi‐disciplines and decreased investigator productivity.