bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality‐of‐Life Assessment before and after Uvulopalatopharyngoplasty Patients with Syndrome Diagnosis of OSA
Authors: Beilke Silvia C. A. S. B. , Peccini Isabele F. C. , Lorenzetti Fabio T. M. 
Published: August 2013

Objectives:Quality of life is dependent on socioeconomic, cultural, and health variables. Obstructive sleep apnea syndrome (OSAS) is an important and prevalent disease associated with poor quality of life in many patients. There are few studies in the literature discussing the surgical treatment for OSA with quality of life. The Short Form‐36 (SF‐36) is an instrument for measuring quality of life. It has been applied in various situations with good sensitivity. 1) Describe the quality of life in patients with OSA before and after performing uvulopalatopharyngoplasty. 2) Extend the literature on the relationship between uvulopalatopharyngoplasty and quality of life of patients with OSA.Methods:A descriptive study, conducted between August and December 2012. We applied the SF‐36 questionnaire before and after uvulopalatopharyngoplasty in 11 patients (10 males and 1 female) between 27 and 67 years old, diagnosed with mild, moderate, or severe OSA (believing in the positive influence of such surgery on quality of life of these patients).Results:11 patients showed improvement in the overall assessment of quality of life. There was improvement in functional capacity in 6 (54.4%) patients; limitation on the physical aspects in 4 (36.36%), the pain in 7 (63.63%), the general state of health in 9 (81.81%), vitality in 5 (45.45%), social aspects in 5 (45.45%), emotional aspects in 5 (45.5%), and mental health in 5 (45.5%), and there was no worsening in any domain (P < 0.05 in all domains).Conclusions:In addition to polysomnographic analysis and the AHI, the questionnaires about quality of life may be relevant in assessing the therapeutic outcome for OSAS.
Relationship between Epiglottis and Severity of Obstructive Sleep Apnea
Authors: Serin Gediz M. , Aksoy Elif A. , Polat Senol , Emre Emrah , Unal Omer Faruk , Tanyeri Hasan M. 
Published: August 2013

Objectives:The aim of this retrospective case‐control study was to define epiglottis morphologies and to investigate the relationship between the angle of the laryngeal surface of the epiglottis (ALSE) and the severity of obstructive sleep apnea (OSA) using flexible optic laryngoscopy (FOL) images.Methods:Eighty‐three patients with OSA (Group 1) and 87 patients with no complaints of OSA (Group 2) were evaluated. The ALSE was measured using ImageJ through FOL images. ALSE measurements were compared between the two groups. The correlation of ALSE measurements to the respiratory disturbance index (RDI) was analyzed.Results:Group 1 comprised 79 male and 4 female patients with a mean age of 43 years. Group 2 comprised 72 male and 15 female patients with a mean age of 39 years. The mean ALSE measurement was 139.7 degrees in Group 1 and 140.08 degrees in Group 2 and was not significantly different between the two groups (P value greater than 0.05). The mean RDI in Group 1 was 28.83, showing evidence of a low correlation between ALSE measurements and RDI. Epiglottis morphology revealed three different shapes: concave epiglottis and slightly observed petiole, minimally concave epiglottis with petiole dominancy, and severe concave epiglottis (omega epiglottis).Conclusions:Three different morphologies were observed through FOL examinations. The ALSE measurements were not significantly different between patients with OSA (Group 1) and control subjects (Group 2). This might indicate that the ALSE cannot be used as a predictive factor in OSA pathophysiology.
Sleep Apnea Syndrome Appears Early, Complicated with Allergic Rhinitis
Authors: Asako Mikiya , Tomoda Koichi 
Published: August 2013

Objectives:The effect of allergic rhinitis on sleep apnea syndrome.Methods:75 outpatients had sleep trouble and consulted the sleep apnea clinic in the otolaryngology department of our hospital from November 2011 through October2012. They were arranged in 4 specific groups (with seasonal allergic rhinitis, with perennial allergic rhinitis, with both types of rhinitis, without allergies). This study was analyzed by Mann‐Whitney U‐test.Results:In our sleep apnea clinic, 35% had no allergic rhinitis and 65% had complicated allergic rhinitis (49/75), including 51%(25/49) with both perennial and seasonal allergic rhinitis, 37% (18/49) with only seasonal rhinitis, and 12% (6/49) only perennial allergic rhinitis. RIST (radioimmunosorbents tests) of people with both types of rhinitis were higher than in other groups (p<0.05). The age of people with both types was lower than without it (p<0.05). Although AHI (apnea hypopnea index) of people without rhinitis were higher than with seasonal rhinitis (p<0.05), AHI without is not much different from with both types of rhinitis.Conclusions:According to inflammation of allergic rhinitis as high RIST, sleep apnea with both perennial and seasonal allergic rhinitis developed young compared with sleep apnea and non allergic rhinitis. Sleep apnea was worse when complicated with severe allergic rhinitis. It is thought that nasal mucosal hypertrophy from inflammation of severe allergic rhinitis would cause nasal obstruction, and sleep apnea would worsen due to inflammation.
Target‐Controlled Infusion of Propofol‐Induced Sleep Endoscopy for Patients with Obstructive Sleep Apnea
Authors: Lin Hsin‐Ching , Friedman Michael 
Published: August 2013

Objectives:Drug‐induced sleep endoscopy (DISE) allows inspection of upper airway to accurately localize the anatomical region that collapses in obstructive sleep‐apnea‐hypopnea syndrome (OSAHS). The sedation technique adopted in most centers throughout Europe is the target controlled infusion (TCI) of propofol without oxygen supply. The goal of this paper is to compare the advantages of supplemental oxygen during this procedure.Methods:Medical records of 61 patients diagnosed with OSAHS by full‐night PSG who underwent drug‐induced sleep endoscopy (DISE) with propofol to evaluate the upper airway were retrospectively reviewed. No patients were on any premedication preoperatively before DISE. Besides applying standard anesthetic monitors, a bispectral index monitor (BIS) Quatro sensor was positioned on the forehead as per manufacturer's instructions. If patients had brisk response of limb movement, the sedative dosage was adjusted by specialized anesthesiologists. The demographic variables of age, gender, BMI and intraoperative presentations of effect site concentration of Propofol ((µg/mL)), BIS level, infusion time, and involuntary movement were collected for analysis.Results:By achieving the same level of sedation detected by the BIS monitor, the severe OSAHS patients needed a higher effect site concentration of propofol (5.3 ± 1.1 μg/mL in severe OSAHS vs. 4.5 ± 1.4 μg/mL in mild/moderate OSAHS, p=0.025, Mann‐Whitney U test) and obviously involuntary movement. No adverse effects or complications were noted during this procedure.Conclusions:Target controlled infusion of Propofol‐induced sleep endoscopy for OSA patients is a feasible and safe procedure. Severe OSAHS patients experienced worse saturation during overnight sleep and obviously involuntary response in sedated endoscopy even with higher predicted concentration of Propofol.
Biochemical and Biomechanical Properties of the Rabbit Nasal Septum
Authors: Watson Jeffrey , Gruissem Sophia , Yamaguchi Tomonori , Briggs Kris , Sah Robert , Masuda Koichi , Watson Deborah 
Published: August 2013

Objectives:1) Characterize biochemical and biomechanical properties of New Zealand White rabbit septal cartilage for future utilization in rabbit septal cartilage tissue engineering studies. 2) Determine whether tensile and bending properties vary when measured in different axes.Methods:Nasal septa were harvested from adult New Zealand White rabbits post‐mortem. Confined compression testing was performed. Samples cut in the vertical and anterior‐posterior (AP) plane were subjected to tensile testing and 3‐point bending. Biochemical assays determined the Glycosaminoglycans (GAG), total collagen, and DNA concentrations in each sample.Results:Confined compression demonstrated an average compressive modulus (HAO) of 0.82 (±0.23 MPa). In tensile testing, peak stress of samples cut in the vertical plane (6.61±1.28 MPa) were significantly greater (p=0.02) than in the AP plane (5.22±1.31 MPa). Tensile stiffness at failure strain for vertical (22.90±5.51 MPa) and AP (18.67±9.56 MPa) samples did not differ significantly (p > 0.05). The flexural moduli of samples cut in the vertical plane (39.31±16.6 MPa) and AP plane (39.32±20.24 MPa) were also not significantly different (p > 0.05). Biochemical characterization demonstrated an average concentration of 43.81±8.34 µg GAG, 104.71±21.52 µg total collagen, and 0.23±0.05 µg DNA per mg wet weight.Conclusions:Rabbit septal cartilage is anisotropic; tensile strength was higher in the vertical plane than in the AP plane. Compared with published properties of human septal cartilage, rabbit septal cartilage is mechanically stronger, stiffer, and less flexible. Rabbit septal cartilage has a similar DNA content, with higher GAG and total collagen levels than values published for human septal cartilage.
Laryngoscope Illuminance in an Academic Medical Center: Industry Standards and Implications for Quality Direct Laryngoscopy
Authors: Murphy Michael K. , Volsky Peter G. , Darrow David H. 
Published: August 2013

Objectives:Compare laryngoscope illuminance to established standards and identify maintenance and design features associated with poor light output.Methods:An observational study in a tertiary‐care medical center (level‐one trauma center, specialty cardiac hospital, and general hospital) was performed from January‐November 2012. Illuminance (lux) was chosen as the unit of measurement. Laryngoscopes in the main operating room (OR), cardiac OR, outpatient OR, emergency department/trauma bay (ED), and code carts were tested using a standard technique. International Standards Organization (ISO) and medical literature values were used for comparison. Maintenance practices were surveyed.Results:Six hundred ninety‐one laryngoscopes were tested. Devices varied by light source and design, including light‐emitting diode (LED), incandescent bulb (on‐blade and in‐handle), and xenon. The lowest illuminance was observed by incandescent designs (bulb on‐blade, 820±700 lux, n=237; bulb in‐handle 1860±1220 lux, n=79), followed by LED (4730±3210 lux, n=354), and xenon source (28800±34500 lux, n=21). Forty units (6%) failed to turn on at all, classified as failing, (11% bulb on‐blade, 6% LED). Compared to illuminance benchmarks for laryngoscopy in the medical literature (867 lux) and ISO (500 lux), 59% of incandescent laryngoscopes, 12% of LED laryngoscopes, and 10% of xenon units did not meet quality standards for laryngoscopy (7% devices overall). All units were cleaned by standard protocols, but no departments reported regular equipment maintenance.Conclusions:Up to 13% of laryngoscopes in an academic medical center were found to be substandard. Quality‐control programs may reduce numbers of deficient laryngoscopes in circulation, improving airway management and patient care.
Military Otolaryngology Resident Case Numbers and Board Passing Rates from 2001‐2010
Authors: Scalzitti Nicholas , Maturo Stephen C. , Brennan Joseph , Boston Andrew 
Published: August 2013

Objectives:1) Compare the caseloads of graduates from military otolaryngology residency programs to the national averages for the years 2001‐2010. 2) Measure residency outcomes by comparing the board exam pass rates of military otolaryngology graduates to their civilian complement.Methods:Resident caseload data and board exam passing rates were requested from each of the Department of Defense Otolaryngology residency programs for the years 2001‐2010. The American Board of Otolaryngology and the Accreditation Council for Graduate Medical Education provided the national averages for resident caseload for these years, as well as national passing rates on the certifying board exam. The pooled numbers from the military programs were then compared to the national averages for total cases, cases in defined categories, and board passing rates.Results:Data were available for all but one military otolaryngology residency program. Regarding total cases, only the years 2001 and 2003 showed a significant difference (p<0.05), with military residents completing more cases in those years. For the 10 year averages in individual categories, the military residents reported more cases in otology (299.6 vs. 261.2, p=0.009) and plastics/reconstruction (248.1 vs. 149.2, p=0.0003). No category showed a significant difference in 10 year average favoring the national average over the military. Military residents demonstrated a first‐time board exam pass rate identical to the national average (93%).Conclusions:The results suggest that as a whole, the military otolaryngology residency programs are keeping pace with their civilian counterparts in resident education. Resident caseload has not been compromised by the war effort.
Older Adult Golf Cart and All‐Terrain Vehicle (ATV)–Related Craniofacial Injuries
Authors: Pate Mariah B. , White Lauren , Jin Chan , Waller Jennifer , McKinnon Brian J. 
Published: August 2013

Objectives:Analyze the etiologies of craniofacial and temporal bone injury in older adults involved in recreational vehicle trauma.Methods:A chart review at a level one trauma center from 2000‐2012 included 58 patients over 50 years old. Data obtained include the following variables: age, gender, race, mechanism of injury, intoxication, hospital stay, vehicle type, Glasgow coma score (GCS), injury severity score (ISS), and helmet use.Results:Of the 58 patients identified, the mean age was 60.5, and the majority were white (90%) and male (78%). Eleven patients (19.3%) had a craniofacial injury (CFI), and two patients (3%) had a temporal bone fracture. The most common CFI was an orbital wall fracture (64%), followed by maxilla (27%) and nasal bone fracture (27%). Patients with a closed head injury are nearly ten times as likely to incur a CFI (P = 0.0346), and those injured while intoxicated are over seven times more likely to have CFI (P = 0.0084). Patients with a temporal bone fracture are more likely to suffer concurrent additional CFI (P = 0.035). There were no statistical differences in the incidence of CFI in relation to age, race, sex, ISS, GCS, or vehicle type. CFI was not a predictor of the length of hospital stay or mortality. Helmet use and mechanism of injury are not related to the incidence of CFI.Conclusions:Recreational vehicle trauma is a risk to older patients. Alcohol is a strong risk factor for CFI. For patients with close head injuries and/or a temporal bone fracture, concurrent CFI should be anticipated.
Percutaneous Tracheostomy Boundaries Revisited
Authors: Kizhner Victor Z. , Bertetti Richard , Lebovics Robert S. 
Published: August 2013

Objectives:As percutaneous tracheostomies (PCT) which have various contra‐indications (CI) are increasingly performed by non‐otolaryngologists, the otolaryngologist's role is reviewed. The ability of tracheal palpation was the single criteria to perform PCT.Methods:A retrospective study analyzing adult PCT performed by otolaryngologists from 2011‐2012. All PCT were performed using the Ciaglia blue‐rhino‐tracheostomy kit and Shiley's tracheostomy cannulas. Most procedures were performed with the same anesthesiologist.Results:A total of 60 PCT were identified with subject ages 18‐91. None were converted to open tracheostomy. No bronchoscopic guidance was used. PCT was performed for the following CI: 2 bleeding disorder, 4 goiters, 4 cervical rigidity (surgical, traumatic and constitutional), 5 emergent tracheostomies, 1 head and neck cancer 9 short necks. Complications recorded were 1 wound bleeding and 1 pneumomediastinum, both controlled locally. Pertinent anatomy revealed the intubation tube was withdrawn to the level of 14cm and 16cm from incisor level in women and men respectively.Conclusions:PCT is a safe procedure. When performed by an otolaryngologist even the relative CI can be overcome. Tracheal palpation and an experienced anesthesiologist are mandatory for the procedure's success. The otolaryngologists’ advantage is a better anatomical understanding with the ability to convert the procedure to a formal tracheostomy as needed and avoidance of hypercarbia due to bronchoscope use. Otolaryngologists should be the first line providers in any tracheostomy
Peritonsillar Abscess Procedural Simulator
Authors: Chen Nan , Chang C. W. David 
Published: August 2013

Objectives:To develop a locally constructed, low‐cost model for simulation of drainage of peritonsillar abscess to help new residents gain familiarity with the instrumentation and essential steps involved in the procedure.Methods:A two‐piece latex moulage model shaped from a plaster mold was constructed to replicate an oropharynx with a unilateral tonsillar abscess. Cream‐colored viscous liquid sandwiched between the outer tonsil moulage and the palate moulage simulated the abscess. The construct was then placed behind a silicone CPR dummy mask.Results:Initial impressions by faculty and senior residents during a simulation lab were favorable in that the models sufficiently replicated the anatomy of oropharynx in the presence of a peritonsillar abscess. Completion of the simulated task required bimanual dexterity and comfort with use of headlight and instrumentation within an enclosed space similar to that required in the real situation. Cost of the models was estimated at less than one dollar each, using materials easily found at local hobby stores.Conclusions:Production of a low‐cost simulator for drainage of peritonsillar abscess is feasible and may provide a reasonably realistic environment to allow residents to practice and develop this skill. Further study is needed to formally assess face, construct, and content validity of this simulator for teaching and assessment of procedural competency.
Presentation and Management of Neck Abscess: Have Things Changed over a 20‐Year Period?
Authors: Mazhar Kashif , Larro‐Popkin Ariel , Masood Kamil , Rice Dale H. 
Published: August 2013

Objectives:Our recent clinical experience with deep neck space infection indicated difference in the presentation, etiology, and bacteriology compared to previously published report from our institution. Hence we decided to evaluate 1) change in the presentation, physical examination, bacteriology, and empiric antibiotic therapy for patients with deep neck space abscess compared to previously published report and, 2) incidence of methicillin‐resistant Staphylococcus aureus (MRSA) related infection in our patient population.Methods:Institutional Review Board approved retrospective analysis of patients who underwent incision and drainage of neck abscess in the operating room between 2008‐2012 at LAC+USC Medical Center. Comparison was made with previously published historical data. Data analysis was done using SAS 9.1.Results:44 patients were included in the present study compared to 50 in previously published study. Compared to previously published report from our institution, there has been a statistically significant difference in 1) most common presenting symptom: dysphagia (64%) vs pain (76%); 2) location of neck abscess: parapharyngeal (54%) vs anterior triangle (28%); 3) etiology: upper respiratory tract infection (URI) (41%) vs intravenous drug abuse (IVDA) (28%); 4) higher prevalence of anaerobic bacteria (86%) vs 50%; 5) MRSA was present in only 1 (2%) patient; 6) Clindamycin was empiric antibiotic in 34 (77%) of the patients, with the need for change after culture report in 5 (11%) patients. Chi‐square p‐value was <0.05 for all comparisons.Conclusions:URI and odontogenic infections are now the major cause of neck abscesses compared to IVDA in previous report. Clindamycin is an appropriate empiric antibiotic. MRSA incidence is low.
The Cost and Inpatient Burden of Treating Mandible Fractures: A Nationwide Inpatient Sample Database Analysis
Authors: Pena Israel , Guy William M. , Zevallos Jose Pedro 
Published: August 2013

Objectives:At the conclusion of this presentation, the participants should be able to discuss the patient demographics, hospitalization characteristics, and costs associated with the treatment of mandible fractures. Study design: Cross‐sectional study.Methods:A cross‐sectional analysis using the 2009 Nationwide Inpatient Sample Database to identify patients hospitalized for isolated mandible fractures.Results:1481 patients were identified with isolated mandible fractures. The average age of patients was 31, and 93.5% were male. Forty‐six percent were White, 30% African‐American, 14% Hispanic, 9% other, and 1% Asian. Twelve percent of patients presented with a history of alcohol abuse, 7.2% drug abuse, and 7.7% mental illness. Forty percent were from the lowest median household income quartile, and 75% were uninsured or had Medicaid. Thirty‐nine percent of patients underwent surgery within 24 hours of admission, the average length of stay (LOS) was 2.95 days, and average cost of hospitalization was $35,804. Increased LOS was associated with alcohol abuse (3.7 vs. 2.9 days, p<0.001), drug use (4.7 vs. 2.8 days, p<0.001), mental illness (3.9 vs. 2.9 days, p=0.001), and age greater than 40 years (3.8 vs. 2.7 days, p<0.001). Increased total cost was associated with drug use ($56,600 vs. $34,391, p<0.001) and alcohol abuse ($42,343 vs. $34,943, p=0.011).Conclusions:Males, persons of low socioeconomic status, and African‐Americans comprise a disproportionately high percentage of mandible fracture patients treated nationally. Healthcare expenditures associated with the treatment of mandible fractures are higher for older patients, those with mental illness, and those with a history of substance abuse.
Representation of Women in Otolaryngology on Editorial Boards
Authors: Chaikhoutdinov Irina , Ghossaini Soha N. , Patel Hetal , Brodsky Linda S. 
Published: August 2013

Objectives:Investigate the involvement of women on the editorial boards of otolaryngology journals.Methods:Five journals were surveyed from 2006 through 2012. The number and position of women were tracked. Characteristics studied included ethnicity, board certification, geographic location, and academic rank using data extracted from publicly available sources. Journal impact was compared to board turnover and diversity.Results:Over the last 7 years, most journals increased their representation of women on editorial boards, with two displaying rates of 23.5% and 24.6% in 2012. Four journals increased their number of women with the highest percent of women and greatest board turnover associated with the greatest increases in impact. Of the 48 women noted to be on the editorial boards of these 5 journals, 9 (20%) are members of more than one board (2 on 3 boards, and 7 on 2 boards); of the 315 men, 67 (21%) were on more than one board, and 10 (3%) on more than two boards. Overall board turnover rates remain low; one journal had no turn over and also had the lowest percent of women. Women were more likely to be Asian than males (21% vs. 9%, P < 0.001) and were board certified fewer years (mean 19.7 vs. 25.3, P < 0.002). No differences in academic rank were noted.Conclusions:Between 2006 and 2012 proportionate rank of women on otolaryngology boards is noted. Their progression and strategies to achieve editor‐in‐chief positions are discussed.