bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spasmodic Dysphonia: Onset, Course, Socioemotional Effects, and Treatment Response
Authors: Tanner Kristine , Roy Nelson , Merrill Ray M. , Sauder Cara , Houtz Daniel R. , Smith Marshall E. 
Published: October 2014

Objectives: This investigation explored the onset, progression, socioemotional effects, and treatment outcomes of spasmodic dysphonia (SD). Methods: A cross-sectional epidemiological approach was used to examine questionnaire responses from 150 individuals with SD. Results: Symptoms of SD (mean age at onset, 46 years) began gradually in 76% of cases and were progressive (ie, failed to plateau) in 34% of cases. Botulinum toxin A (Botox) helped to attenuate voice symptoms in 91% of cases; however, the scores on the Voice-Related Quality of Life questionnaire (V-RQOL) were not associated with this effect. The V-RQOL scores improved with time since symptom onset, independent of age and treatment. The patients with only SD experienced onset, course, and progression of symptoms similar to those of the patients with SD and coexisting vocal tremor. Conclusions: The symptoms of SD begin gradually and worsen over time. New evidence indicates that SD symptoms may continue to progress without plateau in at least a subset of patients. Individuals with SD and coexisting vocal tremor experience symptom trajectories similar to those of patients with SD only. Although Botox may attenuate voice symptoms, these effects do not appear to be strongly related to the V-RQOL scores. These results provide new and valuable insights regarding the onset, course, progression, and treatment of SD.
New Surgical Procedure for Laryngotracheal Separation without a Cannula or Postoperative Treatment
Authors: Nakaya Muneo , Onuki Yuka , Kida Wataru , Watanabe Kenta , Abe Kazuya 
Published: October 2014

Objectives: Laryngotracheal separation is a surgical procedure used in the treatment of intractable aspiration. As with total laryngectomy and laryngotracheal diversion, this procedure requires postoperative pressure above the suture location to prevent leakage at the anastomosis. To date, there have been no reports regarding laryngeal separation without postoperative treatment. The purpose of this study was to evaluate a new surgical procedure for laryngotracheal separation that is performed without a cannula and requires no postoperative treatment. Methods: We performed the new surgical procedure in 7 patients. The mucosa of the cricoid cartilage was sutured to achieve tracheal closure. The closure was covered with a musculocutaneous flap of strap muscle; gauze was then tied over the skin and a 2–0 nylon suture was used to pierce the posterior part of the cricoid cartilage. In addition, a permanent tracheostoma was constructed without a tracheal cannula. Results: No patients required a tracheal cannula or treatment after the operation. Additionally, aspiration pneumonia was prevented without complications in all patients. Conclusions: This new surgical procedure eliminates the need for a cannula and postoperative treatment. The effects of this method in terms of aspiration prevention are comparable to those of other surgical techniques.
Management of Plastic Bronchitis in a Child with Mild Intermittent Asthma
Authors: Pawar Sachin S. , Chun Robert H. , Rao Aparna R. , Kerschner Joseph E. 
Published: October 2014

Objectives: We describe the clinical presentation of a 7 1/2-year-old boy with a history of mild intermittent asthma who presented with left lung collapse and was found to have plastic bronchitis. Methods: We reviewed the patient chart and imaging results and performed a literature review of plastic bronchitis and its management. Results: Bronchoscopy in our patient demonstrated a large white, friable, cast-like material that obstructed the entire left main stem bronchus and could not be easily suctioned. The cast was removed in a piecemeal fashion by means of serial rigid bronchoscopy over a 6-month period with use of both optical forceps and flexible suction catheters. Microscopic examination of the cast-like material showed a predominance of eosinophils along with neutrophils encased in proteinaceous material. Conclusions: Plastic bronchitis in children is a rare condition that can mimic foreign body aspiration and can be associated with underlying pulmonary inflammatory disorders or cardiovascular disease. Aggressive bronchoscopic management of the airway obstruction and medical management of the underlying disease process are important for the successful treatment of plastic bronchitis.
Chronic Pharyngitis is Associated with Severe Acidic Laryngopharyngeal Reflux in Patients with Reinke's Edema
Authors: Kamargiannis Nikolaos , Gouveris Haralampos , Katsinelos Panagiotis , Katotomichelakis Michael , Riga Maria , Beltsis Athanasios , Danielides Vasilios 
Published: October 2014

Objectives: We evaluated the association between pathological acidic laryngopharyngeal reflux (LPR) events and chronic pharyngitis in patients with Reinke's edema. Methods: We performed a prospective controlled study in 20 consecutive patients with Reinke's edema without pathological acidic LPR events (group A) and 40 consecutive patients with Reinke's edema with both clinical symptoms and 24-hour pH-metry suggesting acidic LPR (group B). The severity of acidic LPR was assessed by use of the Reflux Finding Score (RFS), the Reflux Symptom Index (RSI), and dual antimony probe 24-hour pH-metry. The patients were evaluated for the presence of chronic pharyngitis by clinical examination and biopsy specimens taken from the posterior pharyngeal wall. The χ2 test was used to compare the groups for the presence of pharyngitis. In group B, the RSI, the RFS, and the total duration and number of acidic LPR events on 24-hour pH-metry were compared between patients with and without concomitant pharyngitis by use of the Mann-Whitney test. Results: Five patients of group A and 20 patients of group B had chronic pharyngitis. Therefore, more patients with Reinke's edema and clinical signs of LPR tended to have chronic pharyngitis than did those with Reinke's edema and no clinical signs of LPR, but the difference was not statistically significant (p = 0.064; odds ratio, 3.0; 95% confidence interval, 0.9 to 9.8). Among group B patients, those with pharyngitis had significantly more acidic LPR events (p < 0.001) and a greater exposure time to gastric fluid (p = 0.008) than did those without pharyngitis. Their RFS and RSI did not differ significantly (p = 0.692 and p = 0.914, respectively). Conclusions: Only in the subgroup of patients with Reinke's edema and LPR was there a statistically significant correlation between the pH probe results and the incidence of clinical pharyngitis. Awareness should increase among physicians about addressing chronic pharyngitis in therapy for acidic LPR and/or Reinke's edema.
Parapharyngeal Ganglioneuroma with Neurofibromatosis: An Unusual Presentation
Authors: Sinha Parul , Sharma Suresh C. , Agarwal Shipra , Gupta Siddhartha Datta 
Published: October 2014

Objectives: Ganglioneuroma is a rare benign tumor of the sympathetic nervous system that is seldom localized to the head and neck. Rarer still are cases of functional ganglioneuroma with catecholamine production. We report an unusual case of a large parapharyngeal space ganglioneuroma in a patient with neurofibromatosis that caused an intraoperative hypertensive crisis in the absence of a neuroblastomatous component — Hitherto an undocumented complication. Methods: We present a case of functional parapharyngeal ganglioneuroma and review the clinicopathologic and biochemical features of these rare tumors. Results: Fewer than 40 anecdotal cases of parapharyngeal ganglioneuromas have been reported, and there is a lack of ade quate literature on the biology and appropriate treatment approach of these tumors. Conclusions: Our case illustrates the importance of vigilant preoperative precautions in the management of neurogenic tumors, particularly ganglioneuromas. These usually nonfunctional tumors can result in sudden intraoperative and postoperative hypertensive crises even in the absence of any preoperative autonomic symptoms.
Chronic Rhinosinusitis with Nasal Polyps: A Proteomic Analysis
Authors: Upton David C. , Welham Nathan V. , Kuo John S. , Walker Jeffery W. , Pasic Thomas R. 
Published: October 2014

Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a severe subtype of chronic rhinosinusitis that can affect patients despite medical and surgical interventions. The purpose of this study was to utilize the techniques of proteomics to investigate differences in protein abundance within the sinonasal mucosa of patients with CRSwNP compared to healthy controls. Methods: In a case-control study at a tertiary-care academic medical center, sinonasal mucosa was harvested from 3 patients with CRSwNP and 3 control patients undergoing transsphenoidal excision of pituitary tumors. Two-dimensional gel electrophoresis was used to identify proteins with elevated or reduced abundance in CRSwNP patients compared to controls. The proteins showing the greatest abundance differences were characterized by mass spectrometry. Results: More than 300 differentially abundant proteins (p ≤ 0.05) were identified. Many of these protein species were involved in the host inflammatory response. Proteins up-regulated in CRSwNP patients included eosinophil lysophospholipase by a ratio (R) of 18.13, RHO-GDP dissociation inhibitor 2 (R = 2.80), and apolipoprotein A-1 (R = 1.73). Down-regulated proteins in CRSwNP patients included catalase (R = −5.87), annexin A1 (R = −6.27), and keratin II-8 (R = −6.73). A detailed analysis of additional protein species is outlined. Conclusions: The proteomic approach allows detection of significant differences in protein abundance in CRSwNP and provides unique insight into the pathophysiology of this common disease.
Vocal Fold Stellate Cells in the Human Macula Flava and the Diffuse Stellate Cell System
Authors: Sato Kiminori , Umeno Hirohito , Nakashima Tadashi 
Published: October 2014

Objectives: Hepatic stellate cells (HSCs) are desmin-positive cells with perinuclear vitamin A droplets that play important roles in liver fibrogenesis. Morphologically similar cells have been found at many extrahepatic sites. Consequently, the concept of a diffuse stellate cell system has been proposed. Vocal fold stellate cells (VFSCs) in the human maculae flavae (MFs) are starlike in shape and possess lipid droplets and store vitamin A. In this study, the relationship between the VFSCs in the human MFs and the diffuse stellate cell system was investigated. Methods: Light and electron microscopic investigations and immunohistochemical studies were performed in 5 samples of human adult vocal fold mucosa. Results: The VFSCs showed the morphological features of the HSCs (ie, they were desmin-positive cells with perinuclear vitamin A droplets). Glial fibrillary acidic protein and vimentin were identified in the VFSCs in the MFs. Conclusions: The VFSCs in the human adult MFs express the neural and muscle-associated proteins seen in HSCs. Our present and previous investigations suggest that the VFSCs in the human MFs are a member of the diffuse stellate cell system. The VFSCs are considered a new category of cells in the human vocal fold. The MFs are proposed to be special microenvironments, known as niches, that nurture a pool of VFSCs.
Prognosis Tool Based on a Modified Children's Implant Profile for Use in Pediatric Cochlear Implant Candidacy Evaluation
Authors: O'Brien Lynne C. Graham , Valim Clarissa , Neault Marilyn , Kammerer Betsy , Clark Terrell , Johnston Jennifer , Culver Stacey , Zhou Jing , Kenna Margaret A. , Licameli Greg R. 
Published: October 2014

Objectives: We developed a prediction tool to assist in evaluation of pediatric candidates for cochlear implantation (CI) and to help plan for preoperative and postoperative support. Methods: Between 1995 and 2005, 277 patients underwent CI at Children's Hospital Boston. Of these 277 patients, 250 had at least 2 years of post-CI follow-up and adequate pre-CI information for rating by our prediction tool. Of the 250, 106 were randomly selected for inclusion. The patients were divided into group A (auditory/oral communicator); group B (auditory/oral communicator with visual assistance), group C (visual/manual communicator with auditory/oral skills assistance), and group D (will not derive communicative benefit from implant). Predictions were performed with clinical assessment and two statistical techniques: Regression modeling and classification and regression tree (CART) analysis. Results: Among patients who became auditory/oral communicators (group A), clinical assessment predicted that outcome accurately 65% of the time, CART analysis had intermediate sensitivity (79%), and regression modeling was the most sensitive (95%). Groups B through D were predicted 45% of the time by regression modeling, 90% of the time by clinical assessment, and 100% of the time by CART analysis. Conclusions: A combination of speech-language, medical, and educational constructs can provide a reliable prediction of the communication outcome. Our goal for the prognosis tool is to make it part of the overall candidacy process in supporting decision-making about CI and planning for post-CI therapy.
Evaluation of Volitional and Reflexive Swallowing in Elderly Patients with a History of Pneumonia
Authors: Kiyohara Hideyuki , Umezaki Toshiro , Sawatsubashi Motohiro , Matsumoto Nozomu , Komune Shizuo 
Published: October 2014

Objectives: Precise assessment of the risk of aspiration is critical in older patients with a history of pneumonia. However, the currently popular videofluoroscopic and videoendoscopic examinations of swallowing only evaluate volitional swallowing. A method for quantitative analysis of reflexive swallowing is not yet available. Methods: We evaluated volitional swallowing in the sitting position by videoendoscopic examination and then measured the volume of injected water that triggered reflexive swallowing in the supine position in 54 patients with a history of pneumonia and 24 control patients of a similar age who had no history of pneumonia. Results: The volume of injected water that triggered reflexive swallowing was larger in the pneumonia group than in the control group (mean, 1.64 ± 0.61 mL versus 0.71 ± 0.28 mL; p < 0.001). Both impaired volitional swallowing and impaired reflexive swallowing independently correlated with a history of pneumonia. Conclusions: The endoscopic supine swallow-evoking test (“ESSET”) may detect previously omitted risk factors for aspiration in patients who can volitionally swallow.
Language Development, Interpersonal Communication, and Academic Achievement among Japanese Children as Assessed by the ALADJIN
Authors: Sugishita Syuuhei , Fukushima Kunihiro , Kasai Norio , Konishi Takayuki , Omori Kana , Taguchi Tomoko , Fujiyoshi Akie , Ojima Toshiyuki 
Published: October 2014

Objectives: Japanese-speaking children in a standard sample were subjected to a test battery (ALADJIN: Assessment Package for Language Development in Japanese Hearing-Impaired Children) to evaluate the effect of language development on both interpersonal communication skills and academic achievement. Methods: A total of 414 preschool and school-age children without hearing impairment were included in this study. The following tests make up the ALADJIN: The Test of Question-Answer Interaction Development (TQAID), the Japanese Language by Criterion Referenced Test–II (CRT-II) for measuring academic achievement, the Picture Vocabulary Test–Revised (PVT-R), the Standardized Comprehension Test of Abstract Words (SCTAW), both parts of the Syntactic Processing Test for Aphasia (STA), and the Word Fluency Test (WFT). Means and standard deviations at each academic grade level were calculated, and a multiple regression analysis was performed. Results: A ceiling effect was observed for the TQAID and the STA in children in grade 3 of elementary school, and the scores for the PVT-R, SCTAW, and WFT increased incrementally according to grade level. Multiple regression analysis revealed that the PVT-R, WFT, and STA (production) have predictive power for the results of the TQAID (R = 0.59; R2 = 0.58; p < 0.0001), whereas the SCTAW and STA (comprehension) have predictive power for the results of the CRT-II. Conclusions: Both vocabulary and syntax are important in communication development among children. The results of our multiple regression analysis suggest that different language domains may play different roles in the development of interpersonal communication skills and in academic achievement. The development of interpersonal communication skills is largely based on productive vocabulary and syntax abilities, whereas academic achievement is largely based on comprehensive vocabulary and syntax abilities. Children who have difficulties in either area should be evaluated with detailed language assessment tools such as the ALADJIN in an effort to aid in the selection of appropriate intervention.
VTMR, a New Speech Audiometry Test with Verbal Tasks and Motor Responses
Authors: Di Berardino Federica , Forti Stella , Cesarani Antonio 
Published: October 2014

Objectives: The aim of this study was to design a complementary speech audiometry test using verbal tasks and motor responses (VTMR) to assess the ability of a subject to understand and perform simple motor tasks with 3-dimensional objects, to describe its construction, and to show the preliminary results of a pilot study on the Italian version of the test. Methods: The items used in the test setting included 1 base, 1 hammer, 1 wooden structure with 4 sticks, and 5 rings of different colors and 20 lists with 5 verbal tasks per list. The VTMR test and bisyllabic speech audiometry were evaluated in normal-hearing subjects with and without cognitive impairment and in subjects with sensorineural hearing loss. Results: All normal-hearing subjects without cognitive impairment performed the VTMR tasks (100%) correctly at 35 dB sound pressure level. In subjects with sensorineural hearing loss, the percentage of correct answers was significantly higher for the VTMR test than for bisyllabic speech audiometry above 50 dB sound pressure level. This percentage was higher for the VTMR also in normal-hearing subjects with poor cognitive skills. Conclusions: The VTMR might make it easier to check patients' ability to understand verbal commands than does traditional speech audiometry, in particular in those patients with poor test-taking skills.
Tolerability of Sialendoscopy under Local Anesthesia
Authors: Luers Jan Christoffer , Stenner Markus , Schinke Michael , Helmstaedter Victor , Beutner Dirk 
Published: October 2014

Objectives: We sought to investigate patients' tolerance of sialendoscopy of the parotid and submandibular glands with local anesthesia. Methods: In a retrospective case series of 84 adult patients who underwent sialendoscopy with local anesthesia at an academic tertiary referral hospital, we analyzed patients' demographic data, American Society of Anesthesiologists (ASA) status score, perioperative cardiovascular parameters, and results on a 2-question survey. Results: Of the 84 patients, 44 were female and 40 were male (mean age, 48.6 years). The patients had a mean ASA status score of 1.57. On average, 2.16 mL of local anesthetic was used. The mean systolic blood pressure was 137 mm Hg, and the mean diastolic blood pressure was 80 mm Hg. The duration of the procedure showed a significant correlation with the maximum systolic blood pressure (r = 0.35; p = 0.001), the mean systolic blood pressure (r = 0.25; p = 0.02), the maximum diastolic blood pressure (r = 0.37; p = 0.001), and the mean diastolic blood pressure (r = 0.31; p = 0.005). The mean heart rate was 77 beats per minute. The majority of patients considered the procedure to be tolerable. In this series, the indications for conducting sialendoscopy under general anesthesia were procedures of greater invasiveness and complex situations with multiple sialolithiases, difficult anatomic preconditions, or a very long expected operation time. Conclusions: Sialendoscopy performed with local anesthesia is well tolerated, provided that the patient has a good general health status and the operative procedure is not expected to be complex or long-lasting.
Comparative Analysis of Primary and Secondary Rhinoplasties According to Surgeon's Perspective, Patient Satisfaction, and Quality of Life
Authors: Cingi Cemal , Eskiizmir Görkem , Çaklı Hamdi 
Published: October 2014

Objectives: We sought to analyze and compare the problems and technical difficulties related to surgical intervention, patient satisfaction, and quality of life after primary and secondary rhinoplasties. Methods: A total of 168 cases of rhinoplasty were grouped as primary or secondary according to the patient's history of rhinoplasty. The type of nasal deformity, the surgical approach, and the difficulty of the surgery were recorded. The levels of patient satisfaction and the quality of life were assessed before and after the operation with the Rhinoplasty Outcomes Evaluation (ROE) and European Quality of Life–5 Dimension (EQ-5D) questionnaires. A quantitative and statistical analysis was performed. Results: Thirty-three patients had secondary rhinoplasty, and 135 patients had primary rhinoplasty. Relatively high rates of saddle nose deformity, crooked nose, and tip asymmetry were observed in the secondary rhinoplasty group. The preoperative and postoperative scores on the ROE and EQ-5D questionnaires demonstrated statistically significant differences in both the primary and secondary rhinoplasty groups. The comparison of postoperative change between the primary and secondary rhinoplasty groups did not demonstrate a statistically significant difference. Conclusions: The surgical difficulty of secondary rhinoplasty is approximately twice that of primary rhinoplasty because of the high rate of major deformities. However, the levels of patient satisfaction and improvements in quality of life are similar after primary and secondary rhinoplasties.
Musical Pitch Discrimination by Cochlear Implant Users
Authors: Ping Lichuan , Yuan Meng , Feng Haihong 
Published: October 2014

Objectives: The main goal of this study was to investigate the effects of acoustic characteristics, including timbre and fundamental frequency (F0), on the musical pitch discrimination of cochlear implant users. Methods: Eight postlingually deafened cochlear implant users were recruited, along with 8 control subjects with normal hearing. Pitch discrimination tests were carried out using test stimuli from 4 musical instruments plus synthetic complex stimuli. Three reference tones with different F0s were used. Results: The mean difference limens were 1.8 to 10.7 semitones in the just-noticeable difference task and 2.1 to 13.6 semitones in the pitch-direction discrimination task for different timbre and F0 combinations. Three-way analysis of variance showed that the acoustic characteristics of the musical stimuli, such as timbre and F0, significantly influenced pitch discrimination performance. Conclusions: Acoustic characteristics determine the complexity of the electrical stimulation pattern, which directly affects performance in pitch discrimination. A place pattern with a clear and regular low-order harmonic structure is most important for good pitch discrimination. A clear F0-related temporal pattern is also useful when the F0 is low. Pitch perception performance will worsen when there is interference in the high-frequency channels.