bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revision Endoscopic Stapler Zenker's Diverticulotomy
Authors: Oestreicher‐Kedem Yael , Wasserzug Oshri , Sagi Boaz , Fliss Dan M. , Zikk Daniel 
Published: September 2014

Objectives:Endoscopic stapler Zenker's diverticulotomy (ESD) has become a well‐accepted treatment of Zenker's diverticulum (ZD). A small percentage of ZDs may recur after ESD. We sought to evaluate the technical feasibility, safety, and effectiveness of revision endoscopic stapler diverticulotomy (RESD) for recurrent ZD.Methods:A retrospective case study conducted in Tel‐Aviv Sourasky Medical Center. The records of all patients who underwent ESD between the years 2002 and 2013 were reviewed. The records of patients who underwent RESD were identified and screened for primary surgical history, symptoms of recurrent ZD, time to recurrence, intraoperative and postoperative RESD course, complications, and symptom resolution.Results:Eighty‐nine ESD were performed. Twenty were RESD for recurrent ZD and 69 were primary ESD (PESD). Nine RESD were performed for recurrent ZD after open trans‐cervical Zenker's diverticulectomy, 10 ESRD were performed for recurrent ZD after ESD, and 1 initial surgical approach was unknown. Mean patient age at revision was 66.1 years and mean time from first operation for ZD to RESD was 4.7 years. Average ESRD surgery time and hospital stay were 21.4 minutes and 2.8 days, respectively. Endoscopic stapling of the ZD was achieved in 19 of 20 RESD. Relief of symptoms without recurrence was achieved after 18 RESD. Four RESD patients experienced minor postoperative complications. We found no significant differences between the RESD and PESD groups regarding age, operative time, technical feasibility, hospital stay, and complication rate (P >. 05).Conclusions:RESD for ZD is technically feasible, safe, and effective. Results compare to PESD.
A Study of Injection Therapy Using bFGF by High‐Speed Imaging and Acoustic Analysis
Authors: Suzuki Hirotaka , Makiyama Kiyoshi , Takane Tomoyuki , Matuzaki Hiroumi 
Published: September 2014

Objectives:Some authors have reported effects of some materials used for injection. Their effects that reduce the size of glottal gap do not last because the materials are usually absorbed. Thus, patients with deficient glottal closure must be repeatedly injected. To reduce the number of treatments, we injected basic fibroblast growth factor (bFGF) into our patients. The purpose of this study was to examine the effect of bFGF injection by high‐speed imaging and acoustic analysis.Methods:Fifteen patients (8 men and 7 women, mean age 65 years) were enrolled in this study. Four or 8 µg of bFGF were injected into each treated vocal cord. The injection was made into the unilateral or bilateral vocal cord according to the size of glottal gap. All patients were followed up every 3 months. Using high‐speed imaging and PS77E, we analyzed the following factors: KEA (kimograph edge analysis), GAW (glottal area wave form), phase shift analysis, PPQ (period pertubation quotient), APQ (amplitude perturbation quotient), MFR (mean flow rates). The effect of the treatment was assessed by high‐speed imaging and acoustic analysis.Results:Data both from the imaging analysis and acoustic analysis showed significant improvement in all subjects after 6 months. No allergic or long‐term adverse effects were noted.Conclusions:The result of this study suggests bFGF may be effective long‐term and safe as a regenerative agent for aged vocal folds.
A Pilot Study of Muscle‐Nerve‐Muscle Grafting for Facial Reanimation in Rats
Authors: Hotaling Jeffrey M. , Charous Steven , Sappington Joshua M. , Foecking Eileen 
Published: September 2014

Objectives:(1) Describe the muscle‐nerve‐muscle (MNM) reinnervation technique, which involves implanting a graft to serve as a conduit between an innervated donor muscle and a denervated recipient muscle. (2) Analyze the effects of MNM reinnervation with and without electrical stimulation and exogenous testosterone on functional recovery following rat facial nerve injury.Methods:A prospective controlled animal study. Facial nerve branches to the whisker pads of 24 adult male Sprague Dawley rats were harvested and each rat was then randomly assigned to 1 of 3 treatment groups of 8 rats each: no graft (control), MNM grafting alone (MNM), or MNM grafting + electrical stimulation (ES) and testosterone propionate (TP) (MNM+). MNM grafts were implanted from the functioning to the nonfunctioning whisker pads in the experimental groups. One experimental group underwent an ES and TP protocol. Whisker movement was assessed by behavioral observations, electromyographic recordings, and video analysis.Results:Recovery of coordinated movement was displayed at 16 weeks by 0% of the control animals, 71% of the MNM animals, and 85% of the MNM+ animals. Electromyographic recordings demonstrated electrical conductance across grafts in both MNM and MNM+ animals. Histologic analysis of the MNM grafts demonstrated growth of myelinated fibers across nerve grafts in both MNM and MNM+ animals.Conclusions:This study demonstrated not only that reinnervation following MNM grafting can improve tone and movement in a selected muscle following a facial nerve injury, but also that therapy with electrical stimulation and exogenous gonadal steroids further enhances the recovery of these functional measures.
Association of Endolymphatic Hydrops and Otosclerosis
Authors: Terao Kyoichi , Doi Katumi , Cureoglu Sebahattin , Paparella Michael M. 
Published: September 2014

Objectives:Study the correlations of endolymphatic hydrops and vestibular symptoms with otosclerotic foci.Methods:Comparative study of human temporal bone histopathology. In addition to areas of the stria vascularis and spiral ligament and the presence of endolymphatic hydrops, locations and degree of endosteal involvement and size of otosclerotic foci were examined in 132 temporal bones from 95 subjects with otosclerosis. The degree of endolymphatic hydrops was classified as mild, moderate and severe.Results:Fifty temporal bones (37.9%) from 39 subjects with otosclerosis had a histopathological finding of endolymphatic hydrops. The most common location of endosteal involvement was the endosteum of the perilymphatic space of the vestibule. In terms of locations and degree of endosteal involvement and size of otosclerotic foci, there was a significant increase in subjects with otosclerosis with endolymphatic hydrops compared with subjects with otosclerosis without endolymphatic hydrops. Twenty five subjects (26.3%) had a documented history of vestibular symptoms in patients with otosclerosis. In addition to the presence of endolymphatic hydrops, locations and degree of endosteal involvement and size of otosclerotic foci were significantly greater in subjects with otosclerosis with vestibular symptoms compared with subjects with otosclerosis without vestibular symptoms.Conclusions:Endolymphatic hydrops is more common than previously realized in patients with otoslerosis. The common association of these 2 otologic conditions encourages researchers. Clinicians should keep in mind the common association of these 2 otologic conditions when encountering a patient with either of these conditions.
Association of Hearing Impairment and Frailty in Older Adults
Authors: Kamil Rebecca J. , Li Lingsheng , Lin Frank R. 
Published: September 2014

Objectives:Frailty is a state characterized by decreased physiologic reserve and weakness that is associated with poor health outcomes. Whether hearing impairment, which is associated with physical and cognitive decline, is associated with frailty, is unknown.Methods:We analyzed 2109 individuals 70 years and older in the 1999‐2002 cycles of the National Health and Nutrition Examination Survey (NHANES). Hearing impairment was measured by self‐report (good, little trouble, lot of trouble). Frailty was defined as the presence of at least 3 of the following: 5% unintentional weight loss in the past year and/or body mass index <18.5 kg/m2, slow walking speed, weakness, exhaustion, and low physical activity. Logistic regression models were adjusted for demographic characteristics, cardiovascular risk factors, hearing aid use, and health status.Results:Among all individuals, self‐reported hearing impairment was significantly associated with frailty in fully adjusted models (odds ratio [OR] 1.68 [95% confidence interval {CI} 1.00, 2.82]). Analyses stratified by sex demonstrated that this association was observed in women (OR 3.79 [95% CI 1.69, 8.51]) but not men (OR 0.85 [95% CI 0.44, 1.66]).Conclusions:In these cross‐sectional analyses, self‐reported hearing impairment was significantly associated with frailty in women. Further research using objective hearing measures and longitudinal assessment of frailty are needed.
Betahistine Effects on Tinnitus in Patients with Ménière's Disease
Authors: Azadarmaki Roya , Prasad Sanjay 
Published: September 2014

Objectives:Analyze the effects of betahistine on tinnitus in patients with Ménière's disease.Methods:Retrospective review of the effects of betahistine on tinnitus in patients with Ménière's disease treated from January 2010 to January 2014. Patients included in this study received therapy with 8 to 64 mg/d of betahistine. Clinical improvement in tinnitus symptoms was defined as a partial or total response.Results:A total of 764 patients with Ménière's disease were identified in our electronic database. Forty seven of these patients were treated with betahistine for vestibular symptoms. Duration of therapy varied from 1 week to 4 years. Twenty‐seven patients were successfully contacted for a phone interview or via email. Twenty‐three patients reported tinnitus as a symptom. Only 13 of the 23 reported tinnitus as a disturbing symptom. One patient stopped betahistine therapy after the first week because of palpitations, another stopped the betahistine after 2 weeks because of increased dizziness and nausea, and a third briefly stopped treatment while using albuterol for an episode of bronchitis. Only 3 patients had clinical improvement of their tinnitus (3/23; 13%). Sixteen patients reported improvement in their vestibular symptoms (16/27; 59.2%).Conclusions:Betahistine does not significantly reduce tinnitus in Ménière's patients treated for vestibular symptoms. Improvement in tinnitus may occur in some patients.
Bone‐Anchored Hearing Aid Implantation Using the Cochlear BA400 System: Early Experience and Patient‐Reported Outcomes
Authors: Wilkie Mark D. , Chakravarthy Kalyan M. , Mamais Costas , Temple Robert 
Published: September 2014

Objectives:Several contemporary bone‐anchored hearing aid (BAHA) surgical techniques have been described with the common goal of minimizing soft‐tissue reduction, which may benefit patients, surgeons, and audiologists alike. Recently, the hydroxyapatite coated Cochlear BA400 abutment was introduced, the first designed specifically for soft tissue preservation. We present our early experience of this system with corresponding patient‐reported outcomes.Methods:Data were collected prospectively on the first 25 patients implanted with the BA400 system at our institution (February‐September 2013). The Glasgow Benefit Inventory (GBI) was subsequently used to evaluate patient‐perceived quality of life in all patients 4 months following sound processor fitting.Results:Mean patient age was 61 years (range, 23‐91 years). BAHA was indicated for single‐sided deafness in 6 cases (24%) and for conductive or mixed loss when a conventional aid was contraindicated in the remainder. Procedures were performed under local anaesthetic in all but 1 case. Mean operating time was 14 minutes (range, 9‐22 minutes). Four patients (16%) suffered implant site soft tissue reactions which were all successfully managed conservatively and graded as follows: Holger's grade 1 (n = 2), 2 (n = 1), and 3 (n = 1). No other complications were observed. Respective overall, general health, social support, and physical health GBI benefit mean scores were +33 (95% confidence interval [CI]; 27‐39), +46 (95% CI; 37‐55), +15 (95% CI; 5‐25), and 0 (95% CI; –8 to 8).Conclusions:Our data support use of the soft tissue preserving Cochlear BA400 implant system, with shorter operating times, comparable soft‐tissue outcomes, and favorable patient‐reported quality‐of‐life when compared with conventional BAHA implantation techniques.
Bonebridge Implantation with Image Guidance Localization
Authors: Tan Amanda En‐Pei , Pang Jing‐Ying , Tan Tiong‐Yong , Yuen Heng‐Wai 
Published: September 2014

Objectives:The Bonebridge implant (BBI) is a bone‐conduction hearing implant with a relatively large floating mass transducer (FMT), which is seated within a bony well. This well is drilled in the mastoid process and the FMT is anchored onto the bony cortex with screws on the side of the well. The location of the well has to avoid vital structures, such as the posterior canal wall, the dura mater of the middle cranial fossa, and the sigmoid sinus. The size of the well must be sufficient to accommodate the size of the FMT. This becomes more important in patients with contracted mastoids.Methods:This case series aims to review the use of image guidance localization (IGL) in planning the site of the well. Under general anaesthesia, the patient was positioned supine, with the head turned away from the site of the BBI. Local anaesthetic was administered and a postauricular incision was made and deepened down to bone. The subperiosteal flap was elevated and the surgeon determined the location of the FMT, with the help of the IGL. A conservative cortical mastoidectomy was performed to create a well for the FMT to sit in. A subperiosteal pocket for the receiver coil was created posterior‐superior to the well.Results:Five patients underwent BBI surgery with IGL. Rapid and accurate localization of the site of the well for the FMT was possible in each case.Conclusions:The authors recommend IGL as a safe, rapid, and reproducible technique in localization of the site for the well of the BBI.
Cartilage versus Fascia in Pediatric Type 1 Tympanoplasty: Anatomic and Audiometric Results
Authors: Gupta Sachin , Kutz Joe W. , Roland Peter S. , Isaacson Brandon 
Published: September 2014

Objectives:To assess the anatomic and audiometric results of type I cartilage tympanoplasty and to compare them with the results of type I fascia tympanoplasty in children.Methods:A retrospective chart review was performed of pediatric patients who underwent primary type I tympanoplasty with cartilage or fascia at a tertiary academic center between July 2007 and July 2013. Patients were excluded who underwent concurrent mastoidectomy or ossicular chain reconstruction. Graft acceptance rates were compared between the 2 groups. In addition, preoperative and postoperative audiometric results were compared.Results:One hundred twenty patients were identified for inclusion into the study. The mean follow‐up time was 1 year. There was no significant difference between the cartilage and fascia tympanoplasty groups in terms of graft acceptance rate. Audiometrically, there were also no significant differences between the 2 groups in terms of mean pure tone average and speech discrimination score. A significantly higher percentage of patients who underwent cartilage tympanoplasty had a type B tympanogram (P <. 05).Conclusions:In children, cartilage and fascia tympanoplasty have similar results in terms of graft acceptance and hearing outcomes. This study corroborates the findings of other studies, that cartilage tympanoplasty is a safe and effective technique in children.
Clinical Features and Natural Course of Anteriorly Located Congenital Cholesteatoma
Authors: Chung Won‐Ho , Ryu Nam‐gyu , Chang Young Soo , Jang Kyu‐Sun , Hong Sung Hwa , Cho Yang‐Sun 
Published: September 2014

Objectives:Anteriorly located congenital cholesteatoma is a silent disease in the pediatric population. In most cases, they are diagnosed incidentally by endoscopic examination of tympanic membrane. The aims of this study were to evaluate the clinical features and natural courses of congenital cholesteatoma, especially anteriorly located group.Methods:From 2000 to 2012, 117 patients were diagnosed with congenital cholesteatoma. Retrospective chart review was done. Among them, 65 cases were anteriorly located congenital cholesteatoma. A total of 53 patients were exclusively located in the anterosuperior quadrant. Other cases were extended to posteriorly (n = 4) or inferiorly (n = 8). Age distribution, types (closed or open), volumes (measured by tetrahedron beam computed tomography), ossicular involvement, and possible origin of cholesteatoma were assessed.Results:Mean age was 3.07 years (1‐6). Patients older than 6 years were not encountered. Closed type was 61.5% (n = 40) and open type was 38.5% (n = 25). Volume of cholesteatoma was 59.38 ± 6.53 mm3 (closed type: 33.02, open type: 98.44). The incidence of open type and volume increased as age increased. Hearing loss was found in 5 cases. Ossicular involvement was found in 4 cases. During surgery, in many cases, the attachment of cholesteatoma to anterior side of cochleariform process was found by endoscopic examination.Conclusions:Anteriorly located congenital cholesteatoma seems to originate from the anterior side of the cochleariform process. Its size grows with age and tends to rupture into open type. In addition, it might be washed out through E‐tube as patients get older.
Cochlear Implantation Outcome in Patients with Common Cavity Deformity
Authors: Igarashi Kazunori , Hoshi Yujiro , Ashio Akinori , Karino Shotaro , Akamatsu Yusuke , Ogata Erika , Amasoba Tatsuya 
Published: September 2014

Objectives:(1) Analyze our own cases and those in published reports involving cochlear implantation (CI). (2) Determine the factors affecting outcome in patients with common cavity (CC) deformity.Methods:We reviewed the English and Japanese literature published from January 1995 to December 2013 using the keywords “CC,” “CI,” and “cochlear malformation.” We included cochlear implanted CC patients whose records on occurrence of cerebral spinal fluid (CSF) gusher, facial nerve stimulation (FNS), number of inserted and actively used electrodes, or hearing levels before or after CI were available.Results:A total of 72 cochlear implanted CC patients were identified from 11 reports, including 5 patients from our institution. Individual hearing results as monosyllable and word scores were reported in 9 and 15 patients, respectively. Monosyllable hearing levels were greater in patients inserted with ≥20 electrodes and in those younger at time of CI. CSF gusher occurred in 18 (32%) of 57 patients, and FNS occurred in 12 (44%) of 27 patients.Conclusions:Individual data are important in assessing the outcome after CI in patients with CC because the outcomes vary significantly. Although there have been several reports, only a few have reported efficient data to discuss the propriety of each operation. Younger age at CI and greater number of inserted electrodes were associated with better outcome following CI in patients with CC. However, additional data are needed to confirm our findings.
Comparison of 3 Different Steroid Regimes for Idiopathic Sudden Sensorineural Hearing Loss: Trinidadian Experience
Authors: Trinidade Aaron , Trinidade Austin I. 
Published: September 2014

Objectives:Compare the efficacy of 3 steroid regimes in the management of idiopathic sudden sensorineural hearing loss (ISSNHL) in an adult population in Trinidad, West Indies, where management of this phenomenon has not previously been described.Methods:Retrospective review from 2005 to 2013 of 71 adults presenting with unilateral ISSNHL and treated within 72 hours of onset at a private general otolaryngology practice in Trinidad. Patients fell into 3 treatment groups: Group 1, oral prednisolone as the primary modality (n = 25); Group 2, oral prednisolone followed by salvage intratympanic methylprednisolone (n = 28); Group 3, intratympanic methylprednisolone as the primary modality (n = 18). Oral prednisolone was given as 60mg/d for 2 weeks and intratympanic methylprednisolone was given as 1 mL of a 40 mg/mL solution once weekly for 3 weeks.Results:Audiometric measurements were taken pre‐ and poststeroid therapy. Group 1: 50% (n = 13) of patients experienced an improvement in hearing (average 8 dB). Group 2: 22% (n = 6) of patients experienced an improvement in hearing (average 10 dB). Group 3: 88% (n = 16) of patients experienced an improvement in hearing (average 15 dB).Conclusions:The use of intratympanic methylprednisolone as a primary modality in ISSNHL is likely to be more beneficial than oral prednisolone or as salvage therapy following prednisolone. Early intervention is associated with more favorable outcomes.
Comparison of Tinnitus Characteristics and the Impact on Patients with Presbycusis and Noise‐Induced Hearing Loss
Authors: Rosito Leticia S. , Dalligna Celso , Dalligna Daniela P. , Deutsch Konrado M. , Beduschi Giuliana , Jorge Karolina B. , Pappen Carlos H. 
Published: September 2014

Objectives:Compare acufenometry findings of patients with chronic unilateral disturbing tinnitus due to noise‐induced hearing loss (NIHL) or presbycusis, and determine if there is an association with the degree of annoyance.Methods:In this cross‐sectional study, 38 patients with presbycusis and 17 with NIHL were evaluated between September 2003 and January 2014. The tinnitus pitch and loudness were evaluated using acufenometry. Tinnitus handicap inventory (THI) and the visual analog scale (VAS) were used to assess the impact of tinnitus on the patient's life. Statistical analysis was performed using SPSS and Student t test.Results:The mean age of the patients with presbycusis and NIHL was 67.74 ± 8.73 years and 62.29 ± 9.57 years, respectively (P =. 04). The tinnitus pitch (3092 ± 2203 Hz vs 4220.59 ± 2907.26 Hz; P =. 12) as well as the loudness (42.71 ± 19.80 vs 47.40 ± 20.80; P =. 44) were similar in both groups. In addition, no statistically significant difference was observed in the THI and VAS of either group (P =. 76 and P =. 46, respectively).Conclusions:Despite the differences observed in the cause of tinnitus and the mean ages of the patients, no significant difference was observed in the behavior of tinnitus in the groups with presbycusis and NIHL. Furthermore, tinnitus had a similar impact on the lives of patients from both groups.
Conchal Approach Tympanoplasty
Authors: Man S. Christopher , Nunez Desmond A. 
Published: September 2014

Objectives:(1) Review standard tympanoplasty approaches. (2) Describe a novel approach that minimizes soft tissue dissection and provides good access.Methods:The charts of consecutive adult patients who underwent a conchal approach tympanoplasty between January 2010 and December 2012 at an urban teaching hospital under the care of a single surgeon were reviewed. The patient's age in decades at the time of surgery, sex, and proportion of intact tympanic membranes noted at follow‐up were recorded. Postoperative analgesic use and patient recorded satisfaction with the cosmetic appearance of the ear using a Likert type scale from 1 least to 5 most satisfied was collected for consecutive patients undergoing the procedure in 2013. The mean patient satisfaction score was calculated.Results:In the 3‐year period from 2010‐2012, the charts of 75 adults were reviewed. There were 45 females and 30 males with ages ranging from third to eighth decades. Complete tympanic membrane closure was achieved in 74 (98.7%). Twenty‐one adults treated in 2013 recorded a mean satisfaction score with the appearance of the postoperative ear scar of 4.8 out of 5. Postoperative analgesic consumption consisted of acetaminophen or diclofenac sodium on the day of surgery. No patients used analgesics beyond postoperative day 2.Conclusions:The conchal approach tympanoplasty is associated with a high graft take rate, low morbidity and high patient satisfaction with scar cosmesis.