bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stem Cell–Coated Tracheal Replacement in a Rabbit Model
Authors: Wood Megan W. , Wright Stephen C. 
Published: February 2015

ObjectiveDesign a single‐stage stem‐cell based tracheal replacement technique to expand tracheal reconstructive options.MethodA pilot study using 4 rabbits was performed in October through December of 2011 at Wake Forest Institute of Regenerative Medicine. Two procedures were performed on cadaveric animals, and 2 survival surgeries were performed on live animals. Our technique combined a segment of fixed, cell‐free cadaveric donor trachea and adipose or marrow derived stem cells harvested from the recipient animal. These acellular donor conduits were seeded with host stem cells and implanted.ResultsTracheal reconstruction for tracheal stenosis is an evolving field. Recent success using a stem‐cell based engineered trachea required a prolonged incubation ex vivo in a novel “bioreactor.” Taking this idea a step further, a single‐stage method would be optimal. After completion of both cadaveric surgeries, the surgical procedure was optimized. The following 2 live‐animal procedures were successful demonstrations of the ability to suspend stem cells in fibrin glue, seed the conduit, and replace a segment of trachea. Although both animals were euthanized following completion according to approved IACUC protocol, the final animal was extubated prior to euthanasia, and demonstrated comfortable, spontaneous respiration.ConclusionBased on pilot study technical success of short segment tracheal replacement with the use of fixed donor trachea and stem cell support, additional animal studies with extended follow‐up will provide the necessary data to improve tracheal reconstruction in a single‐stage surgical model.
The Effect of Acidity on the Electrical Barrier of Trachea
Authors: Miwa Masato , Miwa Mayumi , Shiozawa Akito , Ikeda Katsuhisa 
Published: February 2015

ObjectiveGastric acid can affect the laryngopharyngeal mucous membranes recognized as laryngopharyngeal reflux disease (LPRD). The aim of this study is to 1) Evaluate the electrical barrier function induced by acid by measuring transepithelial electrical resistance (TER) of tracheal epithelial cells. 2) Determine the effect of proton pump inhibiter (PPI) on TER.MethodTracheal epithelial cells were harvested from the trachea excised from a guinea pig (n = 20). Measurement of TER was performed after application of acid, PPI, and ion channel blockers in vitro. TER was measured with an epithelial voltameter (EVOM, WPI, Sarasota, USA) equipped with STX‐2 “chopstick” electrodes.ResultsAfter the apical administration of hydrochloric acid at a variety of pH values, TER of the epithelial cells decreased, and the electrical barrier was significantly down regulated from pH3. In the groups of cells cultured with a PPI, Lansoprazol (10‐50 µM), there was no significant variation in TER of the epithelial cells, regardless of the variations in acidity. There was an additive increase in TER values along with the addition of 100 µM of the channel blockers DPC and amiloride.ConclusionThe electrical barrier of the trachea was significantly down regulated by acid from pH3 and PPI might recover the down regulation via sodium and chloride channels.
Value of Ultrasonagraphy in Diagnosis of Laryngeal Lesions
Authors: Gomaa Mohammed A. , Hamad Mostafa S. , Osman Naser 
Published: February 2015

ObjectiveEvaluate the value of high‐resolution ultrasonography (HRUS) in diagnosis of various laryngeal lesions.MethodA prospective study done from March 2010 to July 2011 on 66 patients suffering from voice changes, pre‐examined by rigid endoscopy and diagnosed to have a laryngeal lesion, and 32 volunteers composed the control group. All 98 persons (patients and control groups) were examined by HRUS.ResultsHRUS was helpful in describing various laryngeal lesions as vocal cord nodules (13) 19.6%, vocal cord polyps (17) 25.7%, epiglottal enlargement (2) 3.03%, and vocal cord mass (6) 9.09%. It was highly significant in diagnosis of early subglottic lesions—(10) 15.2%—that were missed by rigid endoscopy. Also, vocal cords mobility can be demonstrated by HRUS. However, interarytenoid edema (18) 27.3% was difficult to detect.ConclusionRigid endoscopy is difficult to diagnose laryngeal lesions in patients with sensitive gag reflex, neck or jaw diseases, and stridor and in infants. HRUS is an alternative method in diagnosis of some laryngeal lesions in these patients, and it is superior in the diagnosis of small subglottic lesions.
Antimicrobial Properties of Copper in Hearing Aid Users
Authors: Bravo Gustavo , Duran Claudia , Carrasco Maria I. , Bahamonde Hector , Prado Valeria 
Published: February 2015

Objective1) Evaluate the antimicrobial properties of copper in hearing aid molds against the most prevalent pathogens of otitis externa in an in vitro system. 2) Determine the most suitable mold material to allow adequate diffusion of copper ions to perform its antimicrobial action.MethodExperimental study conducted from January to December 2010, consisting of an in vitro system with hearing‐aid molds made from different materials with and without copper in them, which were inoculated with external otitis pathogens at different concentrations (S aureus, P aeruginosa, C albicans, and A niger), then determine percentage of bacterial adhesion to materials.ResultsThere was a significant reduction in the percentage of microbial adherence to different mold materials with copper in them, in relation to those without copper, at different levels of microbial concentration for S aureus, P aeruginosa, C albicans, and A niger, while the percentages of adherence reduction fluctuated between 27% and 100% in those molds that contained copper. We have observed an inverse relation between the adherence reduction and the concentration of inoculated microorganisms. A greater microbial adherence reduction was shown in molds made of UV sensitive polymer with copper in their interior, compared with other materials.ConclusionResults show that copper exerts its antimicrobial properties through different materials, which opens an interesting challenge in the otolaryngological field and public health area to develop clinical studies focused on confirming whether the use of hearing aids with copper sheets inside reduces the risk of infectious external otitis.
Cytokines Induced by Gentamicin and Sepsis in the Cochlea
Authors: Quintanilla‐Dieck Lourdes , Larrain Barbara , Trune Dennis R. , Steyger Peter 
Published: February 2015

ObjectiveThe mechanism by which sepsis‐induced inflammation enhances aminoglycoside trafficking into the cochlea remains poorly understood. This study sought to determine if protein expression of inflammatory‐mediated cytokines in the cochlea is modulated by systemic sepsis and/or drug treatment.MethodThree groups of mice received 1 of the following treatments: gentamicin, lipopolysaccharide for sepsis induction, or both gentamicin and lipopolysaccharide. A fourth group served as controls. After sacrifice, cochleae were collected and homogenized for protein extraction. This was followed by an enzyme‐linked immunosorbent assay for analysis of 16 inflammatory‐mediated cytokines.ResultsThere was substantial elevation in cochlear expression of multiple cytokines in mice treated with bacteria‐derived lipopolysaccharide, with or without gentamicin. The most salient cytokines were interleukin‐1α, interleukin‐6, monocyte chemotactic protein‐1, and macrophage inflammatory protein‐α. Gentamicin alone did not induce a significant inflammatory response, compared to lipopolysaccharide. This suggests that in the cochlea, specific pro‐inflammatory cytokines are massively produced during a systemic infection, but not in the presence of aminoglycosides as the sole insult. Given that these cytokines increase permeability across blood‐endothelial barriers, permitting transendothelial migration of inflammatory cells, they may also enhance aminoglycoside trafficking and contribute to its ototoxicity.ConclusionAminoglycosides are usually prescribed for prophylaxis or systemic bacterial infection. The latter induces a pro‐inflammatory state that could enhance aminoglycoside uptake by cochlear tissues. Unveiling the mechanisms mediated by sepsis that contribute to cochlear uptake of aminoglycosides will aid the development of strategies to ameliorate or prevent this devastating side‐effect.
Efficacy of Multimodality Approach at Sudden Hearing Loss
Authors: Naiboğlu Barış , Külekçi Semra , Toros Sema Z. , Verim Ayşegül , Ertugay Çiğdem K. , Oysu Cagatay 
Published: February 2015

ObjectiveThe etiological spectrum of sudden hearing loss is ample and ambiguous. The combined form of different treatment modalities geared toward the hypothetical etiologies given at once must work better theoretically. This study is a trial to see whether addition of intratympanic steroid to systemic steroid and hyperbaric oyygen treatment works better or not.MethodProspective randomized study in a tertiary referral hospital. Fifty‐eight patients who presented with sudden hearing loss between 2008 and 2011 were enrolled into the study. Twenty patients who had received systemic steroid and hyperbaric oxygen composed group I while 38 patients who had received intratympanic steroid in addition to systemic steroid and hyperbaric oxygen composed group II.ResultsPosttreatment hearing improvement was statistically significant in both groups in terms of pure tone average according to Siegel’s criteria (P <. 05). Treatment was successful for 55% of patients in group I and 63% in group II. Although there is an increase in success rate with the addition of intratympanic steroid, this was not statistically significant (P >. 05). Regarding profound hearing loss over 90 dB, there seems a strong statistically significant difference. Treatment didn’t work in group I for a total of 6 patients (0%) while addition of intratympanic steroid to the protocol yielded success for 6 patients over 12 (50%) in group II (P <. 05).ConclusionAddition of intratympanic steroids to systemic steroid and hyperbaric oxygen yielded better results, but this was not statistically significant in general. However, intratympanic steroid injection seems beneficial for patients with profound sudden hearing loss.
Endoscopic Cochlear Implantation: A Prospective Study
Authors: Hershcovitch Meir , Samy Ravi N. , Nistor Vasile 
Published: February 2015

ObjectiveTo assess the hypothesis that an endoscopic technique would allow a resident to: 1) be able to create a cochleostomy in a proper location and 2) understand how to more accurately place an electrode into the scala tympani.MethodTwenty cadaveric specimens had a posterior tympanotomy approach performed using standard microscopic techniques. After this approach, a prospective single‐blinded, randomized study was performed with the resident completing 10 cochleostomies using only a microscope and 10 using only an endoscope. After the procedures were completed, both the resident and faculty expert reviewed the bones and assessed placement of cochleostomy, size of cochleostomy, and time to perform the cochleostomy.ResultsThe average time to the cochleostomy using the endoscopic technique was 5 min: 15 sec; with the microscope, this was 2 min: 41 sec. The average size of the cochleostomy with the endoscopic technique was 1.0 mm and with the microscope, it was larger than 1.0 mm. In terms of placement of the cochleostomy, only 5/10 (50%) were placed properly with the microscope but 8/10 (80%) were placed properly with the endoscope. This difference was statistically significant.ConclusionThis study points to some potentially significant advantages in using the endoscope vs the microscope for placement of the cochleostomy. While using the endoscope took longer to create the cochleostomy, the endoscope allowed a smaller cochleostomy with a more accurate placement, in this prospective, cadaveric study. Further study is warranted in the operating room with this technique, as endoscopic techniques may further enhance current microscopic placement.
oVEMP to High Frequencies Show Semicircular Canal Dehiscence
Authors: Manzari Leonardo , Burgess Ann M. , McGarvie Leigh A. , Curthoys Ian S. 
Published: February 2015

ObjectiveIn 26 patients with CT‐verified SSCD, to investigate the effect of frequency on the n10 component of the ocular vestibular‐evoked myogenic potential (oVEMP n10) evoked by air conducted sound (ACS) and bone conducted vibration (BCV) at the midline forehead at the hairline (Fz).MethodsA handheld Bruel and Kjaer 4810 minishaker provided BCV stimulation was used, using surface EMG electrodes beneath both eyes to record oVEMP n10. The stimulus ACS and BCV at either Fz or at the vertex of the skull (Cz) were tone bursts ranging from 125 Hz to 8000 Hz. Twenty‐seven healthy subjects were tested in the same paradigm.ResultsIn response to ACS and Fz BCV from 125 Hz until 8000 Hz in SSCD patients the oVEMP n10 amplitude beneath the contraSSCD eye was substantially and significantly larger than the oVEMP n10 beneath the ipsiSSCD eye. In normal patients, ACS oVEMPs n10 is present and reproducible until 1000 Hz, while in SSCD ACS oVEMPs n10 is present up to far higher frequencies (8000 Hz). To Fz BCV oVEMPs n10 is present until 8000 Hz in 23 patients but only to 1000 Hz in normal patients.ConclusionTesting OVEMP frequency tuning with ACS and BCV allows very simple, very fast identification of a probable unilateral SSCD in a manner which is very easy even for senior patients.
Tinnitus Disturbance in Normal Hearing Patients
Authors: Oliveira Carlos A.C.P. , Sampaio Andre L. L. , Granjeiro Ronaldo C. , Kehrle Helga M. , Oliveira Taciana S. C. 
Published: February 2015

ObjectiveTo evaluate the annoyance of tinnitus by means of the Tinnitus Handicap Inventory (THI) in normal hearing patients and to correlate it with outer hair cell function by means of the evoked otoacustic emission tests and with anxiety and depression disorders investigated by the Beck scale.MethodThis case‐control study was performed in 2 groups of normal hearing patients: study group (SG): 68 patients with tinnitus; and control group (CG): 46 patients without tinnitus. Patients were submitted to otoacoustic emissions tests, to THI evaluation, and to anxiety and depression search by Beck Scale.ResultsSeventy‐five ears (67.0%) in SG showed abnormal TOAE versus 18 ears (19.6%) in CG (P <. 0001). Sixty‐eight ears (65.2%) had abnormal DPOAE in SG versus 46 ears (50%) in the CG (P <. 029). There was no correlation between THI and the results of TOAE (P =. 799) and DPOAE (P >. 7) tests. SG had 44.1% (N = 30) individuals with anxiety versus 17.4% (N = 8) in CG (P <. 003). There was a statistical difference between the presence and absence of depression and anxiety and the THI (P <. 001). The ones with these disturbances showed higher THI scores.ConclusionThere was a correlation between anxiety and depression and the annoyance of tinnitus. Tinnitus annoyance showed no association to the outer hair cells’ function in this study.
Video Head Impulse Test Diagnoses Vestibulotoxicity
Authors: Halmagyi Gabor M. , MacDougall Hamish , Curthoys Ian S. , McGarvie Leigh A. 
Published: February 2015

ObjectiveVideo oculography is a simple, accurate alternative to the scleral search coil method measuring individual semicircular canal function in Head Impulse Testing (HIT). Here we compare the video HIT with the caloric test for the diagnosis of unilateral or bilateral vestibulotoxicity due to systemic gentamicin therapy.MethodUsing the video HIT (ICS Impulse – GN Otometrics, Taastrup, Denmark) we studied 23/126 patients with gentamicin vestibulotoxicity; 5 unilateral, 18 bilateral. All 126 had caloric testing (30°C, 44°C); 82 also had 0°C testing. The video HIT took about 15 minutes and gave immediate results.ResultsAll 126 patients had severe unilateral or bilateral impairment of lateral semicircular canal function on caloric testing. Slow phase velocity was under 5°/s for each 30 or 44°C irrigation and under 7°/s for each 0°C irrigation. The video HIT correctly detected this loss in all 23 patients tested. During the video HIT the gain of the vestibulo‐ocular reflex from each lateral semicircular canal varied from 0.3 to 0.9 (N > 0.95). While a gain of 0.9 is near normal, the data in each patient showed covert or overt catch‐up saccades, confirming the vestibulo‐ocular reflex deficit.ConclusionThe video HIT is a simple, accurate way of immediately diagnosing unilateral or bilateral gentamicin vestibulotoxicity avoiding the need for caloric testing. It might be applicable for monitoring of patients receiving potentially vestibulotoxic drugs and might in time replace the caloric test for the diagnosis of peripheral vestibulopathies.
Aortopexy for Vascular Tracheal Compression in Children
Authors: Wine Todd M. , Colman Kathryn L. , Mehta Deepak K. , Maguire Raymond C. , Morell Victor O. , Simons Jeffrey P. 
Published: February 2015

Objective1) Evaluate the presentation, diagnostic workup, and outcomes of contemporary surgical intervention for airway obstruction from innominate artery tracheal compression in children. 2) Assess the significance of synchronous airway lesions in the treatment of innominate artery tracheal compression.MethodThis study is a retrospective medical record review of 26 consecutive children who underwent aortopexy for innominate artery tracheal compression at a tertiary‐care children’s hospital. Presenting symptoms, diagnostic workup, presence of synchronous airway lesions, length of hospitalization, and treatment outcomes were examined.ResultsTwenty‐six patients (17 male, 65%) were included in the study. All were diagnosed with bronchoscopy and confirmed with radiographic imaging. Median age at diagnosis and surgery was 9.7 and 10.1 months, respectively. Presenting symptoms included noisy breathing (93%), cough (78%), dyspnea (44%), apnea (44%), cyanosis (19%), and recurrent respiratory infections (15%). Average degree of tracheal compression was 71% (SD 12%). Fifteen of 26 (58%) patients had synchronous airway lesions, including mild laryngomalacia and subglottic stenosis. Median length of stay was 2 days. Median follow‐up was 10 months. Subjective improvement occurred in all 20 patients for whom follow‐up information was available.ConclusionAnterior tracheal vascular compression can cause a variety of airway symptoms. Mild synchronous airway lesions are common and do not prevent successful aortopexy. Aortopexy is a safe and effective treatment for symptomatic anterior tracheal vascular compression from the innominate artery.
Effect of Adenotonsillectomy on Attention Tests
Authors: Abreu Cassiana B. , Pascoto Gabriela R. , Guedes Mariana , Weber Raimar , Pignatari Shirley S. N. , Stamm Aldo E. C. 
Published: February 2015

ObjectiveTo evaluate the performance of children and adolescents in tests of visual attention before and after surgical treatment of upper airway obstruction (adenotonsillectomy).MethodStudy group: 27 children (6‐17 years) with excessive daytime sleepiness undergoing surgical treatment of upper airways obstruction. Control group: 30 children (same age) without respiratory or sleep‐related complaints. TAVIS‐3 test was performed at baseline and 60 days after the surgery (patients) or first evaluation (controls).ResultsThe initial study population was comprised of 60 children, 29 in the treatment group and 31 in the control group. The final analysis included 57 patients, 27 in the treatment group and 30 in the control group. Mean Epworth Sleepiness Scale–Children (ESSC) decreased from 9.9 ± 2.8 to 5.1 ± 2.1 (P <. 001) in patients and from 4.7 ± 1.6 to 4.6 ± 1.7 for controls. Response time, number of action errors, and number of omission errors decreased significantly (P <. 001) between the 2 evaluations in patients when compared to controls.ConclusionSurgical treatment of upper airway obstruction and resolution of daytime sleepiness promote improvement in visual attention in children and adolescents.
Predicting Surgical Intervention in Micrognathic Infants
Authors: Tonsager Sara C. , Scott Andrew R. , Mader Nicholas S. , Vecchiotti Mark A. , Sidman James D. 
Published: February 2015

ObjectiveTo determine which factors in the early neonatal period may predict subsequent need for surgical intervention in infants with micrognathia.MethodA retrospective case series of 123 infants from 2 tertiary pediatric referral centers over a 10‐year period.ResultsForty‐eight (39%) of micrognathic children required definitive airway intervention during infancy in this series. These interventions came in the form of tracheostomy (n = 12), mandibular distraction osteogenesis (MDO) (n = 33), or prolonged intubation prior to withdrawal of care (n = 3). Factors associated with a need for definitive airway intervention included a history of intubation or tracheotomy in the first 24 hours of life (OR: 8.22; CI: 3.14‐21.54), a history of intrauterine growth restriction (OR: 4.1; CI: 1.00‐16.71), neurologic impairment (OR: 3.83; CI: 1.33‐11.06), and prematurity (<37 weeks gestational age) (OR: 2.38; CI: 1.02‐5.56). Those with isolated micrognathia without cleft palate were less likely to require intervention (OR: 0.2; CI: 0.05‐0.71).ConclusionWhile it is understood that the need for MDO or tracheostomy should be determined on a case‐by‐case basis, this study identifies a number of factors, which may predict which neonates with micrognathia are at increased risk for requiring early surgical intervention for respiratory and feeding problems.
Fifteen‐Degree Reverse Trendelenburg Position for FESS
Authors: Hathorn Iain F. , Habib Al‐Rahim , Manji Jamil , Javer Amin R. 
Published: February 2015

Objective1) To determine whether the 15‐degree reverse Trendelenburg position (RTP) during FESS improves endoscopic field of view compared to the horizontal position (HP). 2) To determine whether the 15‐degree RTP during FESS reduces intraoperative blood loss compared to the HP.MethodFifty CRS patients undergoing FESS were randomized to either 15‐degree RTP (experimental arm) or HP (control arm) from October 2011 to February 2012. Boezaart endoscopic field of view grading system was the primary outcome measure. Total blood loss, blood loss/minute, MAP, heart rate, anesthetic technique, and surgery time were recorded.ResultsThe 43 patients currently studied show a significant difference in mean Boezaart scoring between RTP and HP: 1.698 vs 2.124 (P =. 009), with RTP producing a better endoscopic field of view. There was also less blood loss per minute with RTP (P =. 05). No significant difference was found in total blood loss (P =. 236), time of surgery (P =. 458), or mean arterial pressure (P =. 825) between the 2 surgical positions.ConclusionThe 15‐degree RTP improves the endoscopic field of view during FESS and also reduces blood loss per minute during surgery. We would therefore recommend its use.