bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voice Production Mechanisms following Phonosurgical Treatment of Early Glottic Cancer
Authors: Mehta Daryush D. , Deliyski Dimitar D. , Zeitels Steven M. , Quatieri Thomas F. , Hillman Robert E. 
Published: October 2014

Objectives: Although near-normal conversational voices can be achieved with the phonosurgical management of early glottic cancer, there are still acoustic and aerodynamic deficits in vocal function that must be better understood to help further optimize phonosurgical interventions. Stroboscopic assessment is inadequate for this purpose. Methods: A newly developed color high-speed videoendoscopy (HSV) system that included time-synchronized recordings of the acoustic signal was used to perform a detailed examination of voice production mechanisms in 14 subjects. Digital image processing techniques were used to quantify glottal phonatory function and to delineate relationships between vocal fold vibratory properties and acoustic perturbation measures. Results: The results for multiple measurements of vibratory asymmetry showed that 31% to 62% of subjects displayed higher-than-normal average values, whereas the mean values for glottal closure duration (open quotient) and periodicity of vibration fell within normal limits. The average HSV-based measures did not correlate significantly with the acoustic perturbation measures, but moderate correlations were exhibited between the acoustic measures and the SDs of the HSV-based parameters. Conclusions: The use of simultaneous, time-synchronized HSV and acoustic recordings can provide new insights into postoperative voice production mechanisms that cannot be obtained with stroboscopic assessment.
Supracricoid Partial Laryngectomy: Swallowing, Voice, and Speech Outcomes
Authors: Webster Kimberly T. , Samlan Robin A. , Jones Bronwyn , Bunton Kate , Tufano Ralph P. 
Published: October 2014

Objectives: The purpose of the study was to describe the swallowing and vocal function of patients after supracricoid partial laryngectomy (SCPL) as they changed over the first postoperative year. Methods: Ten patients with laryngeal carcinoma underwent SCPL at Johns Hopkins Hospital between August 2003 and May 2005. Clinical and videofluoroscopic swallowing examinations and perceptual, acoustic, aerodynamic, and videostroboscopic voice evaluations were completed before operation and at 3 weeks (swallowing only) and 2 (voice only), 6, and 12 months after operation. Results: The mean time to gastrostomy tube removal was 82 days. The patients tolerated an increased variety of foods over the first postoperative year. All patients initially used therapeutic strategies to swallow safely, and some still required them at 1 postoperative year. Over the year, the perceptual ratings of voice quality improved significantly. There were no consistent changes in acoustic or aerodynamic measures. The number of patients who used multiple vibratory sources to phonate increased over the year. Conclusions: The patients tolerated regular diets, yet continued to exhibit silent aspiration and a variety of decompensations. Their voices were breathy, rough, and strained. Their voice quality ratings improved over the year. Group changes were not captured, and it appears that the changes in speech and voice 2 months after surgery were subtle.
Négrevergne Otoplasty Technique
Authors: Songu Murat , Négrevergne Michel , Portmann Didier 
Published: October 2014

Objectives: More than 200 different otoplasty procedures have been described in the literature to treat patients with prominent ears. However, no simple “best” technique exists. Methods: The Négrevergne otoplasty technique was developed by Michel Négrevergne and adopted in the Georges Portmann Institute in France. The technique includes partial-thickness posterior scoring of the auricular cartilage by use of monopolar cutting diathermy. Results: A telephone survey was designed solely for this study, aimed to give general information about the technique's outcomes. The survey, conducted by the first author among his patients who were followed up for more than 1 year, revealed that most patients (46 of 52) were very to completely satisfied with the appearance and symmetry of their ears. Furthermore, evaluation according to the Global Aesthetic Improvement Scale was performed by a blinded nonparticipating observer using the medical photographs of 48 patients who consented to “medical photography” to evaluate the effect of treatment. All patients were rated as “improved” or better on the Global Aesthetic Improvement Scale at 52 weeks. There were no ratings of “no change” or “worse.” Conclusions: The Négrevergne otoplasty technique is a relatively simple and rapid procedure that maintains the natural contours of the auricle with little morbidity by addressing the poorly developed or absent antihelical fold, an abnormally large concha, and a prominent lobule.
Improved Tracheoesophageal Prosthesis Sizing in Office-Based Tracheoesophageal Puncture
Authors: Sidell Douglas , Shamouelian David , Erman Andrew , Gerratt Bruce R. , Chhetri Dinesh 
Published: October 2014

Objectives: Tracheoesophageal puncture (TEP) for postlaryngectomy speech is increasingly being performed as an office-based procedure. We review our experience with office-based TEP and compare outcomes with those of operating room—based TEP. Our hypothesis was that office-based TEP results in improved prosthesis sizing, reducing the number of visits dedicated to prosthesis resizing. Methods: A retrospective chart review was performed of all patients who underwent secondary TEP at our institution from 2001 to 2008. The primary dependent measure was the change in the length of the voice prosthesis. We also evaluated the number of visits made to the speech-language pathologist for resizing before a stable prosthesis length was achieved, and the number of days between voice prosthesis placement and the date a stable prosthesis length was observed. Results: Thirty-one patients were included in this study. There was a significant difference in prosthesis length change between patients who had office-based TEP and patients who had operating room—based TEP (p < 0.001). In addition, the office-based cohort required fewer visits to the speech-language pathologist for TEP adjustments before a stable TEP length was achieved (p < 0.001). Conclusions: Voice prosthesis sizing was better in patients who had office-based TEP than in patients who had operating room—based TEP. This outcome is likely due to the lesser degree of swelling of the tracheoesophageal party wall in the office-based procedure.
FEESST in the Rehabilitation of Dysphagia after Partial Laryngectomy
Authors: Schindler Antonio , Ginocchio Daniela , Peri Andrea , Felisati Giovanni , Ottaviani Francesco 
Published: October 2014

Objectives: We describe the role of the laryngeal adductor reflex (LAR) and fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) in the rehabilitation of patients with oropharyngeal dysphagia after partial laryngectomy. Methods: Ten patients with a mean age of 64 years (range, 45 to 72 years) were included in the study. Seven patients underwent supraglottic laryngectomy, and 3 had supracricoid laryngectomy. Six patients underwent additional radiotherapy (RT), and 8 had functional neck dissection (ND). FEESST was performed on each patient in order to establish a swallowing rehabilitation program. Results: In 2 patients, not submitted to either ND or RT, the LAR was preserved; in 6 patients, who underwent both procedures, the LAR was delayed or absent. In 2 patients who underwent ND but not RT, the LAR was preserved in 1 case and delayed in the other. The patients with an absent LAR presented severe aspiration, whereas in those with a preserved LAR, no penetration was found. Moderate aspiration was found in the remaining patients. In the patients with a reduced or absent LAR, tactile and chemical sensory stimulation was added to the rehabilitation program. Conclusions: FEESST represents a useful tool in everyday clinical practice for the planning of swallowing rehabilitation after partial laryngectomy.
Endoscopic Assessment of the Nasopharynx: An Objective Score of Abnormality to Predict the Likelihood of Malignancy
Authors: Vlantis Alexander C. , Bower Wendy F. , Woo John K. S. , Tong Michael C. F. , van Hasselt C. Andrew 
Published: October 2014

Objectives: We developed an objective endoscopic score of abnormality of the nasopharynx to predict the likelihood of malignancy. Methods: A score sheet with 44 variables was developed to objectively quantify the bilateral endoscopic assessment of the nasopharynx. Patients scheduled to undergo nasopharyngeal biopsies were recruited. The nasopharynx was assessed endoscopically, photographed, and scored on 44 variables. The scores were compared to the biopsy results, and predictors of malignancy were modeled with regression analysis. The sensitivity and specificity of the novel scoring system were examined. Results: Seventeen patients had carcinoma, and 60 had a benign lesion or no disease. Patients with a nasopharyngeal malignancy scored significantly higher than did patients with a benign lesion or no disease. No patient with a malignant lesion had a score of less than 12. With a receiver operating characteristic curve area of 0.917, the score demonstrated an excellent ability to discriminate between nasopharynges that were likely or unlikely to contain malignant disease. Independent predictors for both malignant disease and a score greater than 12 were modeled. Conclusions: A cutoff score above 12 on the novel objective endoscopic assessment of the nasopharynx measure was highly predictive of possible malignancy.
Migration of Ingested Foreign Bodies into the Thyroid Gland: Literature Review and Case Report
Authors: Hohman Marc H. , Harsha Wayne J. , Peterson K. Linnea 
Published: October 2014

Objectives: We review the literature on the migration of ingested foreign bodies into the thyroid gland to analyze trends in patient presentation, evaluation, and management. Additionally, we present a case of an intrathyroidal foreign body from our own experience. Methods: We searched the Medline database using key words “foreign bodies” and “thyroid gland,” and present a new case report of an ingested foreign body that migrated to the thyroid gland. Results: Our search generated 11 relevant articles with 15 total patients. All patients were female; 10 foreign bodies were fish bones, 2 were chicken bones, and 3 were wire bristles. The most common presenting symptoms were throat pain (67%) and dysphagia (47%). Computed tomography was the most sensitive test (100%), although cervical radiography also had high sensitivity (79%). Endoscopy was substantially less sensitive (38%). All patients required neck exploration. Conclusions: Radiographic evaluation has a high likelihood of detecting foreign bodies in the thyroid gland, and a computed tomographic scan is doubly useful because it assists in preoperative planning. Endoscopy has limited utility in cases of extraluminal migration, but should still be performed to evaluate soft tissue that is poorly visualized on a computed tomographic scan. Unless the foreign body can be removed endoscopically and there are no complications from migration or perforation, the definitive treatment is surgical.
Videolaryngoscopic Transoral En Bloc Resection of Supraglottic and Hypopharyngeal Cancers Using Laparoscopic Surgical Instruments
Authors: Shiotani Akihiro , Tomifuji Masayuki , Araki Koji , Yamashita Taku , Saito Koichiro 
Published: October 2014

Objectives: We assessed the outcome of en bloc transoral resection of supraglottic and hypopharyngeal cancer using a distending laryngoscope with rigid videoendoscopic and laparoscopic surgical instruments. Methods: We enrolled 30 patients with T1, T2, or selected T3 supraglottic and hypopharyngeal cancer in the study; 9 patients had undergone radiotherapy. Neck dissections were performed for node-positive patients. Postoperative radiotherapy was administered to patients with multiple lymph node metastases or positive surgical margins. Results: This surgical environment provided a wide view of the operative field, facilitating bimanual manipulation of laparoscopic surgical instruments, and enabled us to perform en bloc transoral resection. In 21 cases with a minimum follow-up period of 1 year (average, 33 months; range, 15 to 56 months), the 3-year disease-specific survival rate and the laryngeal preservation rate were each 95%. Normal food intake was eventually possible in all cases. Tracheostomy was performed for 2 patients as a prophylactic measure and for 1 patient because of a postoperative hemorrhage. Conclusions: These results indicate that videolaryngoscopic transoral en bloc resection using laparoscopic surgical instruments can be one of the minimally invasive treatment options for supraglottic and hypopharyngeal cancers with satisfactory oncological outcome and postoperative laryngeal function.
Diagnosis and Management of Type I Posterior Laryngeal Clefts
Authors: Bakthavachalam Sivi , Schroeder James W. , Holinger Lauren D. 
Published: October 2014

Objectives: We review the diagnosis and management of type I posterior laryngeal clefts (PLCs). Methods: We performed a retrospective study at a tertiary-care children's hospital of children who were diagnosed with a PLC between January 2003 and August 2008. We studied concurrent airway anomalies, comorbidities, presenting symptoms, age at the time of aspiration resolution, and rate of aspiration resolution. Results: Sixty-seven children with PLCs were identified (41 boys and 26 girls). Fifty-nine had type I clefts, 6 had type II, and 2 had type III. Of the 59 type I cases, 15 (25.4%) were surgically repaired by endoscopy. Eleven of these 15 children (73.3%) have had symptomatic improvement since the surgery, and 7 of those 11 (63.6%) are tolerating thin liquids by mouth. Two of the 15 (13.3%) displayed no improvement with surgery, and 2 of the 15 (13.3%) were lost to follow-up. Forty-four of the 59 type I clefts (74.6%) were managed nonsurgically. Twenty of these 44 children (45.5%) did not present with aspiration. Twenty-four of the 44 (54.5%) presented with aspiration, and 16 of the 24 (66.7%) are now tolerating thin liquids by mouth. Seven of these 24 patients (29.2%) are still aspirating, and 1 has died. The average time to resolution of aspiration was 7.8 months for the surgical group and 13.6 months for the nonsurgical group (p = 0.19). In the surgical group, the average age at resolution of aspiration for patients who received their diagnosis at 0 to 6 months of age was 21.5 months; that for those with a diagnosis at 6 to 12 months was 27.3 months; and that for those with a diagnosis at older than 12 months was 27.3 months (p = 0.31). In the nonsurgical group, the average age at resolution of aspiration for patients who received their diagnosis at 0 to 12 months of age was 15.8 months; that for those with a diagnosis at 12 to 24 months was 27.3 months; and that for those with a diagnosis at older than 24 months was 77.3 months (p = 0.0015). Conclusions: We found that 1) the reported incidence of type I PLCs is increasing; 2) type I PLCs can often present without clinical aspiration; 3) aspiration caused by type I PLCs can be managed medically or surgically; and 4) operative intervention is advantageous for patients who have severe symptoms or who have persistent aspiration after 2 years of age.
Endoscopic Removal of Esophageal Impacted Dentures
Authors: Fang Rui , Sun Jingwu , Hu Yanming , Yao Kun , Hu Wei 
Published: October 2014

Objectives: A retrospective study was conducted on 6 patients with esophageal impacted dentures removed via rigid esophagoscopy. Methods: Six patients with esophageal impacted dentures were treated in our department, and the following technique was successfully performed. With the patients under general anesthesia, we inserted the endoscope to visualize the impacted dentures, fixed them with forceps, and then stuffed several cotton slivers soaked in saline solution into the esophagus around the dentures with another forceps. Then we extracted the dentures from the esophagus. Results: All dentures were extracted through esophagoscopy, and there were no severe complications except for 1 case of esophageal hematoma. Conclusions: The dilation method using saline solution—soaked cotton slivers is relatively safe and effective in removing impacted dentures from the esophagus, avoiding open surgery and possible perforation.
Successful Decannulation of T-Tubes According to Type of Tracheal Stenosis
Authors: Kim Sang Cheol , Kim Se-Heon , Kim Benjamin Youngho 
Published: October 2014

Objectives: Although the T-tube has been widely used as a therapeutic method for treatment of tracheal stenosis, predictors for success have not been much studied. The authors analyzed several factors to search for a factor that would be useful as a prognostic indicator for successful decannulation. Methods: A total of 41 patients who underwent T-tube insertion from 1995 to 2004 at Yonsei University Health System were included. The medical records were reviewed retrospectively, and several factors regarding the type of stenosis were evaluated. Results: Age, sex, and multiplicity and severity of stenoses (p = 0.860) were not significantly related to successful decannulation. The longitudinal extent of stenosis had a significant influence on success (p = 0.035), and cases with a greater circumferential involvement tended to result in decannulation failure (p = 0.084). Conclusions: The severity of stenosis did not have a statistically significant relationship to the decannulation rate, although it was closely related to the patient's symptoms. The longitudinal extent and the circumferential involvement of stenosis were found to be correlated to the success rate and represented the extent of the damaged mucosal area. Therefore, it was assumed that the extent of the damaged mucosal area could be more important than the area of the granulation tissue or the patients' symptoms in predicting the decannulation of T-tubes.
Role of Dexamethasone in Reducing Pain after Endoscopic Sinus Surgery in Adults: A Double-Blind Prospective Randomized Trial
Authors: Al-Qudah Mohannad , Rashdan Yasser 
Published: October 2014

Objectives: We sought to study postoperative pain after endoscopic sinus surgery and to evaluate the efficacy of dexamethasone sodium phosphate in reducing pain and rescue analgesic requirements. Methods: In a prospective, double-blind, placebo-controlled clinical trial, 62 patients with chronic rhinosinusitis who were undergoing general anesthesia for endoscopic sinus surgery were randomized to receive either 8 mg (2 mL) of intravenous dexamethasone sodium phosphate or 2 mL of saline solution at the time of induction of anesthesia. After surgery, the patients were observed for 24 hours and were given 1 g of acetaminophen every 6 hours. Pain severity was reported immediately and 6 and 24 hours after surgery on a 10-cm visual analog scale. The need for rescue analgesia with tramadol hydrochloride was recorded and compared between the two groups. Results: The two groups were matched by demographic data, clinical indications, and intraoperative details. The average postoperative pain severity scores at the 3 time intervals were 3.6, 2, and 1 in the dexamethasone group and 3.6, 2.5, and 1.6 in the saline solution group. These differences were not statistically significant. Ten patients in the dexamethasone group required rescue analgesia, compared to 12 in the saline solution group. The average patient required 0.53 doses of rescue analgesic in the dexamethasone group, versus 0.67 doses in the saline solution group. Again, these differences were not statistically significant. Conclusions: Dexamethasone injection at the time of induction of general anesthesia is not superior to placebo in controlling early postoperative pain in patients who undergo endoscopic sinus surgery.
Partial Characterization of Normal and Haemophilus Influenzae—Infected Mucosal Complementary DNA Libraries in Chinchilla Middle Ear Mucosa
Authors: Kerschner Joseph E. , Erdos Geza , Hu Fen Ze , Burrows Amy , Cioffi Joseph , Khampang Pawjai , Dahlgren Margaret , Hayes Jay , Keefe Randy , Janto Benjamin , Post J. Christopher , Ehrlich Garth D. 
Published: October 2014

Objectives: We sought to construct and partially characterize complementary DNA (cDNA) libraries prepared from the middle ear mucosa (MEM) of chinchillas to better understand pathogenic aspects of infection and inflammation, particularly with respect to leukotriene biogenesis and response. Methods: Chinchilla MEM was harvested from controls and after middle ear inoculation with nontypeable Haemophilus influenzae. RNA was extracted to generate cDNA libraries. Randomly selected clones were subjected to sequence analysis to characterize the libraries and to provide DNA sequence for phylogenetic analyses. Reverse transcription—polymerase chain reaction of the RNA pools was used to generate cDNA sequences corresponding to genes associated with leukotriene biosynthesis and metabolism. Results: Sequence analysis of 921 randomly selected clones from the uninfected MEM cDNA library produced approximately 250,000 nucleotides of almost entirely novel sequence data. Searches of the GenBank database with the Basic Local Alignment Search Tool provided for identification of 515 unique genes expressed in the MEM and not previously described in chinchillas. In almost all cases, the chinchilla cDNA sequences displayed much greater homology to human or other primate genes than with rodent species. Genes associated with leukotriene metabolism were present in both normal and infected MEM. Conclusions: Based on both phylogenetic comparisons and gene expression similarities with humans, chinchilla MEM appears to be an excellent model for the study of middle ear inflammation and infection. The higher degree of sequence similarity between chinchillas and humans compared to chinchillas and rodents was unexpected. The cDNA libraries from normal and infected chinchilla MEM will serve as useful molecular tools in the study of otitis media and should yield important information with respect to middle ear pathogenesis.
Initial Clinical Experience with Balloon Dilation in Revision Frontal Sinus Surgery
Authors: Wycherly Benjamin J. , Manes R. Peter , Mikula Suzette K. 
Published: October 2014

Objectives The purpose of this study was to determine whether balloon dilation is effective in revision frontal sinus surgery. Methods We retrospectively reviewed all patients who had previously undergone endoscopic frontal sinus surgery and had persistent sinusitis. AH patients then underwent balloon dilation of the frontal ostium. Outcome measurements included endoscopic patency of the frontal ostium, Lund-Mackay scores, culture-positive postoperative infections, and subjective persistence of symptoms. Results Twenty-four frontal ostia and recesses were dilated in 13 patients. The mean follow-up was 13 months (range, 7 to 19 months). During follow-up, 21 of 24 ostia (86%) remained patent and 3 required additional procedures. Postoperative computed tomography scans were performed an average of 12 months after dilation (range, 6 to 18 months) in 9 patients (17 sinuses). The average Lund-Mackay score was 1.35 before dilation and 0.87 at follow-up (p = 0.0076), with 41 % of sinuses (7 of 17) displaying radiographic improvement. The average number of postoperative infections was 2.07 (range, 0 to 7). Frontal headaches persisted in 38% of patients (5 of 13) at follow-up. Conclusions Balloon dilation of the frontal ostia has a posttreatment patency rate comparable to those of other endoscopic revision techniques. Although it may not fully address the frontal sinus disease of all patients, it is a less invasive technique that may be helpful for some patients.