bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Feasibility Trial for Transtracheal Stimulation of Vocal Fold Closure in Sensate Human Subjects
Authors: Hahn Elizabeth C. , Hadley Aaron , Tyler Dustin J. , Maronian Nicole 
Published: September 2014

Objectives:(1) Apply transtracheal stimulation (TTS) of the recurrent laryngeal nerve (RLN) for vocal fold closure (VFC) in sensate humans. (2) Characterize tracheal sensory response to electrical stimuli.Methods:Patients with chronic tracheostomies were selected for a “first‐in‐man” clinical device trial to stimulate the RLN through tracheal tissue for VFC. Etiologies of trach dependence varied, but all subjects had normal laryngeal sensation, vocal cord mobility, and RLN function. Devices were introduced through subjects’ ostomies, and electrodes were subsequently deployed for tracheal contact. Videoendoscopy recorded responses to square wave pulse trains of varying pulse amplitude (PA) and pulse width (PW; 0.5 mA‐5 mA and 60 us‐500 us, respectively). Subjects were surveyed for sensory changes, discomfort, and pain.Results:TTS of the RLN successfully elicited VFC in all subjects. The PA threshold for closure (ThPA; at PW = 200 us) ranged from 1.5 mA to 3.5 mA unilaterally, and 1.0 mA to 2.5 mA bilaterally for all subjects except 1 outlier with thresholds of 0.9 mA and 1.2 mA unilaterally, and 0.7 mA bilaterally. PW thresholds (ThPW) ranged from 100 us to 300 us for all subjects (PA = 0.75 × ThPA). All subjects denied pain, but 3 described mild incremental “tingling” that initiated cough or swallow responses only at suprathreshold levels.Conclusions:TTS initiated arytenoid medialization for VFC in all subjects without pain or significant discomfort. This study presents a novel technique for noninvasive restoration of VFC in humans. Further trials will determine full clinical utility of this device component, individually and in conjunction with components targeting swallow detection and laryngeal elevation for coordinated airway protection.
Comparative Effectiveness of Office‐Based 532‐nm Laser‐Assisted Vocal Polypectomy and Phonomicrosurgery: A Matched Cohort Study
Authors: Cheng Po‐Wen , Wang Chi‐Te 
Published: September 2014

Objectives:Office‐based procedures, including indirect laryngoscopic surgery and angiolytic laser photocoagulation, have been proposed to treat hemorrhagic vocal polyps. Our previous research documented good treatment outcomes by combining the 2 aforementioned procedures (laser‐assisted vocal polypectomy [LAVP]). This study intends to further compare the effectiveness of LAVP with the gold standard of phonomicrosurgery.Methods:This study retrospectively enrolled 50 age‐, sex‐, and size‐matched patients of hemorrhagic vocal polyps treated by LAVP or phonomicrosurgery at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks after, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10‐item voice‐handicap index (VHI‐10), maximal phonation time (MPT), subjective rating of voice quality, and videolaryngostroboscopic evaluations.Results:Both LAVP and phonomicrosurgery demonstrated significant improvements in most measuring parameters, 2 and 6 weeks postoperatively. Comparative effectiveness demonstrated similar objective outcomes (MPT, VHI‐10, perceptual, endoscopic, and acoustic analyses) between LAVP and phonomicrosurgery, while patients who received LAVP reported more symptomatic relief and higher subjective voice quality then phonomicrosurgery 2 weeks postoperatively. Six weeks after the procedures, both objective and subjective effectiveness revealed non‐significant differences between the 2 treatment groups.Conclusions:This study demonstrated that office‐based 532‐nm LAVP can be an effective, practical, and safe alternative treatment for small hemorrhagic vocal polyps. Patients who received LAVP experienced rapid symptomatic relief with higher subjective effectiveness than phonomicrosurgery, 2 weeks postoperatively. The overall treatment outcomes showed comparable effectiveness between LAVP and phonomicrosurgery.
Comparison between Essential Vocal Tremor and Dystonic Vocal Tremor Treated with Botulinum Toxin and Propranolol
Authors: Guglielmino Grazzia , Vilanova Luiz C. , Moreti Felipe T. G. , Padovani Marina M. P. , De Biase Noemi G. 
Published: September 2014

Objectives:Determine and compare the response to treatment with intramuscular botulinum toxin and oral propranolol on vocal tremors, essential and dystonic.Methods:Randomized clinical trial between January 2012 and September 2013. Fifteen patients with vocal tremor were divided into 2 groups: essential and dystonic vocal tremor. Both groups were treated with botulinum toxin in thyroarytenoid muscle (15 units of Dysport unilaterally) and propranolol (80 to 120 mg daily) at different times. Time to “wash out” after injection of 6 months and after propranolol 2 months. Patients underwent self‐assessment of vocal improvement, nasofibroscopy larynx, perceptual, and acoustic analysis of voice before and after each treatment. Data were compared according to the type of tremor and treatment and subjected to statistical analysis (significance level of. 05).Results:There was statistically significant improvement in perceptual measure of vocal instability in patients with dystonic tremor after treatment with botulium toxin, compared with propranolol (P =. 028). The acoustic measurement variabiity of fundamental frequency was also statistically significant, with a decrease in the treatment of dystonic tremor in connection with the botulinum toxin compared with propranolol (P =. 05) and before treatment (P =. 011).Conclusions:The dystonic and essential tremors differ in responses to treatment. The dystonic tremor responds positively to the injection of botulinum toxin into the thyroarytenoid muscle, but not to the use of oral propranolol.
Development of a Tissue‐Engineered Vocal Fold Cover Replacement from Rabbit Adipose Stem Cells
Authors: Shiba Travis L. , Long Jennifer L. 
Published: September 2014

Objectives:Tissue engineering of a vocal fold replacement is a promising potential treatment for severe vocal fold scarring. Development and testing of such a tissue construct is an ongoing project. We have previously demonstrated that human adipose‐derived stem cells (ASC) can produce a bilayered construct with suitable properties for implantation and phonation. This phase of the project developed a similar construct for pre‐clinical animal studies, using rabbit cells.Methods:Rabbit ASCs were isolated, cultured, and embedded in fibrin gels under air‐liquid interface conditions and with epidermal growth factor. After culture periods of 1 to 4 weeks, constructs were harvested, sectioned, and examined with immunohistochemistry.Results:Rabbit cells attached and survived within fibrin gels. Differentiation of the cells to epithelial and mesenchymal lineages was determined by microscopic markers. Deposition of extracellular matrix and basement membrane proteins was also examined.Conclusions:Rabbit ASCs are suitable for use in a tissue‐engineered vocal fold replacement. This model will be used in future implantation trials in rabbits.
The Impact of Pharyngeal Repair Time and Number of Sutures on Development of Pharyngocutaneous Fistula
Authors: Taskin Umit , Aydin Salih , Orhan Israfil , Altas Bengul , Yucebas Kadir , Ege Sertug S. , Oktay Mehmet F. 
Published: September 2014

Objectives:Pharyngocutaneous fistula (PCF) is the most common postoperative complication following total laryngectomy. The aim of this study was to determine the effects of pharyngeal repair time and number of mucosal sutures used on the development of PCF.Methods:The medical records of 47 patients who underwent total laryngectomy were assessed. The pharyngeal repair time and the number of horizontal, vertical, and cricopharyngeal muscle sutures were recorded.Results:We observed the appearance of PCF in 14 patients (29.8%). The average time for pharyngeal repair in patients without PCF was 22 minutes, 21 seconds ± 5 minutes, and the average number of vertical, horizontal, and cricopharyngeal muscle sutures was 9.54 ± 2.6, 10.84 ± 2.3, and 7.36 ± 2.7, respectively. The average time for pharyngeal repair in patients with PCF was 22 minutes 59 seconds ± 5 minutes, and the average number of vertical, horizontal, and cricopharyngeal muscle sutures was 8.57 ± 2.6, 11.14 ± 2.1, and 8.45 ± 1.9, respectively. The differences in pharyngeal repair time and number of vertical, horizontal, and cricopharyngeal sutures between the 2 groups were not statistically significant (P >. 05). As the number of vertical sutures increased, the fistulas developed later (P <. 05). In addition, as the number of cricopharyngeal sutures increased, the duration of the fistula decreased (P <. 05).Conclusions:Surgeons should not be in a hurry when they are repairing esophageal openings, and more sutures should be used in closing the cricopharyngeal muscle to decrease the duration of PCF. Using more vertical sutures when closing the esophagus delays the onset of fistulas.
Laryngopharyngeal Symptoms in Patients with Chronic Obstructive Pulmonary Disease
Authors: Turfe Zaahir , Kanj Nadim , Sarieddine Doja , Hamdan Abdul Latif 
Published: September 2014

Objectives:Report the prevalence and severity of laryngo‐pharyngeal symptoms in patients with chronic obstructive pulmonary disease (COPD) compared with controls.Methods:A total of 27 patients with COPD and 13 controls matched according to age and sex were included. Demographic data included age, sex, history of smoking, and history of allergic rhinitis. The Reflux Symptom Index described by Belafsky et al was used. The frequency and average score of each of the laryngopharyngeal symptoms in both the patient group and controls were computed.Results:The mean age of patients was 61.67 years ± 11.09 years. Sixty‐three percent were males and 37% were females. Ninety‐two percent were smokers and 11.1% had allergic rhinitis. The mean of total Reflux Symptom Index in patients was significantly higher compared with controls (12.70 ± 7.06 vs 3.00 ± 2.94, P value <.05). In the COPD group, 18 subjects had a positive Reflux Symptom Index (>11) compared with 1 in the control group (P value <.05). There was also a significant difference between the means of 6 laryngopharyngeal symptoms in patients versus controls. COPD patients had higher degree of hoarseness, throat clearing, excessive throat mucus, cough, and sticking sensation in the throat.Conclusions:Laryngopharyngeal reflux is more prevalent in COPD patients versus controls. The frequency and severity of laryngopharyngeal symptoms is significantly higher in COPD patients.
Office‐Based Resection of Large Vocal Process Granulomas
Authors: Lutch Matthew J. 
Published: September 2014

Objectives:(1) Describe techniques to appropriately anesthetize the larynx to facilitate complete resection of large granulomas in an unsedated patient. (2) Implement transnasal and transoral techniques to resect granulomas in conjunction with fiber‐guided lasers.Methods:This is a retrospective review of patients undergoing resection of large symptomatic vocal process granulomas in the office environment. Three patients were treated with resection of granulomas with primarily transoral excision, with transnasal resection and laser ablation utilized as adjunct techniques. Botox injections were also used in a subset of patients to optimize healing. All procedures were documented with video. All patients received only topical anesthesia with no periprocedural sedation.Results:All patients had resolution of their granulomas or self‐reported their vocal function to have returned to baseline after healing.Conclusions:Large vocal process granulomas can be treated in a single session in the laryngology procedure suite on the unsedated patient. An excellent outcome can be attained with readily available technology to include rigid endoscopy, flexible tranasal laser laryngoscopy, and Botox injections. Consideration should be given to treating these bulky granulomas in the office‐based environment.
Unique Clinical Findings in Laryngeal Leukoplakia to Predict Serious Histopathology in Low‐Risk Nonsmokers
Authors: Uno Kosuke , Saito Koichiro , Ono Takeyuki , Yabe Haruna , Ogawa Kaoru 
Published: September 2014

Objectives:Although most of the laryngeal leukoplakias are temporal inflammatory lesions in non‐smokers, some patients represent serious histopathologies to require careful management. The purpose of this study was to clarify unique clinical features of the patients who require cautious care in this low‐risk group.Methods:One hundred fifty‐four consecutive patients referred to our institution with laryngeal leukoplakia from June 2006 to May 2013. Of these, 24 patients without smoking history were incorporated in this study. Retrospective chart reviews and the re‐evaluations of video‐taped laryngeal images were performed. Sequential change of vocal quality (Grade, Roughness, Breathiness, Asthenia, Strain scale) was assessed in each patient. Timings to show improvements of laryngeal images were studied in the patients with spontaneous disappearances of leukoplakias (n = 12). Furthermore, excisional biopsies were performed on 12 patients and their histopathologies and vocal/stroboscopic characteristics were compared with each other.Results:Spontaneous disappearances of the lesions were observed 4.6 months after referral to our hospital on average, and these patients presented vocal quality of G1 or G0 at their first visits. Additionally, gradual recoveries in their glottal closure and/or pliability of diseased vocal folds were observed in this group. Furthermore, patients with histopathology of severe dysplasia/cancer presented with either (1) no improvement in their G2 voice for 1 month, (2) incomplete glottal closure coupled with abnormal pliability of diseased vocal folds for 1 month, or (3) abnormal pliability of diseased vocal folds for 4 months.Conclusions:Our analyses identified several specific findings to predict serious pathology in laryngeal leukoplakia patients without smoking history.
Voice Outcome and Quality of Life after Trasoral Laser Microsurgery for Glottic Cancer
Authors: Kwak Min K. , Lee Yun Jae , Ji Yong Bae , Song Chang Myeon , Lee Seung Hwan , Park Chul Won , Tae Kyung 
Published: September 2014

Objectives:Transoral laser microsurgery is considered one of the best techniques for the treatment of early stage glottic cancer. But voice outcome and quality of life (QOL) after laser cordectomy has not been fully evaluated. The aim of this study is to evaluate the voice outcome and QOL after transoral laser cordectomy in glottic cancer.Methods:We studied 43 glottic cancer patients who underwent transoral laser cordectomy from January 2002 to December 2008, retrospectively. We evaluated objective and subjective voice outcome using acoustic analysis, aerodynamic study, and voice handicap index (VHI). We also assessed QOL using EORTC QLQ‐C30/H&N35 questionnaire at preoperative and postoperative 6 to 12 months. We analyzed the correlation between voice outcome and QOL according to the types of laser cordectomy.Results:Postoperative harmonic to noise ratio, maximum phonation time, and VHI score was significantly improved from preoperative scores in patients who underwent type I‐II cordectomy (P =. 010, P <. 001, and P =. 013, respectively). Functional VHI score after Types I‐II cordectomy group (2.25 ± 6.08) was significantly lower than that of Types III‐VI cordectomy group (7.26 ± 6.96; P =. 043). Postoperative QOL score was not different between Types I‐II (73.71 ± 12.96) and Types III‐VI (82.37 ± 27.32) cordectomy groups (P =. 437). However, postoperative QOL score had a positive correlation with postoperative VHI score (Spearman ρ = 0.494, P =. 017).Conclusions:Objective and subjective voice outcome after laser cordectomy showed favorable results, especially in patients who underwent Type I or II laser cordectomy.
An Analysis of the Correlation between Tinnitus Characteristics and the Annoyance Caused
Authors: Dalligna Celso , Dalligna Daniela P. , Butzke Bruna , Beduschi Giuliana , Freitas Luiza A. , Jorge Karolina B. 
Published: September 2014

Objectives:Ascertain if there is an association between the pitch and loudness of tinnitus and its impact on patient quality of life.Methods:A cross‐sectional study comprising 156 patients (mean age, 57.95 ± 12.53 years) with chronic unilateral disturbing tinnitus was conducted between September 2003 and January 2014. Acufenometry was used to measure the pitch and loudness of tinnitus. We evaluated the impact of the annoyance caused by tinnitus using tinnitus handicap inventory (THI) and the visual analog scale (VAS). Statistical analysis was performed using Pearson's correlation test.Results:Overall, 27.3% of the patients evaluated had presbycusis, while 12.2% had noise‐induced hearing loss (NIHL) and 15.1% had Ménière's disease. The correlation coefficient observed between the loudness of tinnitus and THI was R = 0.001, P =. 99, between loudness and VAS was R = 0.001, P =. 99, and between loudness and age of the patients was R = 0.03, P =. 70. When we analyzed the tinnitus pitch and THI was found R = 0.11, P =. 16, and pitch and VAS R = 0.05, P =. 56. Analysis of the tinnitus pitch and the patient's age verified the correlation observed (R = –0.16, P =. 05).Conclusions:The findings of this study did not reveal a statistically significant correlation between tinnitus characteristics and its impact on patient quality of life. However, a weak negative relationship was observed between the tinnitus pitch and the age of the patients.
Analysis of Dizzy Patients with High Depression and Anxiety Index
Authors: Hong Seok Min , Choi Sung Ho , Park Il‐Seok , Kim Yong Bok , Park Se‐Jin 
Published: September 2014

Objectives:Some patients with dizziness often show psychological distress. However, the association of vestibular deficit with psychological symptoms remains controversial. Thus, we investigated the incidence of high depression and anxiety index in patients who complained of dizziness, their dizziness severity, and the distribution of disease to induce dizziness.Methods:In 562 patients with dizziness, dizziness and the psychological distress of all patients were measured using the Korean versions of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), and the Spielberger State‐Trait Anxiety Inventory (STAI). We examined the incidence of patients having high depression and anxiety using a cutoff value (BDI ≥21, STAI ≥57). We divided patients into a high psychological distress index group and a moderate to low index group on the basis of cut‐off value and compared the type of disease and DHI score between the 2 groups.Results:The incidence of high BDI and STAI scores were 11% and 13.5%, respectively. The high BDI and STAI group showed the higher DHI scores, including functional, emotional and physical subscales, and the higher STAI and BDI scores, respectively. The mean age, sex and the distribution of the type of disease between high psychological distress index group and moderate to low index group showed no difference.Conclusions:Of patients with dizziness, about one‐tenth have serious psychological distress, various vestibular diseases, and more dizzy symptoms. Thus, we should keep in mind the psychological factor in dizzy patients and the necessity of psychological support in the patients.
Preoperative MRA for Patient Selection in Free Fibula Flap: Is a Venous Phase Indicated?
Authors: Lawson Bradley R. , Ram Roopa , Pandey Tarun , Jambhekar Kedar , Moreno Mauricio A. 
Published: September 2014

Objectives:We present our institutional experience with dynamic time‐resolved magnetic resonance angiography (DTR MRA) with delayed venous imaging for free fibula flap (FFF) patient selection. We sought to (1) determine the sensitivity of the test for vascular anomalies predisposing to limb‐threatening complications and (2) assess the impact of the venous phase findings in patient selection.Methods:Retrospective review of 46 patients considered for mandibular reconstruction with FFF in an academic tertiary setting from 2009‐2012. A DTR MRA was performed preoperatively in all cases. Both imaging and physical examination findings were used to determine patient eligibility for the procedure.Results:Thirteen patients (28.2%) had findings on DTR MRA excluding flap harvesting from the preferred leg, with atherosclerosis (n = 8) and anatomic variations (n = 4) being the most common findings. Eight of these patients (61.5%) underwent harvesting from the opposite leg, while 5 underwent reconstruction with a different bony flap. Only 2 of these 13 patients (15.3%) had physical examination findings excluding reconstruction with FFF. DTR MRA was significantly more likely to detect potentially limb threatening vascular anomalies than physical examination (P =. 004). There was 1 patient with an anomaly on delayed venous imaging (asymptomatic deep venous thrombosis–thrombophlebitis) which excluded flap harvesting from the affected leg. Both arterial phase imaging and physical examination were normal in this patient.Conclusions:DTR MRA is significantly more sensitive than physical examination in detecting limb‐threatening anatomic variations and vascular pathology prior to FFF reconstruction. The venous phase allows identification of oligosymptomatic venous anomalies that, while uncommon, may predispose to significant morbidity. These findings justify routine use of this imaging modality.
Comparison of the Vestibular Aqueduct between Acute Low‐Tone Sensorineural Hearing Loss and Ménière's Disease
Authors: Nishimura Masahiko , Kuwashima Shigeru , Sato Hiroaki , Nakasato Tatsuhiko 
Published: September 2014

Objectives:Most acute low‐tone sensorineural hearing loss without vertigo (ALHL) improves over time; however, some cases develop into typical Ménière's disease (MD), suggesting an association between ALHL and MD. This study aimed to investigate associations between ALHL and MD from the perspective of development of the vestibular aqueduct.Methods:Prospective case‐control study at a tertiary referral center. In 51 patients with unilateral ALHL (15 males, 36 females; mean age, 52.3 years), 35 patients with unilateral MD (14 males, 21 females; mean age, 43.1 years) and 11 healthy controls (11 males; mean age, 33.3 years), length of the external aperture of the vestibular aqueduct (EAVA) was measured on 3‐dimensional computed tomography. Results were then compared among ALHL patients, MD patients, and controls.Results:On the affected side, mean length of the EAVA was 5.8 ± 2.7 mm in ALHL patients, 4.3 ± 2.0 mm in MD patients, and 6.5 ± 1.5 mm in controls. The EAVA was significantly shorter in MD than in ALHL or controls. Among ALHL patients, length of the EAVA was significantly shorter in patients with recurrence (4.5 ± 1.9 mm) than in those without recurrence (6.4 ± 2.5 mm).Conclusions:Hypoplasia of the endolymphatic sac may represent a predisposing factor for recurrence of ALHL and/or MD, as development of the endolymphatic sac is known to correlate with length of the EAVA.