bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cordotomy by Coblation in Bilateral Vocal Fold Immobility
Authors: Osborne Kyra M. , Bryson Paul C. , Benninger Michael S. 
Published: February 2015

Objective1) Understand the presentation, etiology, and management of bilateral vocal fold immobility. 2) Understand the utility, technique, and advantage of endoscopic coblation vocal cordotomy for patients with bilateral vocal fold immobility. 3) Compare the use of the laryngeal coblator with the laser.MethodCase series using endoscopic coblation to perform vocal cordotomy in patients with bilateral vocal fold immobility is presented. Seven patients underwent suspension microlaryngoscopy with either initial or revision vocal cordotomy with or without partial arytenoidectomy. Routine follow‐up was performed and wound healing was documented via distal chip videolaryngoscopy.ResultsSeven patients underwent suspension microlaryngoscopy with vocal cordotomy as part of airway management for bilateral vocal fold immobility. The laryngeal coblator was used to perform a transverse cordotomy. The procedure was completed in approximately 5 minutes. No laser protection is required reducing operative set‐up and procedure time versus the laser. Two patients had a prior tracheotomy. No patients required a tracheotomy with this procedure. Patients were seen between 1 day and 1 month postoperatively. Patients had minimal granulation tissue at the cordotomy site and appeared to have quicker healing. The glottic airway and stridor were improved in all patients.ConclusionInitial outcomes of endoscopic coblation vocal cordotomy reveal this technique to be safe and efficient. Coblation increased the glottic airway with minimal granulation tissue and rapid healing. This represents the first described use of coblation for bilateral vocal fold immobility. Long‐term data will be forthcoming.
Newly Devised 3D Videolaryngoscopy for Laryngomicrosurgery
Authors: Umezaki Toshiro 
Published: February 2015

ObjectiveIn order to overcome the drawback of 2D videolaryngoscopy, we have developed a newly devised 3D videolaryngoscope, and we evaluated the usefulness of this device.MethodA 3D high vision camera of 5 mm in diameter was attached to a usual 2D laryngoscope. Real time images were monitored by a dome‐shaped 3D monitor (Panasonic Health Care). We performed endolaryngeal microsurgery on some patients with voice disorders, and compared usefulness between 2D, 3D, and conventional binocular system.ResultsUsing 3D videolaryngoscope allowed better and easier manipulation in grasping and cutting the lesion, and even in suturing the laryngeal mucosa because of its stereoscopic visual effect, as compared to 2D scope. In comparison to the conventional binocular microscopy, 3D videoscope offered equivalent stereoscopic imaging and an advantage in nearer positioning to the patient, resulting accurate operation.ConclusionOur study indicates that 3D imaging offers significant advantages in the performance of endolaryngeal microsurgical skills to every surgeon.
Reproducibility of Salivary Pepsin: Clinic versus Home
Authors: Laohasiriwong Supawan , Johnston Nikki , Woodson B. Tucker 
Published: February 2015

ObjectivePepsin immunoassay of saliva samples is a potential objective test for reflux and extra‐esophageal reflux (EER). This study aims to assess the reproducibility of pepsin samples in a clinical cohort study.MethodSaliva samples were obtained following a standardized protocol on 3 occasions. Subjects expectorated pharyngeal secretions in an upright position in clinic, and on 2 mornings following recumbence and sleep. All samples were frozen for storage and Western blot immunoassay for pepsin was performed.ResultsFrom 70 subjects, 59 first samples completed showed the prevalence of pepsin (+) was 26%. Of 34 subjects who returned the home collected sample, only 6% of the 2nd samples were positive and none of the 3rd samples were positive. 46.3% of the subjects had elevated Reflux Symptom Index (RSI) but the correlation with pepsin (+) was not significant.ConclusionOur study was unable to produce consistent results of pepsin assays in a nonlaryngology clinical setting. Salivary pepsin assay is a conceptually promising non‐invasive test for EER; however the timing and logistics of sample collection in order to be a feasible clinical test may need further studies and adjustments.
Tyramine‐Based Hyaluronan as a Tracheal Cartilage Substitute
Authors: Revenaugh Peter C. , Seth Rahul , Calabro Anthony , Knott Daniel 
Published: February 2015

ObjectiveTo investigate and characterize a novel tyramine‐based hyaluronan/gelatin (THA/G) composite material. First, we demonstrate the ability of THA/G to adhere and maintain respiratory epithelial cells in an in vitro model. Second, we assess the feasibility of THA/G as a biologic cartilage substitute in a rabbit model of tracheal reconstruction.MethodImmortalized human tracheal epithelial cells were grown on various concentrations of THA/G composites in vitro. Cricotracheal resection with replacement by THA/G was performed in 4 New Zealand white rabbits with auricular cartilage as control in 2 animals. Tracheal patency, graft retention, and mucosalization were evaluated via endoscopy, imaging, and histopathology.ResultsEpithelial cell growth was demonstrated on THA/G composites in vitro. In the rabbit model, all composites remained intact within the tracheal resection. However, the limited shear strength of the THA/G posed difficulties in securing the construct. At 3 and 6 weeks postimplantation, composites revealed minimal histologic evidence of macrophage or lymphocyte infiltration and were without apparent degradation. Tracheal lumen diameter was preserved in all animals. No experimental animals had evidence of dynamic airway collapse or chondromalacia. On endoscopy, there was no evidence of tracheal inflammation or granulation. However, at 6 weeks there was limited respiratory mucosa present on histology.ConclusionTHA/G composites are a promising material for cartilage substitution. We demonstrate an ability to support epithelial cells and maintain tracheal structure. Improvements to increase the material’s shear strength are necessary so that it may have potential as an airway cartilage substitute.
A Computerized Closed‐Response Speech Test in the ENT Clinic
Authors: Tringali Stephane , Dubreuil Christian , Moulin Annie 
Published: February 2015

Objective1) To assess the feasibility of a computer‐based closed‐response speech test (CRST) in the ENT clinic. 2) To compare a closed response speech test to standard speech audiometry.MethodThirty patients underwent otoscopy, tympanometry, pure‐tone audiometry, speech audiometry and a closed‐response speech test (CRST). For the CRST, patients were asked to choose, on a tactile computer screen, the words that were presented to their ear, amongst a choice of 4 words. Fifteen sets of 4 words were used.ResultsThe CRST was well accepted by all patients, whatever their computer literacy, but took significantly longer (10 to 15 minutes per ear) than speech audiometry did. Pure transmission hearing losses showed a translation of the performance intensity function toward greater intensities, without change in slope, as in standard speech audiometry. Correlations between auditory thresholds and speech recognition thresholds were greater for the CRST (r = 0.70, P <. 01) than for speech audiometry (r = 0.46, P <. 05). Several cases of patients showing very similar speech audiometry performance intensity functions, but different CRST scores were identified.ConclusionAlthough the closed‐set computerized test took substantially longer than speech audiometry, it was well accepted by patients. It was more sensitive to minor alterations of hearing than speech audiometry and shows promise as a longitudinal assessment tool of speech perception.
Balance Study in Parkinson’s Disease Patients
Authors: Edionwe Susan , Makishima Tomoko , Bryant Mon , Wood Scott 
Published: February 2015

Objective1) To understand the role of vestibular dysfunction in Parkinson’s disease (PD) postural instability. 2) To investigate whether vibrotactile stimulation (VTS) to the trunk can be a tangible form of remediation therapy in patients with postural instability of Parkinson’s disease.MethodProspective pilot study; July 2011‐ongoing. Postural instability in PD investigated. Clinical study of 10 to 15 mild to moderate PD patients. Vibration therapy (independent variable) applied to the trunk to remediate posture during directional tasks. Rotary chair used to evaluate vestibular function. Data compared to controls with T test and suggested improvement.ResultsImprovements in postural instability with vibration therapy: Patients’ postural performances were compared pre‐ and posttherapy. Only 1 of 11 of the Parkinson’s patients had a statistically significant improvement of posture after vibration therapy (P =. 0126284). One patient had a statistically lower performance (P =. 0109707), and the remaining had an overall subjective but no statistically significant improvement. Similarly, only 1 control had significant improvement (.0404138) while 5 had statistically decreased performance and the remaining had no statistically significant change. Overall, no statistical significance was seen between PD patients and controls. Rotary chair data: analysis pending.ConclusionPreliminarily, no improvements in postural instability have been seen yet. This is inconsistent with case reports. However, patients and controls reported fatigue at the end of testing and this may account for the decreased performance. Rotary chair analysis is pending, thus, no conclusion drawn for this at this time.
Bone‐Anchored Hearing Aid: Why Do Some Patients Refuse It?
Authors: Zawawi Faisal , Kabbach Ghassan , Lallemand Marie , Daniel Sam 
Published: February 2015

ObjectiveBAHA is a proven tool to improve hearing. Nevertheless, there are patients who are candidates for BAHA implants who end up refusing the surgery. The objective of this study is to review our BAHA experience with particular emphasis on reasons behind the refusal of some candidates.MethodA retrospective chart review conducted in December 2011 of the most recent 100 consecutive new patients referred to the BAHA program in a tertiary health care center. Candidates’ demographics, hearing status, co‐morbidities, and audiometeric tests were all recorded. Patients’ acceptance or refusal was noted alongside the reasons to refuse BAHA.ResultsOne hundred new patients were seen for BAHA assessment, 10 patients were excluded because of incomplete tests. There were 68 children and 22 adults. Unilateral conductive hearing loss was the most common reason for consultation (40%), followed by unilateral SNHL (23.3%). Aural atresia was the most common clinical finding (36.6%). Seventy patients were candidates for BAHA (77.8%) as per our candidacy rules. Ten candidates refused BAHA (14.3%). The most common reason for refusal in adults was lack of sound localization in patients with unilateral SNHL.ConclusionThe main reason for refusal of BAHA was lack of sound localization in adults, whereas the main reason for refusal in children was cultural and social acceptance by the family. Patients with congenital anomalies were the most likely candidates to accept BAHA implants.
Comfort Level Managing Common Head and Neck Disease
Authors: Wiedermann Joshua P. , Zapanta Philip E. 
Published: February 2015

Objective1) Assess comfort levels in managing common, primary care head and neck disease during the 4 years of medical school and the 3 years of primary care residency. 2) Learn where participants would refer if comfort levels were low.MethodCross‐sectional survey using Survey Monkey (www.surveymonkey.com) of George Washington University medical students (n = 256), George Washington University medicine residents (n = 15), and Children’s National Medical Center residents (n = 50). Common head and neck diagnoses were surveyed (n = 24) using a Likert scale. Data were analyzed with Microsoft Excel.ResultsThroughout all years, respondents were most comfortable with the management of rhinitis/seasonal allergies, otitis media/externa, sinusitis, and epistaxis. Respondents were least comfortable in the management of tracheotomy care, persistent salivary gland swelling, and sudden hearing loss. Among all years, the majority of respondents would refer all conditions to an otolaryngologist with the exception of sleep apnea (pulmonology), vertigo (neurology), cleft lip (plastic surgery), facial nerve palsy (neurology), and thyroid nodules (general surgery).ConclusionAlthough there is a correlation between training year and comfort, there remains a number of conditions that respondents do not feel comfortable managing. In addition, although there is much debate as to which specialty is best to handle management, there tends to be a consensus across all training levels.
Diagnostic Accuracy of Otoneurology Testing
Authors: Hijano Rafael , Fuste Joan , Fontane‐Ventura Joan 
Published: February 2015

Objective1) Compare the cervical vestibular evoked myogenic potential (cVEMP) responses and the ocular VEMP (oVEMP) responses in normal volunteers and patients suffering from vertigo. 2) Analyze the similarities between the evoked responses and the results obtained by videonystagmography (VNG).MethodA prospective study in 126 patients (60 men, 66 women) was conducted at Hospital del Mar Barcelona from January to November 2011. cVEMP responses using click stimuli at 5 Hz monoaural 110 dB nHL intensity with the subjects in a sitting position and head turned to contralateral shoulder were analyzed. oVEMP responses were recorded using surface electrodes below the inferior eyelid. VNG was done using caloric stimulation.ResultsVNG was altered in 23%. The cVEMP response was altered in 29%. The oVEMP responses were classified either as altered or absent in 31%. The sensitivity was similar for both the oVEMP and the cVEMP.ConclusionThe little difference in sensitivity found between the cVEMP and the oVEMP can be explained due to the different neural pathways. The same can be said for the results in the VNG. These current tests may complete the information about the physiology and integrity of the vestibular neural pathways and are easy and quick methods of evaluation.
Effects of Oxiconazole and Alcohol Boric to the Inner Ear
Authors: Özdemir Süleyman , Tuncer Ülkü , Tarkan Özgür , Akar Funda , Sürmelioğlu Özgür 
Published: February 2015

ObjectiveTopical preparations are widely used in the treatment of infections of the external auditory canal and middle ear. However, they can pass through the round window and effect the inner ear. The aim of this study is to evaluate the ototoxicity of topical oxiconazole and boric acid in alcohol solutions.MethodFive groups of 10 male Wistar albino rats. The right tympanic membranes of all of the rats were perforated and baseline and posttreatment distortion product otoacoustic emission (DPAOE) measurements were performed. Oxiconazole, boric acid in alcohol, salin, and gentamicin solutions were applied to the right external ears.ResultsThe solutions were applied through the external ear canal to the middle ear twice a day for 15 days. The rats in group I and group II received oxiconazole and boric acid in alcohol solutions, respectively. Group III received gentamicin (ototoxic control), group IV received saline solution, and group V was followed without any medication. The baseline DPOAE results of the right ears of all animals tested were normal. Animals in groups I, II, IV, and V showed no statistically significant change in the DPOAE values. The rats in the gentamicin group showed a significant decrease.ConclusionThis study demonstrates that topically used oxiconazole and boric acid in alcohol solutions to the middle ear have no effect on the inner ear of rats. In our opinion, ear drops should be chosen more carefully in an external ear infection with a tympanic membrane perforation to avoid ototoxicity.
Effects of Stimulation Rate on Musical Instrument Identification
Authors: Zhang Howie , Runge Christina , Friedland David R. 
Published: February 2015

ObjectiveTo compare the differences in musical instrument identification at different stimulation rates between older and younger cochlear implant (CI) users.MethodAll subjects used Advanced‐Bionics CII or HighRes90k devices. There was a younger (age less than 65; n = 7) and older (age greater than 64; n = 5) group. They used a novel 5‐channel map with stimulation rates of 800, 1200, 2000, and 3000 pps. Subjects underwent music testing with 10 instruments played at 65dB SPL.ResultsScores ranged from 22% to 70%. In the younger group, performance significantly increased with increasing stimulation rate (P =. 0003). A significant difference in performance was noted in the younger group between 3000 pps and 800 pps (P =. 0254). Younger subjects performed best at 3000 pps and worst at 1200 pps. In the older group, there was no significant correlation between stimulation rate and performance. Older subjects performed best at 2000 pps and worst at 800 pps. There was no significant difference between performance at any rates within the older group. There was no significant difference between the scores in the younger and older group at any stimulation rate.ConclusionWe found that stimulation rate affects musical instrument identification for younger CI users, who benefit from higher rates. Older subjects performed best at 2000 pps but generally showed no difference across stimulation rates. Older users may benefit from individualized maps for speech and music with differing stimulation rates.
Evaluation of Hearing in Hypertensive Subjects
Authors: Sahin‐Yilmaz Asli , Habesoglu Mehmet , Korkmaz Deniz , Karaaslan Ahmet , Tosun Ahmet , Oysu Cagatay 
Published: February 2015

ObjectiveTo find out the effect of systemic hypertension on 1) pure tone audiometry (PTA), 2) distortion product emissions (DPOAE) in adults.MethodA clinical controlled prospective study was conducted between January 2011 and December 2011 at Umraniye Education and Research Hospital Otolaryngology Clinic. Thirty subjects with systemic hypertension and 30 controls were included. All subjects underwent a physical examination, including fundus examination, PTA, and DPOAE.ResultsPercentage of tinnitus in subjects with hypertension and in controls was 90% and 40%, respectively (P =. 001). PTA revealed a significantly higher sensorineural hearing loss in all frequencies above 500 Hz in the hypertensives (P <. 05). In the right ear DPOAE revealed response at 4000 and 6000 Hz in 80% of hypertensive patients and 96.7% of controls (P =. 103) and 20% of hypertensive patients and 96.7% of controls, respectively. In the left ear, DPOAE revealed response at 4000 and 6000 Hz in 73.3% of hypertensive patients and 96.7% of controls (P =. 026) and 26.7% of hypertensive patients and 93.3% of controls (P =. 001), respectively.ConclusionIsolated hypertension affects vascular psychodynamics of cochlea and results in a hearing loss at and over 4000 Hz at pure tone audiometry and significant loss of distortion product otoacoustic emissions at 4000 to 6000 Hz.
Facial Nerve Function in Postoperative of Glomus Jugulare
Authors: Kitice Adriano T. , Silva Evandro M. , Abreu Cassiana B. , Weber Raimar , Barauna Iulo , Stamm Aldo E.C. 
Published: February 2015

ObjectiveDescribe the facial nerve function (FNF) in preoperative and postoperative time of patients with glomus jugulare tumors trying to correlate the relationship with functional outcome with epidemiological variables (age and sex) or variables related to the tumor (extent, location, and relationship to the facial nerve and internal carotid artery).MethodRetrospective review of 53 patients with glomus jugulare submitted to surgical treatment (1987 to 2010) in Edmundo Vasconcelos Hospital. The FNF was analyzed preoperatively and at initial PO (until 7 days), PO of 6 months, and PO of 1 year. Results of FNF were compared with tumor aspects and epidemiological features.ResultsIn a preoperative time we observed FNF decreased in 11 patients (20.75%) in which the average of facial function by House Brackmann scale degree was 2.54. Most of those (7%‐63.64%) scaled as HB II. Intraoperative findings demonstrated anatomic invasion in 5 patients. In the immediate PO time (1 to 7 days) a decrease of facial nerve function in 83.02% of the patients (avgHB = 3.32) was noted. In PO of 6 and 12 months, some degree of FNF was observed in 32 (60.37%/avgHB 2.09) and 25 (47.17%/avgHB 1.86). There was no observed relation (P <. 05) between kinds of facial nerve manipulation or epidemiological features with FNF with in 1 year postoperatively.ConclusionFNF is a common feature in PO of patients with jugulare foramen tumors, and its recovery is expected for the majority after initial PO time. For the group of patients with preoperative compromise of VII nerve, poorer outcomes were were observed.
Functional Connectivity Networks in Nonbothersome Tinnitus
Authors: Wineland Andre , Burton Harold , Piccirillo Jay 
Published: February 2015

ObjectiveTo capture resting state functional connectivity in a group of nonbothered tinnitus patients in order to assess the impact of tinnitus in cortical neuroplasticity.MethodCross‐sectional study to examine differences in functional connectivity (FC) in a nonbothered tinnitus group compared to a healthy control group. Enrollment ranged from October 2010 to April 2011. Tinnitus participants were recruited from Washington University. FC differences between the 2 groups were studied by examing 58 seed regions of interest.ResultsThe median age for the 18 subjects was 54 years (interquartile range [IQR] 52 to 57), 66% were men, 90% were white, median Tinnitus Handicap Inventory (THI) score was 8 (IQR 4 to 14), and a median Beck Depression Index score of 1 (IQR 0 to 5). The median age for the control group was 46 (IQR 39 to 54) and 52% were men. Of the 58 seeds analyzed, no regions were significantly different in functional connectivity among the nonbothered tinnitus group when compared to the control group.ConclusionAmong non‐bothered tinnitus patients, the tinnitus percept does not appear to alter the functional connectivity of the auditory corte or other key cortical regions.
Lower Cranial Nerves Compromise in Glomus Jugulare Tumors
Authors: Silva Evandro M. , Kitice Adriano T. , Pascoto Gabriela R. , Weber Raimar , Barauna Iulo , Stamm Aldo E.C. 
Published: February 2015

ObjectiveDescribe lower cranial nerve compromise (IX to XII) in preoperative and postoperative time of patients with glomus jugulare tumors trying to correlate the relationship with functional outcome with epidemiological variables (age, sex) or variables related to the tumor (extent, location, and relationship to the facial nerve and internal carotid artery).MethodRetrospective chart review of 53 patients with glomus jugulare submitted to surgical treatment. We searched for lower cranial nerve compromise (LCNC) in preoperative time and at initial PO (until 7 days), PO of 6 months and 1 year. Results of LCNF were compared with tumor aspects and epidemiological features.ResultsThe LCNC in preoperative time observed was IX (7/13, 21%), X (11/30, 19%), XI (7/13, 21%), and XII (11/20, 75%). All showed decreased function postoperatively as expected but also recovery with 1 year of PO. Vagus nerve (X) was the most affected at 12 months, showing some degree of symptoms in 23 patients (43.39%). There was no epidemiological evidence of relationship of age and gender with the prevalence of cranial nerve compromise. Patients classified as Fisch‐Matto C3/C4 had a higher prevalence of CN involvement preoperatively compared to patients C1/C2 (P <. 05). There was statistical significance between the presences of deficits in lower cranial nerves with the degree of tumor extension in the internal carotid artery.ConclusionFunctional impairment of the lower cranial nerves was observed in the pre‐ and the postoperative time of patients undergoing surgery for resection of the glomus jugulare tumors and that its frequency was directly proportional to the extent of the tumor and its relationship with internal carotid artery.