bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methods and Preliminary Outcomes of Pediatric Auditory Brainstem Implantation
Authors: Bayazıt Yıldırım A. , Kosaner Julie , Cicek Cınar Betul , Atac Ahmet , Tutar Hakan , Gunduz Bulent , Altinyay Senay , Gokdogan Cagıl , Ant Ayca , Ozdek Ali , Goksu Nebil 
Published: March 2014

Objective: The objective was to provide information about methods used and preliminary outcomes for pediatric ABI (auditory brainstem implant). Study Design: An analysis of outcome was performed in children who received an ABI. Methods: Twelve children received a MED-EL ABI system. Progress in audition and language was monitored through parental reports, questionnaires, profiles, and closed-set tests. Results: The median number of active electrodes was 9 of 12. Seven of 12 users consistently respond to sound, and 5 of 12 do not. Highest performers can recognize words in small sets and have begun to use some words. Conclusion: Auditory brainstem implants appear to be beneficial for some pediatric patients who cannot benefit from traditional cochlear implant surgery. Benefits in the short term can be recognition of environmental sounds, recognition of some words and very commonly used phrases, and the beginning use of words. Although some of our ABI users demonstrate no response to sound, they do want to wear their sound processors all waking hours. The cause of lack of response may be related to the second intervention, which might have led to displacement of the electrode array, or presence of additional handicaps or syndromes. However, the results are less than optimal. The relatively short postoperative follow-up duration is a considered weakness of this study.
Partial Mastoid Obliteration Combined With Soft-wall Reconstruction for Middle Ear Cholesteatoma
Authors: Suzuki Hideaki , Ikezaki Shoji , Imazato Kei , Koizumi Hiroki , Ohbuchi Toyoaki , Hohchi Nobusuke , Hashida Koichi 
Published: March 2014

Objectives: The objective was to analyze the surgical outcomes of tympanoplasty with partial mastoid obliteration and soft-wall reconstruction for middle ear cholesteatoma. Methods: Sixty-nine patients (73 ears) with fresh middle ear cholesteatomas, 42 men and 27 women aged 6 to 89 years, were retrospectively analyzed. The cholesteatomas were the pars flaccida and tensa types in 59 and 12 ears, respectively. The patients underwent canal-wall-down tympanoplasty with partial mastoid obliteration and soft-wall reconstruction. Follow-up computed tomography was performed 6 to 12 months after surgery. Hearing outcomes were evaluated by the arithmetic mean of the hearing levels at 500, 1000, and 2000 Hz. Results: Residual cholesteatoma occurred in 7 ears (9.6%) and recurrent cholesteatoma in 1 ear (1.4%). No cavity problem was seen. Primary evaluation of postoperative hearing was performed 6 to 12 months after ossiculoplasy. Of the 50 ears with available audiogram in this period, the postoperative air-bone gaps were ≤15 dB and ≤20 dB in 27 (54.0%) and 37 (74.0%) ears, respectively. The postoperative hearing level was within 30 dB in 22 ears (44.0%). The hearing gain was ≥15 dB in 24 ears (48.0%). Conclusions: The surgical outcomes of tympanoplasty with partial mastoid obliteration and soft-wall reconstruction for middle ear cholesteatoma were satisfactory with a low incidence of cholesteatoma recidivism and tolerable postoperative hearing without cavity problems.
Spindle Cell Carcinoma of the Upper Aerodigestive Tract
Authors: Gerry Daniel , Fritsch Valerie A. , Lentsch Eric J. 
Published: March 2014

Objectives: We sought to better characterize spindle cell carcinoma (SpCC) of the upper aerodigestive tract, a rare and aggressive variant, through comparison of a large cohort of head and neck SpCCs against a cohort of conventional head and neck squamous cell carcinoma (SCC) patients. Methods: We compared epidemiologic and clinicopathologic characteristics of 341 SpCCs with 67 882 SCCs of the head and neck, drawing data from the SEER national database. We also compared disease-specific survivals (DSS) for SpCC and SCC based on tumor site and mode of treatment. Results: SpCCs were predominantly laryngeal (46.4%, P < .001) and were more likely to be high grade ( P > .001). SpCCs were also more likely than SCCs to present at an early stage ( P < .001 to P < .05). Rates of distant metastasis were similar between the tumor types. DSS was similar between SpCCs and SCCs, although site-specific survival rates were higher for SpCCs of the larynx ( P = .017) and lower for those of the oral cavity ( P = .008). Conclusion: SpCC of the head and neck is more likely than SCC to present at an early stage, with fewer nodal metastases. Survival rates appear to depend on anatomic site as well.
Combined Lateral Microscopic/Endoscopic Approaches to Petrous Apex Lesions
Authors: Presutti Livio , Alicandri-Ciufelli Matteo , Rubini Alessia , Gioacchini Federico Maria , Marchioni Daniele 
Published: March 2014

Background: Surgical treatment of lesions involving the temporal bone, petrous apex, or internal auditory canal is usually performed using the classical microscopic approach that necessitates wide external incisions and soft tissue dissection. At present, the main application of endoscopic surgery is in the surgical treatment of middle ear cholesteatoma, but with the natural evolution of the technique, there will be an increasing number of applications in lateral skull base surgery. Objective: This study aimed to describe the pilot clinical experiences of our institution with combined microscopic/endoscopic-assisted approaches to the lateral skull base. Methods: A retrospective chart review was performed on patients undergoing an operation between July 2005 and September 2011 for lateral skull base pathology using the endoscope-assisted technique. Results: Nine patients (7 female, 2 male; mean age = 57.4 years) were reviewed and included in the present study. In all cases, the petrous apex lesion of each patient was unilateral: 6 cases had cholesteatoma of the petrous bone; 2 cases had cholesterinic granuloma of the petrous apex; and 1 case had a low-grade chondrosarcoma of the petrous apex. Overall, after a mean follow-up of 30.7 months, no residual disease has been found in our series up to the present time in the cholesteatoma group. In the cholesterinic granuloma group, only a partial success was obtained in the patient who underwent the infracochlear approach, since the most medial part of the pathology was not accessed and still persisted at neuroradiologic examinations made postoperatively. Conclusion: In our case series, lateral combined microscopic/endoscopic procedures have proved to be effective in the treatment of petrous apex lesions, allowing less destructive approaches compared to exclusive microscopic procedures.
Regional Variation and Factors Associated With Image Guidance Utilization During Endoscopic Sinus Surgery in the Ambulatory Setting
Authors: Bhattacharyya Neil 
Published: March 2014

Objective: Determine regional variation and factors associated with the use of image guidance (IG) during endoscopic sinus surgery (ESS) in the ambulatory surgery center setting. Methods: All cases of ESS in 2010 were extracted from the state ambulatory surgery databases for New York, North Carolina, Florida, Iowa, and California. Current Procedural Terminology codes for individual sinusotomies and IG and International Classification of Diseases codes along with insurance and regional data were analyzed to determine factors that were associated with the use of IG during ESS. Results: Among 36 646 ambulatory ESS procedures (mean age 46.0 years; 49.0% female), 6676 cases utilized IG (18.2%). Polyps were present in 27.9% of cases. North Carolina had the highest utilization rate for IG (26.0%), whereas Iowa had the lowest (12.8%). On multivariate analysis, use of IG was associated with state, insurance status, community setting, total ethmoidectomy, frontal sinusotomy, sphenoidotomy, and polyps (all P < .001), but not maxillary antrostomy ( P = .197). The highest procedural odds ratio for IG use was noted for total ethmoidectomy (2.07), followed by frontal sinusotomy (1.97) and sphenoidotomy (1.26). Conclusion: Although IG is utilized in a relative minority of ESS cases, there is considerable regional variation in use. Factors other than complexity of surgery influence IG utilization as well.
Extrusion of a Cochlear Implant Positioner Through the Tympanic Membrane in a Pediatric Patient
Authors: Dhillon Vaninder K. , Hoa Michael , Winter Margaret , Wilkinson Eric P. 
Published: March 2014

Objective: This study aimed to present a case of an extruded Advanced Bionics positioner, with the goal of educating a new generation of otologic surgeons on management of the delayed complications associated with this cochlear implant model. Methods: Retrospective case report in a pediatric patient. Results: We observed the extrusion of an Advanced Bionics positioner 10 years after cochlear implantation. Conclusion: Awareness of the Advanced Bionics positioner as a component of certain historical models of cochlear implants is important as the delayed complications associated with this model may still be encountered. Management of an extruded positioner should include precautions against infectious complications, repair of the defect, and assessment of the patient’s performance with the cochlear implant.
Safety of Concurrent Nasal and Oropharyngeal Surgery for Obstructive Sleep Apnea
Authors: Banuchi Victoria , Cohen Justin C. , Kacker Ashutosh 
Published: March 2014

Objective: This study evaluated for increased complications or risk associated with concurrent nasal and oropharyngeal surgeries to treat patients with obstructive sleep apnea (OSA). Study Design: Retrospective chart review. Methods: We performed a retrospective chart review on consecutive patients between 2006 and 2011 who underwent either simultaneous nasal and pharyngeal surgery (group 1) or pharyngeal surgery alone (group 2) to treat OSA. We compared the length of hospitalization and the rate of complications in both groups. Results: Group 1 consisted of 20 patients, all male, with ages ranging from 25 to 72 years (average, 35 years) and apnea-hypopnea index (AHI) from 2.6 to 119 (average, 52.2). Group 2 consisted of 20 patients, 1 female, with ages ranging from 23 to 71 years (average, 37 years) and AHI from 10 to 101 (average, 46.1). In group 1, 30% of patients were ambulatory compared to 25% of patients in group 2. In all cases, the nonambulatory patients were observed for only 1 night. The rate of complications in both groups was 10% (2 out of 20 in each group). Both complications in group 1 were post-tonsillectomy bleeds. In group 2, 1 patient had a post-tonsillectomy bleed and 1 patient was readmitted with dehydration due to poor pain control. There was no statistically significant difference in length of hospitalization or rate of complications in these 2 groups. Conclusion: Performing concurrent nasal and oropharyngeal surgery for OSA was safe when compared to oropharyngeal surgery alone in our cohort and, with careful selection criteria, can even be done in the ambulatory setting. Large, multi-institutional investigations are indicated.
Dysphagia Due to Inclusion Body Myositis
Authors: Ko Ellen H. , Rubin Adam D. 
Published: March 2014

Objective: This report aimed to present a case of inclusion body myositis presenting with dysphagia and to review the literature. Methods: Case report and literature review. Results: Inclusion body myositis is a chronic progressive acquired myopathy, uniquely distinguished by its selective muscle involvement, normal or moderately elevated muscle enzyme concentrations, and a progressive corticosteroid-resistant course. Compared to other inflammatory myopathies, the esophagus is the most commonly involved organ. Specifically, upper esophageal sphincter dysfunction often occurs. Dysphagia may be the only symptom at the time of presentation. Conclusion: Unlike other inflammatory myopathies, dysphagia in inclusion body myositis is steroid resistant. Management can be difficult. The otolaryngologist must consider underlying neuromuscular processes when evaluating the patient presenting with oropharyngeal dysphagia.
Five Days of Successful Oral Alimentation for Hospitalized Patients Based Upon Passing the Yale Swallow Protocol
Authors: Leder Steven B. , Suiter Debra M. 
Published: March 2014

Objective: This study aimed to determine the success of oral alimentation and patient retention rate 1 to 5 days after passing the Yale Swallow Protocol. Methods: Participants were 200 consecutive acute care inpatients referred for swallow assessment. Inclusion criteria were adequate cognitive abilities to participate safely, completing an oral mechanism examination, and passing the 3-ounce water swallow challenge. Exclusion criteria were altered mental status, failing the 3-ounce challenge, preadmission dysphagia, head-of-bed restrictions < 30°, and a tracheotomy tube. Electronic medical record monitoring post-protocol passing for 1 to 5 consecutive days determined success of oral alimentation and retention rate. Results: All patients who remained medically and neurologically stable drank thin liquids and ate successfully 1 to 5 days after passing the protocol. Mean (SD) volume of liquid ingested per day was 474.2 (435.5) cc. Patient retention declined steadily from day of testing (n = 200) through post-testing day 5 (n = 95). Conclusion: Passing the Yale Swallow Protocol allowed for initial determination of aspiration risk followed by successful oral alimentation for 1 to 5 days in medically and neurologically stable acute care hospitalized patients and without the need for instrumental dysphagia testing. The decline in patient retention was expected because of increasingly rapid transit through the acute care setting, which often renders longer follow-up problematic.
Copper Cable Theft
Authors: Sidebottom Aiden , Ashby Matt , Johnson Shane D. 
Published: March 2014

Objectives: To test the commonly espoused but little examined hypothesis that fluctuations in the price of metal are associated with changes in the volume of metal theft. Specifically, we analyze the relationship between the price of copper and the number of police recorded “live” copper cable thefts from the British railway network (2006 to 2012). Method: Time-series analysis was performed using 76 months of data to determine the association between mean copper price and police recorded “live” copper cable theft. Two rival hypotheses, that changes in the theft of copper cabling reflect changes in the theft of railway property more generally (or the reporting thereof) or variations in the rate of unemployment, were also tested. Results: We find support for the price–theft hypothesis: Changes in the price of copper were positively associated with variations in the volume of “live” copper cable theft. A downward trend in copper cable theft in recent years is also observed, although the mechanism/mechanisms underpinning this pattern is unclear. Conclusion: The theft of “live” copper cable is associated with fluctuations in copper price. As such, it differs substantially from the “crime drop” typically noted for most types of crime providing further support for the price–theft hypothesis.
A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy)
Authors: Peterson Magnus , Butler Stephen , Eriksson Margaretha , Svärdsudd Kurt 
Published: March 2014

Objective: To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow. Design: Randomized controlled trial. Setting: Primary care in Uppsala County, Sweden. Subjects: A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement. Intervention: Eccentric ( n = 60) or concentric exercise ( n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load. Main measures: Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months. Results: The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, ( p < 0.0001 and p = 0.006, respectively). Significant differences were found in Cox’s analysis from two months onwards (HR 0.78, 95% confidence interval (CI) 0.63–0.96, p < 0.02). This represents an absolute pain reduction of 10% in the eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric ( p < 0.02). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding function or quality of life measures. Conclusion: Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise.
Effect of threshold on the correlation between airflow obstruction and low attenuation volume in smokers assessed by inspiratory and expiratory MDCT
Authors: Yanagawa Noriyuki , Kawata Naoko , Matsuura Yukiko , Sugiura Toshihiko , Suzuki Toshio , Kasai Hajime , Irie Ryosuke , Iesato Ken , Tada Yuji , Tanabe Nobuhiro , Suzuki Yoichi , Tatsumi Koichiro 
Published: March 2014

Background The estimation of emphysematous changes is very sensitive to computed tomography (CT) threshold level. In clinical practice, the predetermined threshold is usually set at −950 Hounsfield units (HU) for the detection of low attenuation volume (LAV). However, threshold levels that are tightly connected to pulmonary function abnormalities have not been determined. Purpose To determine the threshold level for calculating an LAV that closely reflects airflow limitation in patients with chronic obstructive pulmonary disease (COPD). Material and Methods Seventy-six consecutive non-COPD smokers and COPD patients underwent paired inspiratory and expiratory multidetector CT (MDCT). LAV% was segmented every 10 HU between −1000 and −750 HU to examine the correlation between LAV% and indexes of obstructive impairment. Results LAV% gradually increased as the threshold level increased on both inspiratory and expiratory images. LAV% on inspiratory images was higher than that on expiratory images at all threshold levels between −1000 and −750 HU. The threshold level that correlated with obstructive impairment differed between the two images: −930 HU on inspiratory and −870 or −880 HU on expiratory images. Conclusion LAV% dramatically changed according to the threshold level on both inspiratory and expiratory images, indicating that LAV% is dependent on the attenuation threshold level in patients with COPD. The threshold linking LAV% to airflow limitation was higher on expiratory than on inspiratory images.
Anterior Cruciate Ligament Injuries in Adolescents With Open Physis
Authors: Funahashi Kristina M. , Moksnes Havard , Maletis Greg B. , Csintalan Rick P. , Inacio Maria C.S. , Funahashi Tadashi T. 
Published: March 2014

Background: Treatment choices for skeletally immature patients sustaining anterior cruciate ligament (ACL) injuries have been controversial. The main dilemma is whether surgical treatment should be provided before patients reach skeletal maturity or whether nonoperative treatment should be provided until the physis has closed. Surgical reconstruction risks physeal damage, while delaying surgery may increase menisci and cartilage damage. Purpose: To identify patients at the onset of ACL injury and follow them longitudinally to surgery or final follow-up to describe differences between nonoperative and operative patients and to analyze the effect of delayed reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of patients enrolled at a large integrated health care system (IHS) between January 1, 2005, and December 31, 2008, was performed. The study sample included all females ≤12 years old and males ≤14 years old who were evaluated with an ACL injury. The incidence of ACL injuries in each age group was calculated using the number of covered lives by the IHS system per age category as the denominator. Each patient was longitudinally followed using an electronic health record that captures all patient encounters. Every encounter was reviewed for symptoms associated with the index knee, and encounters were considered significant if new-onset pain or swelling was reported. Patients were instructed to restrict their activities while awaiting skeletal maturity to undergo reconstruction by not participating in activities that included any cutting or pivoting movements that would risk injury to the knee. Cartilage and meniscal injuries were recorded for patients who underwent reconstruction. Results: A total of 71 patients were identified during the study period (66 males, 4 females). At the completion of this study, 47 (66.2%) patients had undergone ACL reconstruction, and 24 (33.8%) were being treated nonoperatively. While there were no significant associations between time to surgery and meniscal or cartilage injury, there was a positive association between the number of significant encounters and the likelihood of a combined cartilage and meniscal injury ( P = .01). Conclusion: This is the first study to measure the incidence of ACL injuries in a skeletally immature population. For patients undergoing ACL reconstruction, an increased number of significant encounters was statistically significantly associated with combined meniscal and cartilage injuries, while increased time from injury to surgery was not significantly associated with additional injuries. In addition, one-third of the patients continued nonoperative treatment without symptoms that warranted surgical interventions during the follow-up period.