bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pedicled Temporoparietal Galeal Flap for Reconstruction of Intraoral Defects
Authors: Pinto Fábio Roberto , de Magalhães Roberto Pereira , de Aquino Capelli Fábio , Brandão Lenine Garcia , Kanda Jossi Ledo 
Published: October 2014

Objectives: In this report we aim to describe the surgical technique required to utilize the pedicled temporoparietal galeal flap for repair of selected intraoral defects and to report our experience with this type of reconstructive procedure. Methods: The charts of 6 consecutive patients submitted to reconstruction of intraoral defects using the pedicled temporoparietal galeal flap were reviewed. All of the defects were located in the posterior oral cavity and oropharynx. After resection of the oral cancer, the temporoparietal galeal flap, based on the superficial temporal vessels, was raised and transposed to the mouth through a tunnel under the zygomatic arch. The oral defect was repaired, and no skin graft was applied over the flap. Results: There were no flap losses, and the reconstructive goal was achieved in all cases. The patients' deglutition and phonation abilities were restored, and the donor site scars were well hidden by hair growth. Conclusions: The pedicled temporoparietal galeal flap is another option for selected cases of reconstruction of intraoral defects — Mainly those located in the posterior oral cavity and oropharynx, in which thin and pliable tissues are usually required.
Extracellular Matrix Gene Expression after Vocal Fold Injury in a Rabbit Model
Authors: Rousseau Bernard , Ge Ping Jiang , Ohno Tsunehisa , French Lesley C. , Thibeault Susan L. 
Published: October 2014

Objectives: We determined the expression of matrix metalloproteinase (MMP)–1, MMP-9, collagen types I and III, and fibronectin from rabbit vocal folds after injury. Methods: Thirty rabbits were involved in this study. Five animals were assigned to each time period. Noninjured vocal fold specimens were collected as a control. Gene expression was analyzed at 2, 4, 8, 24, 48, and 72 hours after injury by use of real-time polymerase chain reaction. Results: Compared to 2 hours after injury, MMP-1 expression was increased at 4, 8, 24, 48, and 72 hours. Compared to 4 hours, MMP-1 expression was increased at 8, 24, 48, and 72 hours. Compared to the control specimens, MMP-9 expression was increased at 4, 8, 24, 48, and 72 hours. Compared to 2 hours, MMP-9 expression was increased at 4, 8, 24, 48, and 72 hours. Compared to 2 and 4 hours, collagen type I expression was increased at 72 hours. Collagen type III expression was increased at 72 hours compared to 2, 4, and 8 hours. Compared to 2 hours, fibronectin expression was increased at 24, 48, and 72 hours. Conclusions: Results revealed time-dependent changes in expression of MMP-1, MMP-9, collagen types I and III, and fibronectin from rabbit vocal folds after injury. Future experiments are planned to investigate the effects of phonation on expression of these genes after injury.
Recovery of Potential Pathogens in the Nasopharynx of Healthy and Otitis Media—Prone Children and Their Smoking and Nonsmoking Parents
Authors: Brook Itzhak , Gober Alan E. 
Published: October 2014

Objectives: Exposure to smoking is associated with colonization with pathogenic bacteria. This study investigated the frequency of isolation of potential pathogens in the nasopharynx of healthy and otitis media–prone (OMP) children and their smoking or nonsmoking parents. Methods: Posterior nasopharynx cultures were taken from 40 healthy and 40 OMP children and one of their parents. Twenty parents in each group were smokers. Potential pathogenic organisms were identified. Results: In the healthy children whose parents smoked, 15 potential pathogens were isolated from the parents and 13 were recovered from their children. Among the healthy children whose parents were nonsmokers, 3 potential pathogens were isolated from 2 parents (p < 0.005, compared to the parents and children in the smoking group) and 7 were recovered from their children. In the OMP children whose parents smoked, 16 potential pathogens were isolated from the parents and 19 were found in their children. Among the OMP children with nonsmoking parents, 3 potential pathogens were isolated from the parents (p < 0.001, compared to the parents and children in the OMP smoking group and the healthy children in the nonsmoking parents group) and 17 were recovered from their children. Conclusions: Parents who smoke are more often colonized with pathogens than those who do not smoke. The nasopharynx of healthy children of smokers harbors a high number of pathogens that are similar to the flora found in their parents and OMP children. Pathogenic organisms were found more often in OMP children of both smoking and nonsmoking parents, as compared to healthy children whose parents were nonsmokers. Concordance with pathogens in the parent was high among the OMP children of smoking parents, but this was not observed in the OMP children of nonsmokers.
Effect of Irradiation on the Human Laryngeal Glands
Authors: Sato Kiminori , Nakashima Tadashi 
Published: October 2014

Objectives: The present study was conducted to determine the effects of irradiation on the human laryngeal glands. Methods: Light and transmission electron microscopic observations were made. Results: Granular endoplasmic reticula and Golgi apparatuses were sparse in the cytoplasm of serous and mucous cells in cases with a short duration after radiotherapy. The secretory granules in serous cells had decreased in number. The secretory granules were less electron-dense compared to those in non-irradiated specimens, but were electron-lucent. The mucigen droplets in mucous cells were not as numerous as those in non-irradiated specimens. The discharge of secretory granules and mucigen droplets had decreased. In cases with a long duration after radiotherapy, there were some granular endoplasmic reticula and Golgi apparatuses in the cytoplasm. However, the transmission electron microscopy findings of secretory granules and mucigen droplets were the same as those in the irradiated glands with a short duration after radiotherapy. Conclusions: Morphological changes in the irradiated laryngeal glands influenced not only the amount but also the quality of secretions. The above changes lessened the lubrication of the vocal folds, thus causing a voice disorder to some extent. Local immunity and mucociliary transport were also affected. The effects of irradiation on the laryngeal glands partially altered the laryngeal functions.
Sinocutaneous Fistula Secondary to Chronic Frontal Rhinosinusitis: Case Series and Literature Review
Authors: Wu Vivian F. , Smith Timothy L. , Poetker David M. 
Published: October 2014

Objectives: The purpose of this study was to describe the clinical features of a series of patients in whom sinocutaneous fistula developed in the setting of chronic frontal sinusitis. Methods: We performed a retrospective case review of patients with sinocutaneous fistula. Clinical records, imaging, and operative reports were carefully examined. A complete literature review for relevant studies was performed to examine similar cases and possible pathophysiology. Results: Three patients with sinocutaneous fistula secondary to frontal sinusitis were identified. All patients underwent successful endoscopic sinus surgery with computer-assisted stereotactic localization and closure of the fistula. Conclusions: Development of sinocutaneous fistula secondary to frontal sinusitis is rare, but still occurs in the modern antibiotic era. Definitive management of this disease process requires 1) a frontal sinusotomy ensuring patency of the outflow tract and 2) fistula excision and multilayer closure.
Clinical Assessment of Gustatory Function before and after Middle Ear Surgery: A Prospective Study with a Two-Year Follow-up Period
Authors: Mueller Christian A. , Khatib Saher , Naka Asami , Temmel Andreas F. P. , Hummel Thomas 
Published: October 2014

Objectives: Middle ear surgery can affect gustatory function because of the course of the chorda tympani nerve (CTN) close to the tympanic membrane. The aim of the study was to evaluate the sense of taste before and after middle ear surgery with a test suitable for clinical routine. Moreover, subjective complaints were assessed over a relatively long period of time. Methods: Forty-seven patients (26 female, 21 male; mean age, 42 years) were investigated before and 4 days after surgery on both sides of the anterior part of the tongue. Self-assessment of taste function was performed by visual analog scales. Results: The mean (±SD) taste scores significantly decreased on the side ipsilateral to the operated ear in patients with major manipulation of the CTN (12.0 ± 4.5 before surgery and 6.9 ± 4.5 after surgery; p < 0.001), whereas no significant changes were measured in patients with minor manipulation of the CTN (12.5 ± 3.1 before surgery and 11.2 ± 3.9 after surgery; p = 0.14). Self-assessed ratings of taste function significantly decreased after surgery in all patients (p < 0.001). Reassessment of subjective taste function after 2 years indicated no persisting complaints. Conclusions: Depending on the amount of manipulation of the CTN, taste function is decreased after surgery. However, long-lasting changes of gustatory function seem to be rare.
Treatment of Tinnitus with a Customized, Dynamic Acoustic Neural Stimulus: Clinical Outcomes in General Private Practice
Authors: Hanley Peter J. , Davis Paul B. , Paki Bardia , Quinn Shaunine A. , Bellekom Sandra R. 
Published: October 2014

Objectives: We evaluate the relative effectiveness of a newly available tinnitus treatment approach for different categories of patients in general private practice. Methods: This was a cohort study, sponsored by Neuromonics, involving the first 470 patients to undertake the Neuromonics Tinnitus Treatment in 7 Neuromonics tinnitus clinics. All patients were provided with a dynamic acoustic neural stimulus, customized to each patient's audiometric profile, for daily use as part of a structured rehabilitation program. Tinnitus disturbance was assessed before, during, and after treatment with the Tinnitus Reaction Questionnaire. Results: The outcomes displayed a relation with patients' suitability according to predefined criteria: Among the most suitable patients (tier 1 cohort), 92% exceeded the threshold for success (defined as a reduction in tinnitus-related disturbance of at least 40%), and the mean improvement in tinnitus disturbance was 72%; the discontinuance rate was 4%. For other suitability categories, the success rates and mean improvements were somewhat lower, and the discontinuance rates higher (tier 2: 60%, 49%, and 16%, respectively; tier 3: 39%, 32%, and 17%, respectively). Conclusions: The results showed that the treatment is effective for suitable patients in the private practice setting, and they provide health-care professionals with guidance as to what patients might expect from treatment, depending on their degree of suitability.
Vestibular Evoked Periocular Potentials in Meniere's Disease after Glycerol Testing
Authors: Magliulo Giuseppe , Parrotto Donato , Gagliardi Silvia , Cuiuli Giuseppe , Novello Concetta 
Published: October 2014

Objectives: The present investigation was specifically designed to evaluate the clinical application of vestibular evoked periocular potentials (VEPPs) in the diagnosis of endolymphatic hydrops. Methods: We compared the results of the traditional pure tone audiometry glycerol test with those of the vestibular evoked myogenic potential (VEMP) glycerol test and the VEPP glycerol test in 22 patients affected by unilateral endolymphatic hydrops. Results: Some patients had positive depletive tests with both VEMPs and VEPPs, and other patients had positive tests with either VEMPs or VEPPs. Conclusions: Our outcomes confirmed that vestibular evoked potentials represent a useful additional diagnostic tool in the diagnosis of endolymphatic hydrops. The role of VEPPs in this particular issue was not inferior to that of VEMPs. The outcomes also suggested that not only the saccule, but also the utriculus, may be involved in the genesis of VEPPs.
Computer-Aided Technique for Automatic Determination of the Relationship between Transglottal Pressure Change and Voice Fundamental Frequency
Authors: Deguchi Shinji , Kawashima Kazutaka , Washio Seiichi 
Published: October 2014

Objectives: The effect of artificially altered transglottal pressures on the voice fundamental frequency (F0) is known to be associated with vocal fold stiffness. Its measurement, though useful as a potential diagnostic tool for noncontact assessment of vocal fold stiffness, often requires manual and painstaking determination of an unstable F0 of voice. Here, we provide a computer-aided technique that enables one to carry out the determination easily and accurately. Methods: Human subjects vocalized in accordance with a series of reference sounds from a speaker controlled by a computer. Transglottal pressures were altered by means of a valve embedded in a mouthpiece. Time-varying vocal F0 was extracted, without manual procedures, from a specific range of the voice spectrum determined on the basis of the controlled reference sounds. Results: The validity of the proposed technique was assessed for 11 healthy subjects. Fluctuating voice F0 was tracked automatically during experiments, providing the relationship between transglottal pressure change and F0 on the computer. Conclusions: The proposed technique overcomes the difficulty in automatic determination of the voice F0, which tends to be transient both in normal voice and in some types of pathological voice.
Endoscopic KTP Laser Photocoagulation Therapy for Pharyngolaryngeal Venous Malformations in Adults
Authors: Kishimoto Yo , Hirano Shigeru , Kato Naomi , Suehiro Atsushi , Kanemaru Shin-Ichi , Ito Juichi 
Published: October 2014

Objectives: Venous malformations are benign lesions with thin, fragile mucosa overlying a vascular stroma. Vascular anomalies often manifest as subglottic lesions in infants, but venous malformations in adults are rare in the pharyngolaryngeal region. The treatments include open and endoscopic surgery; intraoperative bleeding is often troublesome. Angiolytic lasers such as the potassium titanyl phosphate (KTP) laser enable photocoagulation for such hemorrhagic lesions without bleeding; we report findings from a series of adult patients. Methods: Seven adults were treated with a KTP laser set at a low power of 1.5 W in continuous mode. Photocoagulation was easily performed for shallow lesions; however, laser irradiation of bulky venous malformations resulted only in surface photocoagulation. In such cases, the crust remaining after photocoagulation was removed, and laser energy was repeatedly delivered until no remnant lesion was seen. An office procedure using flexible endoscopy was performed under topical anesthesia for 1 patient with a limited lesion. Results: The lesions were well controlled in all cases without major complications. A patient with a large obstructing lesion had a relapse. Because the recurrent lesion is small and the patient does not desire additional treatment at this time, she is being observed carefully. Conclusions: Photocoagulation using the KTP laser is a feasible and relatively safe treatment for pharyngolaryngeal venous malformations in adults.
Transnasal Esophagoscopy: White-Light versus Narrowband Imaging
Authors: O'Brien Timothy J. , Parham Kourosh 
Published: October 2014

Objectives: Transnasal esophagoscopy (TNE) is rapidly becoming integrated into otolaryngological practice. A recent report has shown an incongruence between an endoscopic diagnosis of Barrett's esophagus and biopsy-proven Barrett's esophagus in patients with laryngopharyngeal reflux (LPR). The goal of this study was to determine whether performing TNE with narrowband imaging (NBI) improves on the diagnostic yield in the otolaryngologist's hands. Narrowband imaging involves the use of filtered light to enhance the mucosal microvasculature pattern and has been shown to be highly sensitive to detecting Barrett's esophagus under conventional esophagoscopy. Methods: A retrospective chart review of 111 patients with LPR who underwent TNE by the same otolaryngologist was carried out. Pentax EE-1580K (white light only) and Olympus GIF-N180 (with NBI) endoscopes were used in 58 and 53 patients, respectively. Microcup biopsy of the squamocolumnar junction was obtained when Barrett's esophagus was suspected. Results: Biopsy-proven Barrett's esophagus was found in 13.5% of the patients. According to white light only and NBI, 7 of 58 (12.1%) and 8 of 53 (15.1%), respectively, had biopsy-proven Barrett's esophagus. Three patients had dysplasia on biopsy (2.7%), and all of these cases were detected under NBI (5.7%). Conclusions: Narrowband imaging may be a useful adjunct in increasing the diagnostic sensitivity of TNE in the hands of the otolaryngologist.
Microbiology and Antimicrobial Susceptibility Patterns of Commensal Flora in the Middle Nasal Meatus
Authors: Kirtsreesakul Virat , Tuntaraworasin Jompon , Thamjarungwong Benjamas 
Published: October 2014

Objectives: We examined the microbiology and antimicrobial susceptibility patterns of commensal flora in the middle nasal meatus of normal subjects who were free of health care–associated risks and sinonasal disease. Methods: A prospective study was performed on 70 healthy volunteers without health care–associated risks or sinonasal disease. Middle meatal specimens were carefully taken by an endoscopically guided swab technique. The specimens were cultured for aerobic and anaerobic bacteria. Antimicrobial susceptibility testing was performed by the broth disc method. Results: Bacterial growths were recovered in 66 of the 70 specimens (94.3%). Coagulase-negative staphylococci (CNS) were the most common isolates (61.6%), followed by Staphylococcus aureus (11.6%) and Corynebacterium sp (9.3%). All growths were quantified as very rare (73.3%), rare (13.9%), or few (12.8%). Obligate anaerobic bacteria were not identified. The samples positive for CNS showed multiple resistances to antibiotics, including erythromycin stearate (30.2%), clindamycin hydrochloride (28.3%), oxacillin sodium (a clinical substitute for methicillin sodium; 18.9%), and sulfamethoxazole-trimethoprim (9.4%). Conclusions: A small amount of CNS with or without multiple antibiotic resistances and/or S aureus cultured from the middle meatus can be considered contaminants in middle meatal culture during an episode of rhinosinusitis.
Flow Fields and Acoustics in a Unilateral Scarred Vocal Fold Model
Authors: Murugappan Shanmugam , Khosla Sid , Casper Keith , Oren Liran , Gutmark Ephraim 
Published: October 2014

Objectives: From prior work in an excised canine larynx model, it has been shown that intraglottal vortices form between the vocal folds during the latter part of closing. It has also been shown that the vortices generate a negative pressure between the folds, producing a suction force that causes sudden, rapid closing of the folds. This rapid closing will produce increased loudness and increased higher harmonics. We used a unilateral scarred excised canine larynx model to determine whether the intraglottal vortices and resulting acoustics were changed, compared to those of normal larynges. Methods: Acoustic, flow field, and high-speed imaging measurements from 5 normal and 5 unilaterally scarred canine larynges are presented in this report. Scarring was produced by complete resection of the vocal fold mucosa and superficial layer of the lamina propria on the right vocal fold only. Two months later, these dogs were painlessly sacrificed, and testing was done on the excised larynges during phonation. High-speed video imaging was then used to measure vocal fold displacement during different phases. Particle image velocimetry and acoustic measurements were used to describe possible acoustic effects of the vortices. Results: A higher phonation threshold was required to excite the motion of the vocal fold in scarred larynges. As the subglottal pressure increased, the strength of the vortices and the higher harmonics both consistently increased. However, it was seen that increasing the maximum displacement of the scarred fold did not consistently increase the higher harmonics. The improvements that result from increasing subglottal pressure may be due to a combination of increasing the strength of the intraglottal vortices and increasing the maximum displacement of the vocal fold; however, the data in this study suggest that the vortices play a much more important role. Conclusions: The current study indicates that higher subglottal pressures may excite higher harmonics and improve loudness for patients with unilateral vocal fold scarring. This finding implies that therapies that raise the subglottal pressure may be helpful in improving voice quality.
Serial Electromyography of the Thyroarytenoid Muscles Using the NIM-Response System in a Canine Model of Vocal Fold Paralysis
Authors: Scott Andrew R. , Chong Peter Siao Tick , Brigger Matthew T. , Randolph Gregory W. , Hartnick Christopher J. 
Published: October 2014

Objectives: We sought to determine whether serial intraoperative laryngeal electromyography (L-EMG) or evoked L-EMG predicts vocal fold (VF) recovery following iatrogenic injury. Methods: Six beagles were sedated, and bipolar needle electrodes were inserted into each thyroarytenoid (TA) muscle. Endotracheal tube surface electrodes were also placed. As the sedation lightened, L-EMG activity was recorded from all electrodes with an intraoperative nerve monitoring system. The neck was opened, and direct recurrent laryngeal nerve (RLN) stimulation was performed. Subsequently, 4 animals underwent crush injury of the left RLN, and 2 animals underwent nerve transection. The L-EMG procedures were repeated every 1 to 2 weeks until left VF motion was observed in the dogs that suffered RLN crush injury. At each time point, the neck was opened and both RLNs were stimulated. Results: Fibrillation potentials were detected in all animals after RLN injury. A change to electrical silence was seen in the animals in the crush injury group that were evaluated during the week preceding VF recovery. Fibrillation potentials and VF immobility persisted in the transection group throughout the complete time course of these experiments. The first appearance of an evoked response coincided with or occurred after the return of left VF motion in the crush injury group. The threshold, latency, and amplitude differed from those of the controls and approached normal values over time. No response was detected in the transected nerves. Conclusions: The disappearance of fibrillations on intraoperative L-EMG was noted in the animals tested the week before the return of VF motion, and the return of motor unit action potentials was seen along with return of VF function. Evoked L-EMG was not helpful in predicting the return of VF mobility, but it may help quantify degrees of RLN injury and predict the speed of recovery.