bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal Upper Airway Obstruction in Osteogenesis Imperfecta: Series of Three Cases and Review of the Literature
Authors: Johnson Kaalan , Pineda Melissa , Darrow David , Proud Virginia , Derkay Craig 
Published: October 2014

Objectives: Osteogenesis imperfecta (OI) is a genetic disorder characterized by variable degrees of dysfunction in type I collagen formation. We sought to explore an association between OI and upper airway obstruction (UAO) in light of our recent experience. Methods: We performed a retrospective chart audit and a review of the literature. Results: Three consecutive cases of OI at our institution required otolaryngological evaluation for UAO. The first patient had the mildest mutation type and did well until he developed severe reflux-triggered laryngospasm that improved with Nissen fundoplication and gastrostomy tube placement. He had mild hypotonia on endoscopy. The second patient had severe OI and the greatest acute fracture burden at birth. He required tracheotomy after early respiratory failure, and some mild bronchomalacia was noted. The third patient had severe OI and underwent cesarean section delivery. She developed respiratory failure after 1 month, requiring tracheotomy; mild tracheomalacia and glottic narrowing were noted on endoscopy. Conclusions: The UAO consisted of mild hypotonia or malacia in 3 consecutive cases of OI, and may have contributed to pulmonary and mechanical causes of tracheotomy requirement. The greatest predictors of tracheotomy requirement appear to be the severity of the OI mutation and the fracture burden. Elective cesarean section should be considered in severe cases of OI.
Harmonic Scalpel Tonsillectomy Using the Curved Shears Instrument versus Cold Dissection Tonsillectomy: A Retrospective Study
Authors: Gilbey Peter , Gadban Hussain , Letichevsky Vadim , Talmon Yoav 
Published: October 2014

Objectives: We compared operating time, intraoperative blood loss, and rate of postoperative bleeding in harmonic scalpel (HS) tonsillectomy using the curved shears instrument to those in cold dissection (CD) tonsillectomy. Methods: The charts of 560 patients who underwent tonsillectomy were retrospectively reviewed. Three hundred nineteen patients underwent CD tonsillectomy between the years 1998 and 1999, and 241 patients underwent HS tonsillectomy using the curved shears instrument between the years 2001 and 2005. For the purpose of evaluation of postoperative bleeding rates, the groups were further stratified by age (11 years of age or less versus 12 years of age or more). Results: For the HS group, the mean operating time was shorter (7 minutes versus 17.57 minutes) and the intraoperative blood loss was lower (0 mL versus 42.12 mL). These differences were statistically significant (p < .05). There was no significant difference in the overall postoperative bleeding rates between the two groups. The postoperative bleeding rate in the HS patients 11 years of age or younger was lower than that in the equivalent age group in the CD group (0.56% versus 2%, respectively), although this difference did not reach statistical significance. The postoperative bleeding rate in the HS patients 12 years of age or older was significantly higher than that in the equivalent age group in the CD group (7.93% versus 1%, respectively; p < .05). Conclusions: Harmonic scalpel tonsillectomy using the curved shears instrument offers advantages over CD tonsillectomy regarding operating time and intraoperative blood loss. In our patients more than 12 years of age, HS tonsillectomy using the curved shears instrument was associated with an increased postoperative bleeding rate compared to CD tonsillectomy.
Roles of Vitamin a and Macula Flava in Maintaining Vocal Folds
Authors: Tateya Tomoko , Tateya Ichiro , Surles Rebecca Lynn , Tanumihardjo Sherry , Bless Diane M. 
Published: October 2014

Objectives: Vitamin A plays important roles in development, growth, and regeneration. Vitamin A-storing stellate cells have been identified in several organs. The functional roles of vitamin A in the vocal folds are still unknown, although vitamin A-storing vocal fold stellate cells have been observed in the macula flava of human and rat vocal folds. The purpose of this study was to investigate the roles of vitamin A in vocal folds. Methods: Vitamin A-deficient rats were generated, and the vocal folds were examined histologically. Messenger RNA was extracted from the vocal folds and analyzed by real-time polymerase chain reaction. Results: Immunohistochemical analysis of normal vocal folds revealed expression of retinoic acid receptor α in vocal fold stellate cells. The cells in the macula flava of vitamin A-deficient rats showed a larger nucleus/cytoplasm ratio than did those of vitamin A-sufficient rats, but messenger RNA expression of major extracellular matrix components in the macula flava of vitamin A-deficient rats did not present a remarkable change except for procollagen type I. Expression of hyaluronic acid, collagen types I and III, and elastin did not show a significant change in vitamin A-deficient rat vocal folds. Conclusions: These results indicate that vitamin A is not essential to maintaining the extracellular matrix of normal adult vocal folds, although vocal fold stellate cells participate in vitamin A storage.
Comparative Ultrasonographic, Magnetic Resonance Sialographic, and Videoendoscopic Assessment of Salivary Duct Disorders
Authors: Capaccio Pasquale , Cuccarini Valeria , Ottaviani Francesco , Minorati Davide , Sambataro Giuseppe , Cornalba Paolo , Pignataro Lorenzo 
Published: October 2014

Objectives: Salivary duct disorders are the second most common cause of obstruction after calculi. Magnetic resonance sialography has been recently proposed as a means of diagnosing a heterogeneous group of salivary disorders, and so we compared it with sialoendoscopy in evaluating stenoses and sialectasia in 24 patients with obstructive symptoms and ultrasonographic results negative for calculi or masses. Methods: All of the patients (19 of whom had recurrent unilateral or bilateral swollen parotid glands and 5 of whom also had recurrent swollen submandibular glands) underwent dynamic color Doppler ultrasonography and dynamic magnetic resonance sialography with lemon juice stimulation of saliva; 18 patients also underwent diagnostic sialoendoscopy. Results: Ultrasonography and color Doppler ultrasonography showed duct dilatation in all patients (bilateral in 5 with parotid stenosis). Magnetic resonance sialography confirmed duct dilatation and stenosis in all of the patients, and revealed the simultaneous presence of calculi in 4 cases. A parotid sialocele was found in 4 cases. The magnetic resonance sialographic findings were confirmed in the patients who underwent sialoendoscopy. No side effects were observed. Conclusions: Magnetic resonance sialography following prediagnostic ultrasonography allows an adequate diagnosis of salivary duct disorders such as stenosis and sialectasia, as confirmed by objective sialoendoscopic assessment. Magnetic resonance sialography also makes it possible to visualize the salivary duct system up to its tertiary branches and, in this regard, may be considered a valid, noninvasive method for the evaluation of salivary duct disorders.
Assessment of Swallowing Sounds by Digital Cervical Auscultation in Children
Authors: Almeida Sheila T. , Ferlin Elton L. , Parente Maria Alice M. P. , Goldani Helena A. S. 
Published: October 2014

Objectives: There is a lack of studies regarding swallowing sounds in children 3 to 11 years of age. This study aimed to assess swallowing sounds by digital cervical auscultation in children of this age group without symptoms of oropharyngeal dysphagia. Methods: Digital cervical auscultation was performed in 118 subjects by use of a piezoelectric microphone. The children swallowed 5 mL of liquid and yogurt. The components of perceptual acoustic analysis were discrete initial signal (DIS), main signal of swallowing sound (MS), discrete final signal (DFS), and expiratory return (ER). Duration in seconds was the objective parameter of the swallowing sound signal analyzed. Results: Fifty-six boys and 62 girls were evaluated at a mean (±SD) age of 6.9 ± 2.03 years. A complete DIS-MS-DFS-ER swallowing sequence was found in 60% of the children. There was no significant difference in swallowing sound duration between both food consistencies (p = .189) or between genders either for liquid (p = .327) or yogurt (p = .792). There was no correlation between age and duration of the swallowing sound for liquid or yogurt. Conclusions: We concluded that digital cervical auscultation was able to provide objective information about the swallowing process that could contribute to methodological standardization in children.
Pediatric Voice-Related Quality of Life: Findings in Healthy Children and in Common Laryngeal Disorders
Authors: Merati Albert L. , Keppel Kristina , Braun Nicole M. , Blumin Joel H. , Kerschner Joseph E. 
Published: October 2014

Objectives: Although several instruments have been validated to assess voice quality, the incidence and degree of impairment in normal, healthy children has not been widely reported. It is hypothesized that healthy children outside a medical setting do not demonstrate impairment as measured by the Pediatric Voice-Related Quality of Life (PVRQOL) instrument; in contrast, patients with vocal fold paralysis (VFP), vocal nodules (VNs), and paradoxical vocal fold dysfunction (PVFD) have significant impairment as compared to control populations. Methods: The PVRQOL was measured prospectively in children with VFP, VNs, and PVFD. The findings were compared to findings in 100 children surveyed at the 2006 Wisconsin State Fair. Results: Of the 100 surveys of healthy children and their parents, 95 were completed correctly; their mean (±SD) PVRQOL score was 96.8 ± 5.85. The VFP patients (n = 11; mean PVRQOL score, 70.5 ± 28.6) reported significant impairment (p < .0001, unpaired t-test). This was also true of patients with VNs (n = 13; PVRQOL score, 84.8 ± 9.4; p < .0001) and PVFD (n = 25; PVRQOL score, 86.7 ± 14.3; p < .0001); statistically significant differences were also noted for the Social-Emotional and Physical-Functional domains for each of the 3 disease states compared to the group of healthy children (p < .001). Conclusions: The PVRQOL scores of healthy children reveal essentially no self-reported vocal impairment. In contrast, common disorders such as VNs, VFP, and PVFD demonstrate statistically significant impairment in age-matched children for total PVRQOL, as well as for the Social-Emotional and Physical-Functional domains. This is the first report of normative PVRQOL data in children.
Computational Fluid Dynamics Analysis of Upper Airway Reconstructed from Magnetic Resonance Imaging Data
Authors: Mihaescu Mihai , Murugappan Shanmugam , Gutmark Ephraim , Donnelly Lane F. , Khosla Siddarth , Kalra Maninder 
Published: October 2014

Objectives: We performed flow computations on an accurate upper airway model in a patient with obstructive sleep apnea and computed the velocity, static pressure, and wall shear stress distribution in the model. Methods: Cartesian coordinates for airway boundaries were determined from cross-sectional magnetic resonance images, and a 3-dimensional computational model of the upper airway was constructed. Flow simulations were then performed within a FLUENT commercial software framework. Four different flow conditions were simulated during inspiration, assuming the steady-state condition. The results were analyzed from the perspectives of velocity, static pressure, and wall shear stress distribution. Results: We observed that the highest axial velocity was at the site of minimum cross-sectional area (retropalatal pharynx) resulting in the lowest level of wall static pressure. The highest wall shear stresses were at the same location. The pressure drop was significantly larger for higher flow rates than for lower flow rates. Conclusions: Our results indicate that the presence of airway narrowing, through change in the flow characteristics that result in increased flow velocity and reduced static pressure, can itself increase airway collapsibility. Additionally, the effects of wall shear stress on airway walls may be an important factor in the progression over time of the severity of obstructive sleep apnea.
Tone Perception in Cantonese-Speaking Children with Hearing Aids
Authors: Lee Kathy Y. S. , van Hasselt Charles Andrew , Tong Michael C. F. 
Published: October 2014

Objectives: In this study we investigated the benefit of using hearing aids for Cantonese tone perception among children with various degrees of hearing impairment. Methods: Forty-eight children with moderate to profound hearing loss were investigated. They were required to perform a lexical tone perception test with recorded test stimuli presented at 65 dB in soundproof booths. To allow for comparison, the subjects performed the test under 2 conditions: With their hearing aids turned off (unaided condition) and with them turned on (aided condition). Results: The mean tone perception scores for the aided condition were higher than those for the unaided condition across all of the subject groups. Paired sample t-tests showed statistically significant improvement in tone perception in the moderate and severe hearing loss groups (p = .02 and p = .03, respectively). The result obtained from the moderately severe hearing loss group was marginally significant (p = .058). The improvement in tone perception in the profound hearing loss group was insignificant (p = .55). Conclusions: The use of a hearing aid is beneficial for Cantonese tone perception in children who have moderate to severe hearing impairment. When a hearing loss is greater than 90 dB, ie, in children who are classified as having profound hearing loss, a hearing aid is not effective in aiding Cantonese tone perception.
Results of Sonotubometry in Testing Eustachian Tube Ventilatory Function in Children with Cleft Palate
Authors: van der Avoort Stijn J. C. , van Heerbeek Niels , Admiraal Ronald J. C. , Zielhuis Gerhard A. , Cremers W. R. J. 
Published: October 2014

Objectives: In previous studies, an updated sonotubometry setup was tested in healthy adults and children to test its validity and reproducibility in the assessment of the ventilatory function of the eustachian tube (ET). The results were promising, but further investigations were needed to confirm the discriminative potential of this sonotubometry setup. Our objective in the present study was to test the discriminative potential of an updated sonotubometry setup in children with cleft palate. Methods: The ET ventilatory function was tested in 56 children with cleft palate, ie, children with impaired ET function, and compared to the outcomes in 61 healthy children who served as a control group. All of the children were between 5 and 9 years of age. To test the reproducibility, we performed the sonotubometric testing in 2 sessions of 10 acts of swallowing each. Spearman's coefficient was used to test the correlation between the 2 sets of measurements. The results of measurements in the cleft palate group were compared with those in the otologically healthy control group and analyzed by means of a Mann-Whitney U test. Results: Opening of the ET was recorded in at least 1 of the 2 measurement sessions in 57% of the children with cleft palate, as compared to 82% in the control group. The mean number of openings was lower in the cleft palate group than in the control group (respectively, 2.3 versus 3.7 out of 10; p < .01). The first and second sessions were highly correlated in both the cleft palate group and the control group, with Spearman's coefficients of, respectively, 0.96 and 0.89. Conclusions: The results of this study show that this updated sonotubometry setup has the potential to discriminate between these groups of children with various states of ET ventilatory function. Furthermore, the results of this study once again show that this updated sonotubometry setup is capable of assessing ET ventilatory function in both healthy children and children with cleft palate and that the measurements are highly reproducible. A persistent disadvantage remains that in 18% of the 61 healthy children there was no ET opening that could be registered, which still prohibits a definite assessment at the individual level.
Regeneration of Tracheal Epithelium Utilizing a Novel Bipotential Collagen Scaffold
Authors: Tada Yasuhiro , Suzuki Teruhisa , Takezawa Toshiaki , Nomoto Yukio , Kobayashi Ken , Nakamura Tatuo , Omori Koichi 
Published: October 2014

Objectives: The purpose of the present study was to evaluate the effectiveness of a novel bipotential collagen scaffold as a bioengineered trachea for the regeneration of the tracheal epithelium. Methods: The bipotential collagen scaffold was developed by conjugating a collagen vitrigel membrane to a collagen sponge in order to promote both epithelial cell growth and mesenchymal cell infiltration. The bipotential collagen scaffold was transplanted into tracheal defects in rats, and a conventional collagen sponge was implanted as a control model. Histologic examinations were undertaken to evaluate the results. Results: The bioengineered trachea was covered with epithelium in the vitrigel model, but not in the control model, at 7 days after implantation. At 14 days after implantation, the bioengineered trachea was covered with epithelium involving the basal cell layer in the vitrigel model. At 28 days after implantation, a columnar ciliated epithelium was observed only in the vitrigel model. Conclusions: Our technique for trachea reconstruction using a novel bipotential collagen scaffold affords a feasible approach for accelerating epithelial regeneration on the intraluminal surface of the host tracheal defect.
Auditory Evaluation in Patients with Type 1 Diabetes
Authors: Pessin Adriana Bueno Benito , Martins Regina Helena Garcia , de Paula Pimenta Walkyíria , Simões Antônio Caetano Pereira , Marsiglia Alessandra , Amaral Amanda Vieira 
Published: October 2014

Objectives: We performed a prospective clinical study of the cochleovestibular symptoms and the risk cofactors and characteristics of hearing loss in patients with type 1 diabetes. Methods: Group 1 consisted of 40 patients with type 1 diabetes, and group 2 consisted of 20 control subjects without diabetes. All participants answered a questionnaire, and their medical records were reviewed. They also were submitted to otorhinolaryngological examinations and to auditory tests (pure tone audiometry and acoustic immitance and auditory brain stem response [ABR] tests). Results: Dyslipidemia, hypertension, retinopathy, and diabetic neuropathy were not frequent in the patients of group 1, but incipient nephropathy was present in 47.5% of them. The most frequent cochleovestibular symptoms were tinnitus and hearing loss. Sensorineural hearing loss was found in 4 patients of group 1 and was predominantly bilateral, symmetric, and affecting the high frequencies, coexisting with normal vocal discrimination. These patients had a longer time from diabetes diagnosis and had poor glycemia control. A delay of ABR interpeak latency I-III was observed in 11.25% of the group 1 ears. All patients of group 2 presented normal audiograms and ABR tests. Conclusions: In group 1, the most frequent cochleovestibular symptoms were tinnitus and hearing loss. The sensorineural hearing loss was mild, symmetric, and predominantly high-frequency. A delay of ABR interpeak latencies was detected in the patients of group 1 who had normal audiometric thresholds.
Intrinsic Laryngeal Muscle Reinnervation Using the Muscle-Nerve-Muscle Technique
Authors: Debnath Indranil , Rich Jason T. , Paniello Randal C. 
Published: October 2014

Objectives: This study was performed to investigate the muscle-nerve-muscle reinnervation technique in the larynx, in which a nerve conduit implanted into an innervated muscle conducts axonal sprouting into a denervated muscle while maintaining function of the donor muscle. Methods: In this study, the muscle-nerve-muscle technique was used to direct superior laryngeal nerve axons to reinnervate intrinsic laryngeal muscles by implanting the recurrent laryngeal nerve stump into the cricothyroid muscle in 8 dogs. In 4 of the dogs, the recurrent laryngeal nerve trunk to the adductor muscles was divided so that all axonal sprouting was directed to the posterior cricoarytenoid muscle. Six-month electromyography data were obtained from 6 of the 8 dogs. Results: All 6 dogs showed evidence of successful reinnervation of the thyroarytenoid or posterior cricoarytenoid muscles with action potentials that corresponded to spontaneous respiratory efforts, while the donor cricothyroid muscles retained their phasic contraction. These responses were obliterated when the recurrent laryngeal nerve conduit was divided. Histologic examination of the intrinsic laryngeal muscles demonstrated successful reinnervation. Conclusions: The results confirm that intrinsic laryngeal muscles may be successfully reinnervated by the superior laryngeal nerve with the muscle-nerve-muscle technique, without sacrifice of function of the cricothyroid muscle. This method offers an alternative source of appropriately firing axons for laryngeal reinnervation procedures.
Treatment of Sinusitis with Corticosteroids in Combination with Antibiotics in Experimentally Induced Rhinosinusitis
Authors: Sütbeyaz Yavuz , Aktan Bülent , Yoruk Ozgur , Özdemir Hasan , Gundogdu Cemal 
Published: October 2014

Objectives: The objective of this study was to investigate the effects of corticosteroids, antibiotics, and their combination in the therapy of experimental bacterial rhinosinusitis. Methods: Twenty-eight rabbits underwent experimental induction of bacterial rhinosinusitis with Staphylococcus aureus. The animals were assigned randomly to 1 of 4 treatments (saline solution, methylprednisolone, cefazolin sodium, methylprednisolone–cefazolin sodium) for 7 days. After the treatment period, sinus mucosa samples of the animals were examined stereologically. In addition, mucosa samples were used in the determination of myeloperoxidase (MPO) activity. Results: Methylprednisolone, cefazolin, and methylprednisolone-cefazolin had a positive effect on the reduction of neutrophil infiltration to the sinus mucosa in experimental bacterial rhinosinusitis as compared to the group treated with saline solution. However, the effects of methylprednisolone, cefazolin, and methylprednisolone-cefazolin did not significantly differ (p > .05). Similarly, the use of methylprednisolone, cefazolin, and methylprednisolone-cefazolin decreased MPO activity as compared to the group with saline solution (p < .05), and the difference among methylprednisolone, cefazolin, and methylprednisolone-cefazolin was statistically significant (p < .05). The most significant decrease in MPO (neutrophil marker enzyme) activity was determined in the animals treated with methylprednisolone-cefazolin (p < .05). Conclusions: Administering corticosteroids as an adjunct to antibiotics may accelerate the healing process in experimentally induced rhinosinusitis. In this model of rhinosinusitis, an MPO assay was supportive of this hypothesis, although stereological examination showed no statistically significant difference.