bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voice-Related Symptoms and Their Effects on Quality of Life
Authors: Merrill Ray M. , Roy Nelson , Lowe Jessica 
Published: October 2014

Objectives: The purpose of this study was to identify the extent to which selected voice symptoms formed underlying constructs called factors, and the degree to which these factors influenced specific quality-of-life domains among a group of relatively healthy older adults. Methods: A cross-sectional survey was completed in October 2010 by 461 individuals 50 years of age and older. The questionnaire items included demographics, medical history, health, voice use, and voice symptoms. Quality-of-life indicators were used from the Short Form 36 Health Survey, an 8-scale measure of functional health and well-being. Results: Two clusters of symptoms were identified in the factor analysis. One cluster, consisting of 5 voice-related symptoms and labeled “phonatory effort,” shared all significant negative correlations with health outcomes, whereas the other cluster, consisting of 2 voice-related symptoms and labeled “chronic throat condition,” had a pattern of sharing significant negative correlations with only 3 health outcomes. All voice symptoms had significant negative correlations with general health, bodily pain, and energy/fatigue. Conclusions: Voice-related symptoms share complex relationships with and have negative effects on health outcomes. The specific mechanisms of impact need further research in order for us to better understand these effects on quality of life and how to prevent and treat the symptoms.
Predictors of Hearing Preservation in the Management of Labyrinthine Fistulas Positioned on the Semicircular Canals
Authors: Albu Silviu , Amadori Maurizio , Babighian Gregorio 
Published: October 2014

Objectives: We sought to identify factors that would predict hearing preservation in the treatment of semicircular canal labyrinthine fistulas. Methods: Between 1990 and 2010, 97 patients with semicircular canal fistulas were operated on and enrolled in this retrospective study. In 62 patients the matrix was removed and the fistula was sealed, whereas in 35 patients the canal was drilled, the matrix was detached, and the canal was occluded. Perioperative corticosteroids were administered in 51 patients. The main outcome measures were the bone conduction thresholds evaluated at 1 year after the operation. Factors considered for possible association with hearing preservation included age, gender, site and size of the fistula, primary versus revision surgery, surgeon, perioperative corticosteroid treatment, and surgical management of the fistula. Results: The bone conduction hearing level was improved in 16 patients, remained unchanged in 73 patients, and had worsened in 11 patients. On the univariate analysis, good hearing was predicted by grade II fistula, canal plugging, and corticosteroid treatment. However, none of these factors attained significance in the logistic regression model. Conclusions: In surgery of semicircular canal fistulas, good hearing outcomes are to be expected if perioperative corticosteroids are administered, matrix removal and fistula sealing is performed in grade II fistulas, and canal occlusion is performed in grade III and IV fistulas.
Management of Upper Aerodigestive Tract Amyloidosis
Authors: Celenk Fatih , Durucu Cengiz , Baysal Elif , Karatas Zeynel A. , Polat Mustafa , Bakir Kemal , Mumbuc Semih , Kanlikama Muzaffer 
Published: October 2014

Objectives: The aim of this study was to discuss the treatment options for upper aerodigestive tract amyloidosis. Methods: Four patients with histologically confirmed amyloidosis were included in the study. All patients underwent surgical treatment. Three patients had laryngeal amyloidosis, and 1 patient had tonsillar amyloidosis. Results: Two of the cases of laryngeal amyloidosis were successfully treated with a combination of surgery and radiation therapy. One case of laryngeal amyloidosis was treated with surgery alone. The tonsillar amyloidosis was removed by tonsillectomy. None of the cases showed systemic involvement. Long-term follow-up of the patients showed no recurrence or evidence of systemic disease. Conclusions: Surgical resection is the primary treatment for patients with upper aerodigestive tract amyloidosis. Radiation therapy is especially effective in cases of recurrent amyloidosis with submucosal involvement. Pedunculated polypoid lesions may be treated with surgery alone, and in cases of recurrence, irradiation following the surgical removal should be considered. Tonsillectomy is usually sufficient for treating tonsillar amyloidosis.
Comparison of Carbon Dioxide Laser—Assisted versus Stapler-Assisted Endoscopic Cricopharyngeal Myotomy
Authors: Pollei Taylor R. , Hinni Michael L. , Hayden Richard E. , Lott David G. , Mors Matthew B. 
Published: October 2014

Objectives: We directly compared endoscopic carbon dioxide (CO2) laser and stapler treatment methods for both cricopharyngeal hypertrophy (CPH) and Zenker's diverticulum (ZD). Methods: We performed a single-institution retrospective chart review of 153 patients who underwent either CO2 laser–assisted or stapler-assisted endoscopic cricopharyngeal myotomy (CPM). Results: Isolated CPH was more likely to be treated with the CO2 laser than by stapler techniques. The ZD pouch size decreased significantly after surgery in both laser (p = 0.04) and stapler (p = 0.008) groups. The average duration of the procedure for CPM was longer for the laser than for the stapler (p = 0.01). Both techniques were successful when used in revision procedures. The overall complication rates were not statistically significantly different. Laser surgery trended toward a higher rate of major complications (2.4% versus 0%). Symptomatic recurrence was more likely after stapler surgery (p = 0.002). The rates of revision surgery were similar in the two groups (3.3% for laser and 4.3% for stapler). Conclusions: In the treatment of isolated CPH or ZD, stapler-assisted endoscopic surgery results in a shorter operative time, whereas laser-assisted CPM results in a decreased incidence of symptomatic recurrence.
Thyroid Storm Complicated by Fulminant Hepatic Failure: Case Report and Literature Review
Authors: Hambleton Catherine , Buell Joseph , Saggi Bob , Balart Luis , Shores Nathan J. , Kandil Emad 
Published: October 2014

Objectives: Thyroid storm is a presentation of severe thyrotoxicosis that has a mortality rate of up to 20% to 30%. Fulminant hepatic failure (FHF) entails encephalopathy with severe coagulopathy in the setting of liver disease. It carries a high mortality rate, with an approximately 60% rate of overall survival for patients who undergo orthotopic liver transplantation (OLT). Fulminant hepatic failure is a rare but serious complication of thyroid storm. There have been only 6 previously reported cases of FHF with thyroid storm. Methods: We present a patient from our institution with thyroid storm and FHF. A literature review was performed to analyze the outcomes of the 6 additional cases of concomitant thyroid storm and FHF. Results: Our patient underwent thyroidectomy followed by OLT. Her serum levels of thyroid-stimulating hormone, triiodothyronine, thyroxine, and transaminase normalized, and she was ready for discharge within 10 days of surgery. She has survived without complication. There is a 40% mortality rate for the reported patients treated medically with these conditions. Of the 7 total cases of reported FHF and thyroid storm, 2 patients died. Only 2 of the 7 patients underwent thyroidectomy and OLT — Both at our institution. Both patients survived without complications. Conclusions: Thyroid storm and FHF each independently carry high mortality rates, and managing patients with both conditions simultaneously is an extraordinary challenge. These cases should compel clinicians to investigate liver function in hyperthyroid patients and to be wary of its rapid decline in patients who present in thyroid storm with symptoms of liver dysfunction. Patients with rapidly progressing thyroid storm and FHF should be considered for total thyroidectomy and OLT.
Pro-Resolution Mediator Lipoxin A4 and its Receptor in Upper Airway Inflammation
Authors: Shimizu Shino , Ogawa Takao , Seno Satoshi , Kouzaki Hideaki , Shimizu Takeshi 
Published: October 2014

Objectives: The resolution of inflammation is an active process controlled by several anti-inflammatory and pro-resolution mediators. Lipoxin A4, an endogenous lipid mediator, is a potential pro-resolution mediator that could attenuate inflammation. This study was conducted to elucidate the role of lipoxin A4 in upper airway inflammation. Methods: Nasal secretions were collected from patients with chronic rhinosinusitis with nasal polyposis, patients with allergic rhinitis, and control subjects. The concentration of lipoxin A4 was measured by enzyme-linked immunosorbent assay. Nasal tissues were obtained from nasal polyps and inferior turbinates during endonasal surgery. The mRNA expressions of lipoxygenases (LOXs), lipoxin receptor (formyl peptide receptor-like 1; FPRL-1), and cysteinyl leukotriene type 1 receptor (CysLT1R) in nasal tissues were examined by reverse-transcription polymerase chain reaction. Tissue localization of FPRL-1 was determined by immunohistochemical staining. The in vitro effect of lipoxin A4 on airway epithelial cells was also examined. Results: A significant concentration of lipoxin A4 was found in nasal secretions, and the concentration was increased in patients with allergic rhinitis. The mRNA expressions of 5-LOX, 15-LOX-1, FPRL-1, and CysLT1R were significantly greater in nasal polyps than in inferior turbinates. FPRL-1 was localized in nasal epithelial cells. Lipoxin A4 inhibited tumor necrosis factor α-induced interleukin 8 release from airway epithelial cells via its receptor FPRL-1. Conclusions: These results indicate that lipoxin A4 may play a role in the resolution of upper airway inflammation. A low concentration of lipoxin A4 may be involved in chronic inflammation of the upper airways.
Sleep Architecture Parameters That Predict Postoperative Resolution of Nocturnal Enuresis in Children with Obstructive Sleep Apnea
Authors: Thottam Prasad John , Kovacevic Larisa , Madgy David N. , Abdulhamid Ibrahim 
Published: October 2014

Objectives: We performed a prospective cohort study in a pediatric tertiary care center to determine whether preoperative sleep architecture is associated with complete resolution of nocturnal enuresis (NE) after adenotonsillectomy. Methods: Thirty-seven pediatric patients with primary NE who underwent adenotonsillectomy for obstructive sleep apnea (OSA) were evaluated. Preoperative polysomnograms, as well as preoperative and postoperative reports of NE, were recorded. We performed χ2 analysis, Fisher's exact test (for p values), and t-tests to evaluate the impact of multiple demographic characteristics on sleep architecture, comparing children with resolved NE to those with unresolved NE after adenotonsillectomy. Results: The patients' mean age was 8.0 years (SD, 2.32 years). All children had presurgical primary NE. No age or gender differences were identified between children with resolved NE and those with unresolved NE. After surgery, more than half of the participants had resolution of NE. A higher percentage of boys had unresolved NE (χ2 = 3.63; p = 0.06). Improvement of NE was identified in children with a higher obstructive apnea-hypopnea index and more desaturation events. Eleven of the 12 children with prolonged stage 2 sleep reported resolution of NE (p = 0.001). Children with an obstructive apnea-hypopnea index of greater than 10 had a significantly greater rate of resolution of NE (p = 0.01). Logistic regression demonstrated that an elevated body mass index and the interaction of severe OSA and prolonged stage 2 sleep predicted resolution of NE. All 10 children with severe OSA and an abnormal total time spent in stage 2 sleep had resolution of NE. Conclusions: Adenotonsillectomy is a treatment option for children with OSA and NE. Postoperative resolution of NE was seen in 51.4% of patients who underwent adenotonsillectomy. The children with both severe OSA and prolonged stage 2 sleep were 3.4 times as likely to have postoperative resolution of NE. These results suggest that there are significant differences in preoperative sleep architecture between children whose NE resolves after adenotonsillectomy and those whose NE does not resolve.
Association between Tinnitus and Sleep Disorders in the General Japanese Population
Authors: Izuhara Keiichi , Wada Keiko , Nakamura Kozue , Tamai Yuya , Tsuji Michiko , Ito Yatsuji , Nagata Chisato 
Published: October 2014

Objectives: There are few studies about the association between tinnitus and sleep disorders in the general population worldwide. This study assessed this association in a Japanese community. Methods: A total of 14,027 participants 45 to 79 years of age who were in the Takayama Study responded to a self-administered questionnaire about tinnitus and sleep disorders. Results: Of this population, 13.3% of men and 10.6% of women had current tinnitus. The percentages of insomnia, respectively, among individuals with and without tinnitus were 28.1% in men and 36.1% in women and 18.8% in men and 21.5% in women. There were 1.7-fold (95% confidence interval [CI], 1.4 to 2.1) and 1.8-fold (95% CI, 1.5 to 2.2) increases in the odds ratios (ORs) of insomnia for those with tinnitus compared with those without tinnitus in men and women, respectively. Loud or very loud tinnitus was associated with 2.8-fold (95% CI, 1.8 to 4.3) and 3.3-fold (95% CI, 1.9 to 5.6) increases in the OR of insomnia in men and women, respectively. Even low (ie, quiet) or moderate tinnitus was significantly associated with insomnia. Difficulty initiating sleep, difficulty maintaining sleep, and a poor perceived quality of sleep were also significantly associated with tinnitus. Conclusions: Insomnia and other sleep disorders were significantly associated with tinnitus in Japanese adults.
Reliability and Validity of the Italian Eating Assessment Tool
Authors: Schindler Antonio , Mozzanica Francesco , Monzani Anna , Ceriani Eleonora , Atac Murat , Jukic-Peladic Nikolina , Venturini Claudia , Orlandoni Paolo 
Published: October 2014

Objectives: We sought to evaluate the reliability and validity of the Italian EAT-10 (Italian Eating Assessment Tool; I-EAT-10). Methods: The study consisted of 4 phases: Item generation, internal consistency and reliability analysis, normative data generation, and validity analysis. Discussion of the EAT-10 with 30 patients and its back-translation were accomplished. The recruited population included 172 patients (40 with dysphonia and 132 with dysphagia) and 269 asymptomatic subjects for testing of internal consistency, and 94 patients with dysphagia and 158 asymptomatic subjects for test-retest reliability analysis. Normative data were gathered from the 269 subjects. The scores of patients and asymptomatic subjects were compared. The I-EAT-10 and flexible endoscopic evaluation of swallowing (FEES) scores in 94 patients were correlated. The I-EAT-10 scores made before and after successful swallowing rehabilitation in 38 patients were compared. Results: Excellent internal consistency (Cronbach's alpha values of 0.90 and 0.93) and strong test-retest reliability (intraclass correlation coefficients of 0.95 and 0.98) were found in patients and asymptomatic subjects. The I-EAT-10 mean (±SD) score of the normal cohort was 0.6 ± 1.1. The asymptomatic subjects and dysphonic patients scored lower than the dysphagic patients on the Kruskal-Wallis test (p = 0.001). The I-EAT-10 and FEES scores were mildly correlated. The mean I-EAT-10 score improved from 9.8 ± 10.3 to 5.8 ± 6.7 after swallowing rehabilitation (p = 0.04). Conclusions: The I-EAT-10 is a reliable, valid, symptom-specific outcome tool.
PEComa of the Nasal Cavity with Worrisome Histologic Features and Benign Behavior: A Case Report
Authors: Bocciolini Corso , Fornelli Adele , Casadei Gian Piero , Cattani Maria Grazia , Dall'Olio Danilo 
Published: October 2014

Objectives: PEComas (perivascular epithelioid cell tumors) are a family of neoplastic lesions that share overlapping ultrastructure and morphological and immunohistochemical appearance and include angiomyolipoma, lymphangioleiomyomatosis, and clear cell “sugar” tumor of the lung, as well as similar tumors that occur in a variety of visceral, cutaneous, and soft tissue sites throughout the body. Methods: A 40-year-old woman came to medical attention because of epistaxis and because of unilateral nasal obstruction of 3 months' duration. Endoscopic examination revealed a well-demarcated exophytic lesion attached to the anterior portion of the middle turbinate. Results: The lesion was superficially located, and therefore amenable to complete surgical excision. Seven years after surgery, the patient is alive and well, without evidence of local recurrence or metastastic disease. Based on morphological and immunohistochemical appearance, a diagnosis of PEComa with worrisome histologic features was rendered. Conclusions: In the present study, we describe a PEComa that occurred in the nasal cavity and discuss the behavior of this entity. The importance of recognizing this disease will ensure its consideration in the differential diagnosis of tumors of the head that have similar morphological features. The histogenesis of PEComa still remains elusive, and collection of additional cases with a prolonged follow-up will be important in accurately determining the behavior of these distinctive tumors.
In Vitro Epithelial Differentiation of Human Induced Pluripotent Stem Cells for Vocal Fold Tissue Engineering
Authors: Imaizumi Mitsuyoshi , Sato Yuka , Yang David T. , Thibeault Susan L. 
Published: October 2014

Objectives: We determined the feasibility and optimization of differentiating human induced pluripotent stem cells (hiPS) into nonkeratinized stratified squamous epithelial cells for vocal fold engineering. Methods: hiPS were cultured and assessed for differentiation in 3 conditions: A 3-dimensional (3D) hyaluronic acid (HA) hydrogel scaffold, a 3D HA hydrogel scaffold with epidermal growth factor (EGF), and a 3D HA hydrogel scaffold co-cultured with human vocal fold fibroblasts (hVFF). After 1, 2, and 4 weeks of cultivation, hiPS were selected for histology, immunohistochemistry, and/or transcript expression analysis. Results: At 4 weeks, hiPS cultivated with hVFF or with EGF had significantly decreased levels of Oct 3/4, indicating loss of pluripotency. Immunofluorescence revealed the presence of pancytokeratin and of cytokeratin (CK) 13 and 14 epithelial-associated proteins at 4 weeks after cultivation in hiPS EGF and hiPS hVFF cultures. The transcript expression level of CK14 was significantly increased for hiPS hVFF cultures only and was measured concomitantly with cell morphology that was clearly cohesive and displayed a degree of nuclear polarity suggestive of epithelial differentiation. Conclusions: We found that hiPS cultivated in 3D HA hydrogel with hVFF demonstrated the most robust conversion evidence to date of epithelial differentiation. Further work is necessary to focus on amplification of these progenitors for application in vocal fold regenerative biology.
Skull Base Chondrosarcomas: Surgical Treatment and Results
Authors: Sbaihat Ahmad , Bacciu Andrea , Pasanisi Enrico , Sanna Mario 
Published: October 2014

Objectives: We describe our experience in the management of patients with skull base chondrosarcoma, an uncommon neoplasm of the skull base. Methods: Thirteen cases of surgically treated skull base chondrosarcomas were identified. The patients' follow-ups ranged from 7 to 86 months (mean, 47 months). Results: The most common tumor locations were the jugular foramen (5 cases), the petrous apex (3 cases), and the petroclival region (3 cases). An infratemporal fossa type A approach was performed in 2 cases, and 2 patients underwent an infratemporal fossa type B approach. Two patients underwent a transotic approach, 1 patient underwent a petro-occipital transsigmoid approach, and a petro-occipital transsigmoid approach combined with a transotic approach was chosen in 1 case. One patient underwent an infratemporal fossa type C approach combined with a transotic approach, and 2 patients underwent an infratemporal fossa type B approach combined with a transotic approach. One patient underwent an infratemporal fossa type B approach combined with a transzygomatic approach, and the last patient underwent a transmastoid approach. Gross total tumor removal was achieved in all patients. Postoperative radiotherapy was performed in 7 cases. The most common complications were lower cranial nerve deficits. Two patients experienced recurrences, 36 months and 6 years after surgical removal. Conclusions: We believe that the primary treatment for chondrosarcomas of the skull base is gross total surgical resection. We usually do not recommend radiotherapy as the primary treatment for patients with skull base chondrosarcomas; however, radiotherapy may be considered as an alternative primary treatment in selected cases in which there are serious medical contraindications to surgery, as well as in elderly patients. We reserve postoperative radiotherapy for patients with histologically aggressive tumors (grade II or III), as well as for cases of subtotal resection or recurrent tumors.
Incidence of Chronic Laryngitis
Authors: Stein Daniel J. , Noordzij J. Pieter 
Published: October 2014

Objectives: We describe the incidence of chronic laryngitis (CL) and identify the most common presenting symptoms and initial treatments used. Methods: We retrospectively identified patients with a diagnosis of CL who were seen among a primary care cohort at an urban academic medical center from 2009 to 2010. The incidence of CL was calculated. Symptoms, first-visit treatment, smoking, and demographics were recorded. Results: Of a population of 40,317 people, 280 received a new diagnosis of CL over a 2-year period, representing a yearly incidence of 3.47 cases per 1,000 people. The subjects consisted of 160 women and 120 men. Race was recorded as black (126), Hispanic (47), white (68), or other (39). The mean age was 52.9 years (range, 20 to 90 years). The initial therapies included proton pump inhibitors (79%), voice therapy (17%), nasal steroid (13%), antihistamine (4%), amitriptyline (4%), other (17%), and none (11%). The most common symptoms were dysphonia (53%), pain/soreness (45%), globus sensation (40%), cough (33%), excessive throat clearing (28%), and dysphagia (32%). An otolaryngologist saw 93% of the cases. Conclusions: The yearly CL incidence was 3.47 per 1,000 people. Up to 21% of the population may develop CL in their lifetime. Most of the patients in this cohort were referred to otolaryngologists, and the majority were treated with proton pump inhibitors. Dysphonia, globus sensation, and pain were the most common symptoms. Population surveys could be used to define undiagnosed disease and the overall prevalence of CL.
C. A Proposed Operation for the Relief of Congenital Atresia of the Esophagus.
Authors: Iglauer Samuel 
Published: October 2014

A two-stage operation is proposed for the relief of congenital atresia of the esophagus: Stage 1. Cervical esophagostomy for drainage of the blind esophageal pouch. Stage 2. A transthoracic operation for the externalization of the lower esophagus, i. e., dorsal esophagostomy for feeding purposes. I wish to express my indebtedness to Dr. Richard Austin of the Pathological Department for anatomic material, and to Mr. Philip Goland for assistance in dissections.