bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Utilization of Vocal Fold Injection Procedures
Authors: Rosow David E. 
Published: September 2014

Objectives:Office‐based laryngeal procedures, vocal fold injections in particular, have become increasingly popular over the past 15 years. The purpose of this study was to examine trends in the use of different vocal fold injection techniques in the United States from 2000 to 2012 and see if they reflect this shift.Methods:The United States Part B Medicare claims database was queried from the years 2000 through 2012. The Current Procedural Terminology codes for indirect laryngoscopy with injection (31513), direct laryngoscopy with injection (31570), and direct laryngoscopy with injection, aided by telescope or operating microscope (31571) were used. For comparison, data for medialization laryngoplasty (31588) were also examined. The volume of procedures performed was tabulated for each code by year.Results:Over the time period studied, the number of non‐operative laryngoscopic injections (31513, 31570) and operative medialization laryngoplasties remained constant. Operative vocal fold injection (31571) demonstrated significant, linear growth over the 12‐year study period, from 744 procedures in 2000 to 4788 in 2012, an increase of over 640%.Conclusions:The dramatic increased incidence in the use of code 31571 reflects an increasing share of vocal fold injections being performed in the operating room and not in an office setting, which runs counter to the prevailing trend within laryngology of awake, office‐based injection procedures. This may indicate that these procedures have become more popular over time within the otolaryngology community and are being performed increasingly by providers more comfortable with the controlled operating room setting.
The Adenoid Microbiome in Recurrent Acute Otitis Media and Obstructive Sleep Apnea
Authors: Ojano‐Dirain Carolyn P. , Silva Rodrigo C. , Collins William O. , Antonelli Patrick J. 
Published: September 2014

Objectives:Compare the microbial flora of adenoids from patients with recurrent acute otitis media (AOM) and patients with obstructive sleep apnea (OSA).Methods:This study was prospective and controlled. Adenoids were obtained from children undergoing adenoidectomy for recurrent AOM or OSA. Specimens were processed for total deoxyribonucleic acid (DNA) isolation; 16s DNA 454‐pyrosequencing was performed on AOM (n = 5) or OSA (n = 5) specimens.Results:All adenoid specimens had evidence of microbes. Haemophilus influenzae was detected in almost all of the specimens. Moraxella catarrhalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pneumoniae were also among the most dominant species in all samples. Streptococcus salivarius, Prevotella sp, and Terrahaemophilus aromaticivorans were more common on adenoids from OSA patients (P <. 05). Bradyrhizobium sp. was more common on adenoids from patients with recurrent AOM (p < 0.05). The microbial profiles associated with recurrent AOM were different from, but overlapped with, OSA.Conclusions:Microbes are present on all adenoid specimens, however, the microbial profile differs between recurrent AOM and OSA. The clinical significance of these differences remains to be determined.
Antivirals for Idiopathic Sudden Sensorineural Hearing Loss
Authors: Awad Zaid , Huins Charlie , Pothier David D. 
Published: September 2014

Objectives:Determine the effectiveness and side effect profile of antivirals in the treatment of idiopathic sudden sensorineural hearing loss (ISSHL).Methods:We systematically searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 5), PubMed, EMBASE, CINAHL, and other databases to June 12, 2012. Reference lists of identified studies for further trials were also scanned. Selection criteria: Randomized controlled trials (RCTs) comparing different antivirals versus placebo (both with or without other treatment). Two authors independently extracted data. Meta‐analysis was considered inappropriate and ultimately not possible due to differing treatment protocols and differing inclusion criteria and outcome measures between studies.Results:Four RCTs (257 participants) were identified. Two trials compared the addition of intravenous acyclovir with a steroid (prednisolone). Neither demonstrated any hearing improvement with ISSHL. Another showed no benefit with the addition of valacyclovir to prednisolone on hearing outcome. Comparing intravenous acyclovir plus hydrocortisone with hydrocortisone alone, the final trial did not show any statistically significant difference between groups. Even though no meta‐analysis was possible, evidence from 4 RCTs has demonstrated no statistically significant advantage in the use of antivirals in the treatment of ISSHL.Conclusions:There is no evidence to support the use of antiviral drugs in the treatment of ISSHL. Further randomized controlled trials are needed for adequate meta‐analysis to be performed to reach definitive conclusions. A uniform definition of ISSHL should also be established, together with what constitutes adequate recovery.
Audiological Evaluation of the Contralateral Ear in Patients with Cholesteatoma
Authors: da Costa Sady S. , Rosito Leticia S. , Canali Inesangela , Netto Luciana , Jung Larissa P. , Pauletti Marcos G.T. , Ronchi Andre D. 
Published: September 2014

Objectives:Evaluate the contralateral ear (CLE) audiometric findings in patients with middle ear cholesteatoma. (2) Correlate the audiometric thresholds to videotoscopic findings.Methods:Cross‐sectional study. Videotoscopies and audiometries of 300 patients with cholesteatoma at a tertiary hospital were analyzed. The CLE videotoscopy, bone conduction, air conduction, and air‐bone gap pure tone average (PTA) were analyzed.Results:The mean patient age was 32.35 ± 19.26 years, and 52.2% were female. The CLE was abnormal in 60.8% of cases: 5.6% had perforation, 39.9% had moderate or severe retraction, and 15.6% had cholesteatoma. The CLE bone conduction PTA was 16.75 ± 16.1 dB, the air conduction PTA was 47.1 ± 22.8 dB, and the air‐bone gap PTA was 32.2 ± 18.7 dB. The CLE prevalence of severe and profound sensorineural hearing loss was 1.7%. Severe hearing impairment did not occur in patients with a normal CLE, whereas it did occur in 2.7% of patients with an abnormal CLE (P =. 02). Bone conduction PTA was similar between normal and abnormal CLE (P =. 82), but the air conduction and air‐bone gap PTA were higher in abnormal CLE (P <. 001 and P <. 001, respectively).Conclusions:In patients with cholesteatoma, the CLE had a high prevalence of abnormalities and hearing impairment. Severe and profound sensorineural hearing loss was only observed in abnormal CLE. The air bone gap and air conduction PTA were also higher in the abnormal CLE.
Body Mass Index and Imaging Abnormalities in Spontaneous Cerebrospinal Fluid Leaks of the Temporal Bone
Authors: Rivera Andrew M. , Jethanamest Daniel , Angeli Simon I. 
Published: September 2014

Objectives:Determine if (1) increased body mass index (BMI) is associated with spontaneous cerebrospinal fluid leak (SCSFL) of the temporal bone when compared with NSCSFL; (2) if body mass index (BMI) is a prognostic factor in the management of SCSFL; (3) if aberrant arachnoid granulations and empty sella are associated with SCSFL when compared to NSCSFL.Methods:Retrospective chart review of patients from 2002 to 2013 of all patients treated for CSFL.Results:Eighteen patients were treated for SCSFL and 17 for NSCSFL between 2002 and 2013. The mean BMI of the SCSFL group was 32.86 (median 33.53). The mean BMI of the NSCSFL group was 28.54 (median 29) (P =. 0683). The average BMI of patients requiring revision surgery was 37.88 compared to patients who only required a single intervention 30.35 (P =. 012). 100% of patients with SCSFL had ectopic arachnoid granulations identified on CT temporal bone while none of the patients with NSCSFL had these (P <. 001). 66% (8/12) of patients with SCSFL had empty sella on MRI compared to 16 % (2/12) of those with NSCSFL (P =. 04).Conclusions:Patients with SCSFL of the temporal bone have an elevated BMI when compared with NSCSFL. The presence of arachnoid granulations and empty sella on diagnostic imaging is associated with SCSFL when compared to NSCSFL. Patients with SCSFL requiring multiple interventions demonstrated a higher BMI than those treated successfully with a single intervention, indicating that this may be a poor prognostic factor.
Caloric Test and Video‐Head‐Impulse (v‐HIT): Usefulness as Screening Tool of Vestibular Pathology
Authors: Espitia Elizabeth A. , García Estefania Hernández , Parez‐Martan Nuria , Plaza Guillermo 
Published: September 2014

Objectives:Investigate the horizontal vestibulo‐ocular reflex (VOR) by means of vHIT in peripheral vestibular disorders.Methods:Prospective clinical trial at a university hospital. Using 2 vHIT equipments (Otometrics(R) and Ullmer(R)), and the caloric response as gold standard, we examined the VOR in a group of 73 patients, and a control group of 18 healthy subjects. The group of patients included BPPV (n = 26), vestibular neuritis (VN) (n = 12), Ménière's disease (MD) (n = 10), and idiopatic vestibulopathy (IV) (n = 25).Results:An abnormal VOR gain (less than 0.60) was found in 70.4% of all cases, whereas healthy subjects showed a normal gain in 94.44% of cases. An abnormal vHIT was found more commonly in VN (91.66%) and MD (80%), P <. 05. Isolated covert saccades and/or isolated overt saccades were present in all cases showing poor VOR gain. Caloric responses were paretic in 75% of cases showing poor VOR gain in vHIT, showing good correlation.Conclusions:The vHIT detects abnormal VOR changes in the combination of gain assessment and refixation saccades. vHIT might be a good screening tool to assess vestibular disorders, avoiding caloric stimulation in certain patients.
Central Auditory Gain Secondary to Hearing Deprivation and Its Role in Hyperacusis
Authors: Chiossone‐Kerdel Juan A. , Graterón Eleazar E. , Goncalves Stefania , Ceballos Sinay A. , Gonzalez‐Abascal Daniel , Baguley David 
Published: September 2014

Objectives:Determine the characteristics of the auditory central gain due to bilateral hearing deprivation, and its relationship with circadian variations as a function of cortical activity.Methods:The study was designed as a prospective observational research, in a national referral center. A total of 28 volunteers ranging between 18 and 30 years old underwent bilateral earplugging with Merocel, previous medical examination, anthropometry, author developed questionnaire, Hamilton anxiety and depression inventory, speech and pure tone audiometry, tympanometry and middle ear reflex (MER), distortion products otoacoustics emissions input/output(DPOAE‐I/O), and uncomfortable loudness levels (ULLs) in 0.5‐4 kHz. Subjects were randomly divided in 2 groups: Group A, starting at 8:00 am and finishing at 8:00 pm; Group B, starting at 4:00 pm ending at 4:00 am. Serum cortisol levels and audiological test were obtained at the beginning and at the end of the session. A 24‐hour free urinary cortisol levels were measured.Results:We observed an air conduction drop in right ears (AD) at 1 kHz (P =. 036) and 0.125, 4 y 8 kHz frequencies in left ears(AS) (P =. 013,. 003,. 003), respectively. The ULLs in Group A showed a decline in AD/AS thresholds in all frequencies. Contralateral AD MER thresholds presented a decline on 0.5 to 1 kHz. AS DPOAE‐I/O fell by 25 and 45 dB (P =. 046,. 461) in group B, and 25 dB in Group A (P =. 047). In group B, serum cortisol levels increased by 19.28 ± 4.37 µg/µL (P =. 018).Conclusions:We report an association between the increase of serum cortisol and auditory gain and an indirect relationship with normal cortical activity. Thus, bilateral hearing deprivation can potentially be used as a convenient model for the study of hyperacusis.
Chiari Type I Malformations in Patients with Dizziness
Authors: Mostovych Nadia K. , Willcox Thomas O. , Artz Gregory J. 
Published: September 2014

Objectives:(1) Investigate the association between magnetic resonance imaging (MRI) findings of Chiari Type I malformation and symptoms of dizziness in patients presenting to a neurotology clinic. (2) Recommend indications for intervention for Chiari Type I malformation in patients presenting with dizziness.Methods:A retrospective chart review was conducted for 16 patients presenting to our neurotology clinic between 2002 and 2009 found to have Chiari Type I malformation on MRI. All patients presented with symptoms of disequilibrium and/or vertigo. Charts were reviewed for demographics, symptoms, surgical procedures, videonystagmography, and degree of malformation based radiographic measurements.Results:The prevalence of Chiari Type I malformation in patients presenting to the neurotology clinic with dizziness is 16 out of 6427 (0.2%). During this time period, 16 patients were found to have radiographically confirmed Chiari Type I malformations. The mean herniation was 6.3 mm with a range of 5 to 13mm. Videonystagmography testing was done on 12 out of 16 patients and 7 out of 12 were abnormal with a mean RVR of 38%. Two of 16 patients (12.5%) underwent posterior fossa decompression. Surgical patients tended to have more severe symptoms.Conclusions:A small subset of patients who present to neurotology clinics with vertigo and/or disequilibrium will have radiographic findings of Chiari Type I malformation without the traditional symptoms of headaches and neurologic disturbances. The dilemma for clinicians is to determine if the radiographic findings are contributing to the patients symptoms or are an incidental finding. Intervention should only be considered if the herniation is greater than 10 mm, a cervical syrinx is present, or patients have the classic Chiari‐type symptoms.
Correlation between DWI‐MRI and Findings at Cholesteatoma Surgery: Should DWI‐MRI Be Standardized Prior to Surgery?
Authors: Deleito Javier M. , Ray Jaydip , Twigg Victoria , Wu Kenneth 
Published: September 2014

Objectives:Evaluate the accuracy of diffusion‐weighted imaging magnetic resonance imaging (DWI‐MRI) in diagnosis of cholesteatoma and the planning of surgery in our hospital.Methods:We conducted a retrospective study of all patients who had cholesteatoma surgery in our hospital from November 2007 until September 2013 that had undergone a DWI‐MRI previous to the surgery.Results:A total of 24 patients were found. A total of 22 DWI‐MRI findings were correctly correlated to findings in operation. There was 1 false positive where cholesteatoma was identified on imaging and mucosal disease was found in surgery; and 1 false negative that failed to identify a small cholesteatoma found during surgery. Of the 22 accurate correlations, 4 were of mucosal disease and the rest were correctly diagnosed as cholesteatomas. The DWI‐MRI was able to localize the location of the cholesteatoma (from middle ear, attic, mastoid, aditus, hypotympanium and Eustachian tube) in 78% of the cases (14/18).Conclusions:DWI MRI is highly sensitive in the identification of the presence of cholesteatoma. Negative findings should be followed up because imaging sequences can miss cholesteatomas smaller than 3 mm. There is still a learning curve in the diagnosis and use of DWI MRI.
Development and Characterization of Chemical Cochleostomy in the Guinea Pig
Authors: Alyono Jennifer C. , Corrales Eduardo , Blevins Nikolas H. , Ricci Anthony 
Published: September 2014

Objectives:Creation of an atraumatic, hearing‐preservation cochleostomy is integral to the future of minimally invasive inner ear surgery. Current techniques generally take 1 of 2 approaches: mechanical or thermal. The goal of this study was to develop and characterize a novel chemical approach to cochleostomy.Methods:Experimental animal study in which phosphoric acid gel (PAG) was used to decalcify the otic capsule in 25 Hartley guinea pigs. Five animals in each of 5 groups were studied: (1) mechanically opening the auditory bulla alone, (2) PAG thinning of the basal turn otic capsule, leaving endosteum covered by a layer of bone, (3) micro‐pick manual cochleostomy, (4) PAG chemical cochleostomy, exposing the endosteum, and (5) combined PAG/micro‐pick cochleostomy, with initial chemical thinning and subsequent manual removal of the last osseous layer. Preoperative and postoperative auditory brainstem responses and otoacoustic emissions were obtained at 2, 6, 10, and 16 kHz. Hematoxylin and eosin stained paraffin sections were compared.Results:Surgical and histologic findings confirmed that application of PAG provided reproducible local bone removal, and cochlear access was enabled. Statistically significant auditory threshold shifts were observed at 10 and 16 kHz following cochleostomy using PAG alone (group 4), and at 16 kHz using manual cochleostomy (group 3) (P <. 05). No statistically significant postoperative auditory threshold shifts were observed in the other groups, including PAG thinning with manual completion cochleostomy (group 5).Conclusions:Hearing preservation cochleostomy can be performed in an animal model using a novel technique of thinning cochlear bone with PAG and manually completing cochleostomy.
Efficacy of L‐N‐Acetyl Cysteine in the Prevention of Gentamicin Vestibulotoxicity in Rats
Authors: Chokkalingam Venkatakarthikeyan , Bas Esperanza , Goncalves Stefania , Adams Michelle , Rajguru Suhrud , Van De Water Thomas R. , Angeli Simon I. 
Published: September 2014

Objectives:Determine the effect of L‐N‐acetylcysteine (LNAC) on gentamicin (GM) initiated vestibulotoxicity.Methods:Wistar rats were divided into 4 groups: Group A (n = 7) had intratympanic (IT) GM (20 mg in 40 µL); group B (n = 6) had IT GM and intraperitoneal (IP) LNAC (350 mg/kg) at 24 hours and 1 hour before GM administration; group C (n = 6) had IT GM and IT LNAC (5 mg in 40 µL); and group D (n = 6) had only IT saline (40 µL). Rats were tested by ABR and cervical vestibular evoked myogenic potentials (VEMP) pretreatment, and at 1 week and 1 month posttreatment. Morphological analysis of the inner ears was performed at 1 month. Main outcome measures were the mean change in VEMP P1 latency at sound stimulation from 80 to 110 dB SPL, and hair cell count in the saccule.Results:Rats treated with IT LNAC exhibited the least change in mean VEMP latencies, although the intergroup differences were not statistically significant except for 80 dB stimulation at 1 week posttreatment. IP and IT LNAC resulted in preservation of the VEMP response in all rats, whereas 42% of rats not receiving LNAC had absent responses. Morphological analysis of the saccule revealed lower mean hair cell counts in rats not receiving LNAC.Conclusions:Systemic and IT administration of LNAC of rats treated with GM resulted in minimal variations in VEMP latencies and greater preservation of vestibular hair cells. The protective effect of LNAC in GM‐initiated vestibulotoxicity is promising and warrants further research.
Endoscopic Cochlear Implant: A Series of Cases
Authors: Leite Janaina , Lobo Raquel , Cabral Ticiana , Nogueira João F. 
Published: September 2014

Objectives:Cochlear implant is traditionally performed using a mastoidectomy, posterior tympanotomy and cochleostomy using a surgical microscope. Because of the anatomical and physiological understanding of the mastoid cells and their role in maintaining ventilation and pressure equalization in the middle ear, and the possible risk of facial nerve injury, some techniques without mastoidectomy and without posterior tympanotomy have been introduced as an alternative approach, showing excellent results. The aim of the study was to describe totally endoscopic technique without mastoidectomy in 6 patients with bilateral profound hearing loss who underwent cochlear implantation from January 2012 to February 2013, showing its viability and the advantages and disadvantages.Methods:All cases were selected based on computed tomography, magnetic resonance, audiological tests and psychological evaluation. Surgical steps, intra‐ and postoperative complications were analyzed. Each procedure duration was recorded. Surgical procedure was described step by step focusing on the anatomy of the round window (RW) niche.Results:The mean duration of the procedure was 62 minutes. No facial nerve injury was observed. All cases showed a normal RW conformation and endoscopic cochleostomy was conducted. No difficult insertion of the IC electrode was observed. The longest follow‐up is 2 years. No postoperative complications were observed in this series.Conclusions:Totally endoscopic cochlear implantation is safe and allows a direct approach to the RW and cochlea. A larger series is paramount to evaluate its total benefits and may represent a breakthrough in the ongoing process of developing scientific knowledge.
Endoscopic Stapes Surgery: A Prospective, Controlled Study
Authors: Gallo Andrea , Martellucci Salvatore , Gallipoli Camilla , De Vincentiis Marco , Greco Antonio , Rosato Chiara , Pagliuca Giulio 
Published: September 2014

Objectives:(1) Describe basic and essential surgical steps of the endoscopic‐assisted approach to stapedotomy. (2) Analyze advantages and disadvantages of the endoscopic technique. (3) Compare the outcomes of the endoscopic‐assisted stapedotomy with those obtained with the traditional microscopic approach.Methods:The study was conducted from September 2011 to September 2013 at the ENT University Unit of the “A. Fiorini” Hospital, Sapienza University of Rome. Thirty patients (average age 47.5 years, 11 males, 19 females, 30 ears) with clinical otosclerosis undergoing stapedotomy under general anesthesia were enrolled in this prospective, controlled trial. Patients were randomly divided into 2 groups. Group A patients underwent stapedotomy under endoscopic viewing, whereas in Group B the same procedure was traditionally performed using a surgical microscope. The endoscopic set, originally used for endoscopic sinus surgery, included a 3 mm 0° endoscope, a 3CCD camera, and a video monitor. All procedures were performed by the same surgeon and the surgical steps were recorded. Videos were analyzed to compare the details of the anatomical structures in the operative field. Surgical times, functional results, and complications were recorded.Results:Functional results were comparable in both groups (air‐bone gap ≤20 dB). No complications occurred. Surgical times were significantly longer in Group A (P <. 05).Conclusions:Endoscopic stapedotomy is a feasible, viable alternative to traditional stapes surgery performed with the microscopic approach. The use of endoscopes improve the visualization of the operative field and allow a detailed view of the anatomical structures in an educational perspective.