bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voice Outcomes following Laser Surgery or Radiotherapy for T1 Glottic Cancer: Systemic Review and Meta‐Analysis
Authors: Greulich Matthew T. , Parker Noah P. , Lee Phil , Merati Albert L. , Misono Stephanie 
Published: September 2014

Objectives:Systematic review of literature on patient‐reported voice handicap following T1 glottic squamous cell carcinoma treatment using endoscopic surgery or radiation therapy.Methods:PubMed, Web of Science, and Scopus (1988‐2013) were searched for papers reporting Voice Handicap Index (VHI) after treatment of early glottic carcinoma. Review and reference cross‐checking were performed using a priori selection criteria. Study data were abstracted and publication quality categorized independently by 2 authors. Corresponding authors were contacted to maximize data for analysis. Meta‐analysis was performed using a random‐effects model.Results:Twenty‐three studies with VHI data following surgery (n = 7), radiation (n = 4), or both (n = 12) were reviewed. Meta‐analysis was then pursued with studies that included both modalities. Excluding studies reporting multiple T‐stages or systematic treatment selection bias, 5 retrospective cohort studies describing 238 patients in total were suitable for meta‐analysis. Depth of excision and follow‐up time (mean, 47 months; range, 1‐298 months) varied across studies. Three studies showed no VHI difference between treatment arms, 2 favored radiotherapy over surgery (one of which reported transmuscular cordectomy for all surgical patients), and none favored surgery. Meta‐analysis slightly favored radiotherapy over endoscopic surgery (mean difference 7.73, 95% confidence interval 0.29‐15.16, P =. 03, I2 = 63%).Conclusions:Best available evidence was Level 4 with significant heterogeneity. Current literature may suggest lesser patient‐reported voice handicap after radiation than endoscopic cordectomy, but the difference is of minimal clinical significance. Prospective randomized studies are needed for greater clarity when counseling patients.
Assessment of Mitochondrial Function and Membrane Potential in PK1 Cells Treated with Gentamicin and MitoQ
Authors: Ng Maria Raye Anne V. , Antonelli Patrick J. , Raisch Kevin , Joseph Jerin , Ojano‐Dirain Carolyn P. 
Published: September 2014

Objectives:Determine the effects of concurrent treatment with the aminoglycoside antibiotic gentamicin and mitoquinone (MitoQ), a mitochondria‐targeted derivative of the antioxidant ubiquinone that may protect against aminoglycoside ototoxicity, on mitochondrial function and membrane potential.Methods:This study was prospective and controlled. Mitochondrial membrane potential (MMP) was assessed by flow cytometry using MitoProbeTM JC‐1 Kit in untreated PK1 cells and cells exposed to low (100 µM) or high (2000 µM) dose gentamicin for 24 hours, with and without 0.5 µM each of MitoQ or idebenone (an untargeted ubiquinone). Mitochondrial function was determined using the Seahorse XF‐24TM flux analyzer.Results:MMP was not different in untreated cells and cells co‐incubated with low‐dose gentamicin and MitoQ or idebenone (P >. 05). Co‐incubation with high‐dose gentamicin and MitoQ or idebenone decreased MMP (P <. 0001), with MitoQ co‐incubation decreasing MMP to a greater extent compared with idebenone (P =. 0001). Basal oxygen consumption rate (OCR) was not different between treatments (P =. 15). Maximal OCR was not different between untreated cells and cells treated with MitoQ alone, low dose gentamicin alone, or the combination of MitoQ and low dose gentamicin (P >. 05). In contrast, cells treated with high dose gentamicin and in combination with MitoQ have reduced maximal OCR (P =. 037 and. 026).Conclusions:The combination of gentamicin and MitoQ holds the potential to disrupt mitochondrial function and membrane potential. This suggests a heightened need to monitor for toxicity in patients receiving both agents.
Canal Wall Reconstruction Tympanomastoidectomy with Mastoid Obliteration: Outcomes in Smokers
Authors: Buchanan Patrick C. , Golub Justin S. , Samy Ravi N. 
Published: September 2014

Objectives:(1) Describe the canal wall reconstruction with mastoid obliteration (CWR/MO) technique, (2) understand the benefits for eradication of cholesteatoma, and (3) assess for poorer outcomes in smokers.Methods:Retrospective study analyzing the results of CWR/MO in 82 adult subjects at a tertiary referral center between 2006 and 2013. Subjects were 19 to 79 years old (mean, 44 years) and underwent CWR/MO for either primary or recurrent cholesteatoma. Subjects were re‐evaluated with a second look tympanoplasty at least 6 months later. Long‐term follow up ranged from 6 to 96 months (mean, 33 months). Fisher's exact test was employed for significance.Results:Twenty‐one of 82 subjects (26%) had residual cholesteatoma on second look, including 10 of 29 smokers (34%) and 11 of 53 nonsmokers (21%) (P =. 19). Five subjects (6%) had a retraction pocket without cholesteatoma on second look, including 3 smokers (10%) and 2 nonsmokers (4%). Twelve subjects (15%) had recurrent cholesteatoma on long term follow up, including 6 smokers (21%) and 6 nonsmokers (11%) (P =. 33). Three subjects (4%) required a canal wall down (CWD) procedure at some point during the follow up period, including 1 smoker (3%) and 2 nonsmokers (4%) (P = 1).Conclusion:CWR/MO is an alternative to CWD without creation of a mastoid bowl. A second look is recommended to eliminate any residual/recurrent disease. This technique resulted in an overall recurrence rate of 15%, comparable to the CWD technique. Despite a trend towards increased recurrent disease in smokers, this did not reach significance.
Comparison of Hearing Status of HIV‐Exposed and ‐Unexposed Newborns and Immunovirologic Correlates in HIV‐Exposed Newborns
Authors: Fasunla Ayotunde J. , Nwaorgu Onyekwere G. , Taiwo Babafemi , Olaleye David O. , Murphy Robert L. , Adewole Isaac F. , Akinyinka Olusegun O. 
Published: September 2014

Objectives:(1) Compare hearing status of HIV‐exposed newborns with HIV‐unexposed newborns and (2) determine the association between their hearing threshold and maternal and newborn laboratory parameters.Methods:A cohort audiometric study of newborns in secondary and tertiary hospitals between October 2012 and September 2013. Subjects studied: Consecutive 126 HIV‐exposed and 121 HIV‐unexposed newborns. Interventions: Hearing screening and thresholds of the newborns were done with Auditory Brainstem Response and compared against maternal highly active antiretroviral therapy (HAART), CD4 cell counts, RNA viral loads, and newborn CD4 percentage. Outcome measurements: Hearing threshold levels of both groups were measured and analyzed using appropriate statistics.Results:A total of 9.5% of HIV‐exposed and 5% of unexposed newborns had hearing impairment (P =. 1771; relative risk [RR] = 1.9206 [0.7445‐4.9549]). A total of 6.4% of HIV‐exposed and 2.5% HIV‐unexposed newborns had hearing threshold >20 dBHL (P =. 1578). There was no significant association between the hearing threshold of HIV‐exposed newborn and maternal CD4 cell counts (P =. 059) but there was a significant association with maternal viral load (P =. 034). Study showed a significant difference in the hearing of the 119 HAART‐exposed newborns and 7 unexposed newborns (P =. 002; RR = 0.13 [0.05‐0.32]).Conclusions:There was a trend toward more hearing loss in HIV‐exposed newborns and a significant difference between the hearing thresholds of HIV‐exposed newborns with CD4 % of ≤25 and >25. There is a significant association between newborn hearing threshold and mothers’ viral load. This background information supports the need for further study on the role of in‐utero exposure to HIV and HAART in newborn hearing loss.
Efficacy of Antibiotic Prophylaxis Prior to Tympanoplasty with Mastoidectomy for Contaminated Cholesteatoma
Authors: Pierce Nathan , Antonelli Patrick J. 
Published: September 2014

Objectives:Evaluate the efficacy of combined anti‐staphylococcal and anti‐pseudomonal preoperative antibiotics for preventing surgical site infections following tympanoplasty with mastoidectomy for contaminated cholesteatoma.Methods:Retrospective chart review of medical records of patients who underwent tympanoplasty with mastoidectomy for cholesteatoma were reviewed. Only cases considered to have contaminated or dirty/infected surgical fields were included. The primary outcome measure was postoperative perichondritis, pinna abscess, periotic cellulitis, and periotic abscess requiring systemic antibiotics or surgical intervention.Results:Charts of 362 patients who underwent tympanoplasty with mastoidectomy were reviewed, and 195 met inclusion criteria. Preoperative antibiotics included single doses of clindamycin and ceftazidime or gentamicin prior to incision. Patients that received no preoperative antibiotics had an infection rate of 11% and those given perioperative antibiotics had a rate of 1% (P =. 02).Conclusions:Use of preoperative antibiotics covering both staphylococcus and pseudomonas species appears to be efficacious for the prevention of surgical site infections following tympanoplasty with mastoidectomy for contaminated cholesteatoma.
Efficacy of Common Reagents for Killing Ticks in the Ear Canal
Authors: Orobello Nicklas C. , Ojano‐Dirain Carolyn P. , Kaufman Phillip E. , Antonelli Patrick J. 
Published: September 2014

Objectives:Determine if widely available solutions can effectively kill ticks that may be found in the human ear canal.Methods:This study was prospective, controlled, and blinded. Lone star ticks (Amblyomma americanum), both nymphal and adult, were submerged in 1 of 4 preparations in test tubes (20/group) for 20 minutes. Ticks were agitated by intermittent probing. Activity of adult ticks was video‐recorded during the exposure period. A blinded investigator viewed the videos of adult ticks and directly observed the nymphal ticks during the exposure period to determine the time until death (ie, movement cessation). Mortality was assessed immediately after exposure, and confirmed 24 and 48 hours after exposure.Results:Acetone killed ticks most rapidly (nymph mean time, 185.1 s; adult mean, 562.9 s). Isopropanol 70% (nymphs, 328.9 s; adults, 1128.4 s) and ethanol 95% (nymphs, 294.0 s; adults, 1129.4 s) took longer to kill the ticks. All ticks treated with 4% lidocaine survived. These differences were significant (nymphs, P <. 0001; adults, P <. 0001).Conclusions:Acetone is the most effective of the tested, commonly available solutions to kill ticks in the ear canal.
Efficacy of SPI‐1005 for Prevention of Noise‐Induced Hearing Loss: Phase 2 Clinical Trial Results
Authors: Kil Jonathan , Lynch Eric D. , Griffiths Scott , Lobarinas Edward , Spankovich Christopher , Antonelli Patrick J. , Prell Colleen Le 
Published: September 2014

Objectives:Determine the safety and efficacy of SPI‐1005, a novel oral glutathione peroxidase (GPx) mimic and inducer, in preventing and treating noise‐induced hearing loss (NIHL) in adults ranging from slight hearing loss (≤25 dBHL) to normal hearing.Methods:Randomized double blind placebo controlled Phase 2 clinical trial conducted December 2012 through November 2013. A total of 83 subjects at the University of Florida were enrolled and treated with either placebo or SPI‐1005 prior to a single iPod sound exposure lasting 4 hours that induced a slight temporary threshold shift (TTS). The incidence (≥10 dBHL), severity (dBHL), and duration (up to 1 week post sound) of the TTS were determined by serial pure tone audiometry. The intervention (200, 400, or 600 mg SPI‐1005 twice daily × 4 days) was compared with matching placebo in reducing the TTS. Significance was determined by 2‐tailed t tests comparing a specific SPI‐1005 treatment group versus placebo.Results:Oral SPI‐1005 treatment showed a significant reduction in TTS incidence (60% vs 20%, P <. 01), severity (4.2 vs 1.1 dBHL at 4 kHz, P <. 01), and duration (24 vs 1.3 hours, P <. 01). SPI‐1005 treatment was well tolerated with no drug‐related adverse events (CBC, Chem20, chest x‐ray).Conclusions:SPI‐1005 treatment demonstrated clinically relevant reductions in TTS induced by loud sound exposure. Multiday treatment with all SPI‐1005 dosages was well tolerated. These data support the continued development of SPI‐1005 in noise exposed populations and the GPx mechanism of action in preventing and treating NIHL.
The Envoy Esteem Hearing System: Single Surgeon Experience
Authors: Sappington Joshua M. , Marzo Sam J. 
Published: September 2014

Objectives:(1) Review the results of patients undergoing Envoy Esteem implantation from December 2010 through December 2013. All procedures were performed by the same senior surgeon (S.J.M.). (2) Analyze results following implantation of the Envoy Esteem System to determine if patients achieved statistically significant improvement in pure tone average (PTA).Methods:Patients undergoing implantation at Loyola University Medical Center were analyzed regarding preoperative, postimplantation audiometric data, complications, infections, and revision surgery. Study design: Institutional review board approved, retrospective study.Results:A total of 109 Esteem related procedures were performed. Seventy‐one primary implants were performed. A total of 51 were male and 20 were female. A total of 29 revision cases were performed. Additionally, 9 patients were explanted and 9 cases were aborted prior to implantation. The average age of the implant population was 62.8 years old. The average length of follow‐up was 20 months. A total of 43 primary implant patients had sufficient data available for analysis. The mean preoperative PTA was 63.4 dB and the mean postoperative PTA was 50.7 dB. Patients demonstrated a 9.90 dB average increase in PTA. A paired t test was used to determine if the difference was statistically significant. The difference proved to be statistically significant with a t‐stat of 5.87, which was statistically significant at the. 05 level of confidence.Conclusions:Initial results of The Envoy Esteem system demonstrated a significant hearing benefit in our study population. The revision surgery rate of 26.6% is concerning and patients need to be aware of this potential issue.
Evolution in Surgical Management of Glomus Tympanicum over 40 Years: A Review of 114 Cases
Authors: Carlson Matthew L. , Pelosi Stanley , Sweeney Alex D. , Wanna George B. , Bennett Marc L. , Rivas Alejandro , Haynes David S. 
Published: September 2014

Objectives:Report surgical management and outcomes among a large cohort of patients with glomus tympanicum (GT) managed by a single tertiary referral group over 4 decades.Methods:Retrospective chart review evaluating all patients that underwent surgical treatment of histopathologically confirmed GT between 1973 and 2013. Pre‐ and postoperative audiometric outcomes were reported according to American Academy of Otolaryngology—Head and Neck Surgery reporting guidelines and tumor stage was described using the Glasscock‐Jackson classification system.Results:A total of 114 patients (90.2% female, mean age 54.0 years) met inclusion criteria. Eleven cases were referred following recurrence, while the remaining 103 patients were treated primarily; 38 (33.3%) GTs were stage I, 52 (45.6%) stage II, 9 (7.9%) stage III, and 15 (13.2%) stage IV. A total of 105 (92.1%) patients underwent gross total removal, while 9 (7.9%) received subtotal resection for advanced disease adherent to the carotid artery and/or facial nerve. Two patients who underwent gross total resection experienced transient facial paresis and one suffered internal carotid injury with stroke. No patients have recurred at a mean follow‐up of 39 months.Conclusions:Surgical approach and extent of resection should be tailored to the patient. Gross total resection can be obtained in over 90% of patients, however leaving adherent tumor remnant on the facial nerve or carotid artery should be considered in patients with advanced infiltrative disease in order to prevent unnecessary morbidity. Microsurgical resection remains the treatment of choice for GT providing a high rate of tumor control and improvement in audiologic symptoms.
Expression of HDAC2 in Peripheral Blood Mononuclear Cells from Patients with Sudden Sensorineural Hearing Loss
Authors: She Wandong , Hou Jie , Dai Yanhong , Zhou Qiongqiong , Xie Lisheng 
Published: September 2014

Objectives:(1) Compare the expression of HDAC2 in peripheral blood mononuclear cells (PBMC) of refractory sudden sensorineural hearing loss (SSNHL) patients before and after intratympanic methylprednisolone perfusion (IMP). (2) Identify the relationship between the level of HDAC2 and the prognosis of patients.Methods:Twenty cases of refractory SSNHL patients were selected as therapy group and 10 volunteers were chosen as control group. All 20 SSNHL patients received one course of routine therapy or more, including GC, vasodilator, and neurotrophins. SSNHL patients‐PBMCs were collected in the morning before and after IMP, while volunteers were collected on the second day in hospital from January 2013 to September 2013. After therapy, the 20 SSNHL patients were divided into 2 groups (GC sensitive group and GC insensitive group) according to their hearing recovery. Real‐time polymerase chain reaction and HDAC2 Assay Kit were used to detect the expression level of HDAC2 mRNA and amount of HDAC2 protein in PBMCs. The data were analyzed with SPSS 17.0 software.Results:Before intratympanic methylprednisolone perfusion, the level of HDAC2 protein were significantly depressed in all SSNHL patients (F = 13.291,<.0001), while the HDAC2 mRNA expressing much higher than the control group (F = 6.047, =.007). The expression level of HDAC2 mRNA increased significantly after intratympanic methylprednisolone (GC sensitive group: t = 3.941, P =. 006; GC insensitive group: t = 2.57, P =. 026). The HDAC2 protein level in GC sensitive group increased significantly (t = 6.148, P <. 001).Conclusions:Knockdown of HDAC2 expression induces corticosteroid insensitivity. Glucocorticoids can increase the expression of HDAC2 mRNA. HDAC2 can be down‐regulated by posttranslational modifications.
Generation of a Novel Transgenic ChR2 Mouse to Investigate Cochlear Implant Model Based on Optogenetics
Authors: Meng Xiankai , Hight Ariel E. , Kozin Elliott D. , Brown Chris , Edge Albert S. , Lee Daniel J. 
Published: September 2014

Objectives:Optogenetics is a powerful new tool to use for the auditory system and involves the introduction of a light‐sensitive protein into neurons. This exciting approach may help to increase spatial resolution of auditory implants that are limited due to electrical current spread and to improve outcomes. Herein, we describe: (1) generation of a novel transgenic mouse expressing channelrhodopsin‐2 (ChR2+) in spiral ganglion cells (SGC), (2) auditory responses to optical stimulation of the cochlea in our ChR2+ transgenic mouse.Methods:A left cochleostomy was performed and the right inferior colliculus (IC) was exposed via craniotomy in adult ChR2+ mice. Optically evoked auditory brainstem responses (oABRs) and IC multi‐unit recordings were conducted in response to optical stimulation via a blue‐light laser fiber (473nm wavelength) placed into the cochleostomy. The expression of ChR2 in cochlea was histologically identified under confocal microscope.Results:ChR2 expression was observed in the soma, the peripheral and central axons of almost all SGCs in 1 to 7‐ month‐old ChR2+ mice. A single 1‐ms blue light pulse can evoke oABRs with peak magnitudes up to 10uV and latencies short as 2 ms. Evoked multi‐unit activity (~180 spikes/second) in the IC was substantially synchronized (0.9 synchronization index) to a 28‐Hz light pulse train applied in cochlea.Conclusions:We generated and characterized a novel ChR2 transgenic mouse line that is sensitive to light‐based stimulation in the peripheral auditory system. Our study may demonstrate the feasibility of using optogenetic technology as the basis for new neuronal stimulation paradigm for cochlear implants.
Osteocutaneous Radial Forearm Flap Reconstruction for Naso‐ethmoid‐orbital Defects
Authors: Cannady Steven B. , Newman Jason G. , Friedman Oren , Chalian Ara A. , Wax Mark K. 
Published: September 2014

Objectives:(1) Describe the usefulness of osteocutaneous forearm flaps in reconstruction of the naso‐ethmoid‐orbital (NOE) defect. (2) Describe a case series outlining the authors’ experiences with this reconstruction.Methods:A retrospective review and case series was conducted on patients between 2000 and 2014 who underwent NOE involving resections with reconstruction using radial forearm flap. All disease causes were included and all consecutive patients at 2 institutions were analyzed. Aesthetic results, nasal airway, diplopia, and enophthalmus were assessed in recent patients available. Technical feasibility and methods of reconstruction were assessed, including where bone was plated and which portions of the NOE structure were reconstructed. Patient disease outcomes were included to assess the durability of reconstruction for remaining survival period.Results:Fifteen patients underwent NOE reconstruction in the timeframe studied. Four recent patients reported poor nasal airway, but no diplopia, and no immediate enopthalmus after NOE reconstruction. Patients felt their appearance had been positively impacted by reconstruction. One‐third of patients succumbed to disease in the study period within 3 years of reconstruction, but without need for additional reconstructions.Conclusions:Ostteocutaneous radial forearm flap (OCRFF) is a cosmetically acceptable and functional method of reconstructing a variety of NOE defects. In NOE cancer patients with limited survival, a one‐step reconstruction can be serviceable and not require multiple additional procedures, while ensuring aesthetic results and prevention of ocular comorbidity.
Hearing Outcomes after Revision Stapedectomy Managed with Total Ossicular Reconstruction Prostheses
Authors: Lupo J. Eric , Strickland Brian M. , House John W. 
Published: September 2014

Objectives:(1) Describe the use of total ossicular reconstruction prostheses (TORP) during revision stapedectomy in the setting of advanced incus erosion. (2) Analyze the short‐ and medium‐term audiometric results of TORP for revision stapedectomy.Methods:A retrospective case review at a tertiary neurotological referral center was conducted of nineteen cases of revision stapedectomy where TORP reconstruction was performed due to advanced incus erosion. Pre‐ and postoperative bone conduction (BC‐PTA) and air conduction (AC‐PTA) pure tone averages (0.5, 1, 2, 3 kHz) including high tone bone conduction (1, 2, 3 kHz), air‐bone gap (ABG), and speech discrimination scores (SDS) were measured. Short‐term (3 weeks) and medium‐term (median, 12 months) hearing outcomes were measured.Results:Among 19 ears undergoing revision stapedectomy managed with TORP reconstruction, the average number of previous revision attempts was 1.2 (SD, 2; range, 1‐6). The preoperative BC‐PTA was 32.1 dB preoperatively while the preoperative AC‐PTA was 65.3 dB. The mean postoperative ABG significantly decreased to 16.6 dB (SD, 13.68; range, −2.5 to 46.3 dB, P <. 003) with mean follow‐up of 15 months (SD, 18.8; range, 0.75‐54 months). A nonsignificant mean high tone BC‐PTA decrement of 3.8 dB (SD = 5.9, range −8.33 to 18.33 dB, P =. 427) was observed including one ear with no responses postoperatively. No further revisions were noted in follow‐up.Conclusions:Total ossicular reconstruction in the setting of previous revision stapedectomy with limited incudovestibular reconstructive options may lead to favorable hearing outcomes but carries an increased risk of sensorineural hearing loss.