bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling Nasal Physiology Changes due to Septal Perforations
Authors: Cannon Daniel E. , Frank Dennis O. , Kimbell Julia S. , Poetker David M. , Rhee John S. 
Published: February 2015

ObjectiveSome surgical procedures intentionally create asymptomatic septal perforations or inadvertently produce problematic ones. The purpose of this study is to use computational fluid dynamics (CFD) technology to help providers understand 1) how septal perforations alter nasal physiology, and 2) how this is influenced by perforation size and location.MethodSeptal perforations of 1 and 2 cm were virtually created in a nasal cavity digital model in anterior, posterior, and superior (similar to a modified Lothrop procedure) locations. CFD technology was used to analyze airflow, conditioning, and wall shear stress.ResultsTotal nasal resistance was not significantly altered by septal perforations. Airflow allocation changed, with more airflow through the lower‐resistance nasal cavity. This effect was less in the superior perforations compared to the other locations. There was less localized heat and moisture fluand wall shear stress in superior perforations compared to those in anterior or posterior locations. For anterior perforations, larger size (2 cm) correlated with 59% higher velocity and 22% greater wall shear, while the reverse relationship was seen in posterior perforations, with 5% higher velocity and 29% greater wall shear in the smaller perforation (1 cm).ConclusionSeptal perforations may alter nasal physiology. Airflow allocation is changed as air is shunted through the perforation to the lower‐resistance nasal cavity. Superior perforations cause less alteration in nasal physiology than those in other locations. Larger anterior and smaller posterior perforations cause greater alterations in velocity and wall shear.
Posterior Turbinectomy in Turbinate Reduction Procedures
Authors: Ismail Ahmed S. 
Published: February 2015

Objective1) Evaluate the role of turbinoplasty and/or submucous diathermy in management of hypertrophied inferior turbinates. 2) Evaluate the role of posterior turbinectomy in combination with turbinoplasty and submucous diathermy for better, longer‐lasting results.MethodRetrospective study on 205 patients who were divided into group A (120 patients who underwent turbinoplasty) and B (85 patients who underwent submucous diathermy). Each group was subdivided to subgroup 1 for those who had posterior turbinectomy and 2 for those with no posterior turbinectomy. The follow‐up period was 26‐38 months.ResultsIn group A: (98.3%) of group A1 and (71.6%) of group A2 reported very good or good improvement after surgical procedure. (1.7%) of group A1 and (23.3%) patients of group A2, reported fair results and only 3.3% of group A2 reported bad or no change. In group B: (84.4%) of group B1 and (55%) of group B2 patients reported very good or good results after surgical procedure, (13.3%) of group B1 and (22.5%) of group B2 patients reported fair improvement. (2.3%) of group B1 and (22.5%) of group B2 patients reported bad or no change.ConclusionTurbinoplasty still shows better outcome than submucous diathermy. Furthermore, combining posterior turbinectomy with any of the turbinate reduction procedure gives better, longer‐lasting results.
Preventing Endotracheal Cuff Rupture during Tracheostomy
Authors: Joshi Arjun S. , Sood Amit J. 
Published: February 2015

Objective1) To demonstrate the importance of endotracheal tube (ETT) positioning in avoiding complications of ETT cuff penetration during tracheostomy. 2) To describe the author’s technique of ETT positioning. 3) To determine the probability of cuff penetration utilizing the technique in a 3D‐computed tomography model.MethodFrom July 2008 to January 2012, 89 patients who had undergone tracheostomy using the mentioned technique in a tertiary hospital setting were evaluated. One hundred fifty random patient CT scans were chosen, measurements were taken, and probability of cuff penetration during virtual tracheostomy was generated. Primary outcome was ETT cuff penetration.ResultsOver the period studied, 85/89 patients underwent tracheotomy without ETT cuff rupture by positioning the ETT just proximal to the carina after neck extension. After evaluating 150 random 3D‐CT scans, it was determined that the average distance between the tracheotomy to superior aspect of cuff was 80 mm in males and 63.8 mm in females when a 6.5 sized ETT was utilized, and 70.2 mm in males and 54 mm in females when a 7.5 ETT was utilized. Virtual tracheotomy between the second and third tracheal rings resulted in no probability of inadvertent ETT cuff rupture.ConclusionETT cuff rupture is a common occurrence that may result in disastrous intraoperative complications during tracheostomy. This study serves to underscore the importance of ETT positioning and provides radiologic evidence for the author’s approach. Distal ETT positioning should be strongly considered for avoiding problems of ETT cuff rupture during tracheostomy.
Smoking Cessation in Cancer Patients: A Systematic Review
Authors: Nayan Smriti , Gupta Michael K. , Sommer Doron 
Published: February 2015

ObjectiveComprehensive treatment plans for oncology patients including tobacco smoking cessation interventions are essential, as smoking after the diagnosis of a smoking‐related cancer negatively impacts many aspects of treatment in this patient population. The primary objective was to evaluate, through a systematic review, smoking cessation interventions and cessation rates in cancer patients.MethodThe literature was searched using Medline, EMBASE, Google Scholar, and the Cochrane Library (inception to September 2011) by 3 independent review authors. Included studies described tobacco smoking cessation interventions with patients randomized to usual care or an intervention. The primary outcome measure was cessation rates. Two authors extracted data independently, and disagreements were resolved by consensus.ResultsEight randomized control trials (RCTs) investigating smoking cessation interventions in the oncology patient population were identified. Pooled relative risks were calculated from 2 groups of RCTs of smoking cessation interventions based on follow‐up duration. In both groups, the pooled relative risk did not suggest a statistically significant improvement in tobacco cessation compared to usual care. However, a subgroup analysis looking at newer combination interventions within the last 10 years yielded a statistically significant difference in smoking cessation rates.ConclusionDespite the importance of smoking cessation in oncology patients, there are a paucity of studies. The review suggests that newer combination interventions involving both nonphamacological and pharmacological approaches, in the last decade, yield a statistically significant difference in smoking cessation rates compared to usual care.
The HLA‐G and IL‐17A Expression in Nasal Polyposis
Authors: Avelino Melissa A. G. , Wastowski Isabela J. , Ferri Ricardo G. , Marinho Larissa C. , Batista Aline C. , Weckx Luc L. M. 
Published: February 2015

ObjectiveThe HLA‐G molecules are nonclassic class I antigens with anti‐inflammatory and tolerogenic properties, while interleukin‐17A (IL‐17A) is a key inflammatory cytokine in many disorders. Considering that, the aims of this study were: 1) to evaluate the HLA‐G molecule, and 2) to evaluate IL‐17A expression in patients presenting with nasal polyposis.MethodSamples of patients presenting with nasal polyposis (n = 20) were subjected to immunohistochemistry technique. All patients were grouped into atopic and nonatopic patients according to skin prick test and IgE dosage. All statistical analyses were performed using the GraphPad Prism 5.0. The level of statistical significance was accepted at P <. 05.ResultsOur preliminary results showed the HLA‐G and IL‐17A expression in nasal polyposis. Immunohistochemical staining demonstrated a higher expression of HLA‐G molecule in samples of nonatopic patients when compared with atopic patients (P =. 04). The IL‐17A expression was also observed in both atopic and nonatopic patients; however, the numbers of IL‐17A positive cells were greater in nasal polyps of atopic patients than in those of nonatopic patients.ConclusionThese preliminary results indicated that HLA‐G and IL‐17A may play an important role in the pathology of nasal polyposis. Considering the anti‐inflammatory properties of HLA‐G and inflammatory activities of IL‐17A, we suggest that HLA‐G could decreased the susceptibility to disease, while IL‐17 should be associated with more severe atopy.
Prospective Evaluation of Perioperative Errors and Delays
Authors: Dedhia Raj C. , Shwaish Kawa , Snyderman Carl H. , Monte Robert , Eibling David E. 
Published: February 2015

Objective1) Understand the leading causes for process errors and delays in the otolaryngology operating room. 2) Recognize the impact of process errors and delays on patient safety, hospital costs, and environmental waste.MethodA 4‐week prospective, observational study was conducted in January 2012 evaluating 23 elective otolaryngology cases. A standardized data collection tool was developed and refined based on pilot observations. Two trained observers recorded relevant times and actions from patient check‐in in the preoperative holding area to the “wheels out” time.ResultsThe mean case observation time was 220.0 ± 167.8 minutes with mean duration of operation length being 107.0 ± 146.2 minutes. The perioperative period was divided into 6 stages: patient holding, room preparation, preintubation, postintubation, intraoperative, postextubation. One hundred (average of 4.3 per case) process errors were recorded, 34% of which were due to communication failures. Forty delays were observed resulting in 336 minutes of standstill delay. Again, communication failures represented the most common etiology with 17 communication failures resulting in 146 minutes of standstill delay. The preintubation stage was most affected by delay with 1 in 6 minutes comprising standstill delay.ConclusionThis is the first study in otolaryngology to examine perioperative process errors and delays. Preoperative team discussion and use of technology represent potential strategies in minimizing communication‐related process errors and standstill delays. Further work is currently being undertaken to study this critical perioperative issue in greater detail across specialties.
Treatment of Acute Rhinosinusitis by Otolaryngologists
Authors: Smith Stephanie Shintani , Evans Charlesnika T. , Kern Robert , Chandra Rakesh K. 
Published: February 2015

ObjectiveRecent studies confirm that antibiotics are unnecessary for the vast majority of acute rhinosinusitis (ARS) cases. Guidelines advocate watchful waiting for mild‐moderate ARS, with initiation of antibiotics and inhaled nasal steroids (INS) if symptoms do not improve. This study assesses treatment for ARS by otolaryngologists on a national level.MethodAmbulatory visits to otolaryngologists for ARS were extracted from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Care Survey (NHAMCS) for 2006‐2009. This survey is conducted annually by the US Department of Health and Human Services. Descriptive statistics were calculated to determine utilization of antibiotics and INS.ResultsAmong an estimated 19.8 million adult visits for ARS, 955,000 visits were to otolaryngologists (mean age, 47.8 ± 2.5 years; 60.0 ± 7.1% female). Otolaryngologists prescribed intranasal steroids in 24.9 ± 6.2% of visits. Antibiotics were prescribed in 57.0 ± 6.5% of ARS visits to otolaryngologists, and 93.0 ± 4.6% of these prescriptions were for broad‐spectrum antibiotics (amoxicillin‐clavulanate, second/third generation cephalosporins, azithromycin, clarithromycin, or quinolones).ConclusionOtolaryngologists widely prescribe antibiotics for ARS, though current data suggest that the majority of ARS cases resolve without antibiotics. High rates of antibiotic prescribing, often with broad spectrum coverage, and relative scarcity of INS utilization suggest opportunities to improve prescribing patterns.
Treatment of Ranula by OK‐432: Pearls and Pitfalls
Authors: Ohta Nobuo , Fukase Shigeru , Suzuki Yusuke , Kakehata Seiji 
Published: February 2015

ObjectiveIntralesional injection therapy with OK‐432 was developed as a therapy for operatively difficult lymphangioma (cystic hygroma) and is currently becoming a first choice treatment of this disease. The aim of this article was to evaluate the outcome and complications of the treatment of patients with ranula by OK‐432 therapy.MethodWe tried this therapy in 55 patients with ranula between January 2001 and February 2012. We injected OK‐432 solution into the lesion with a 27‐gauge needle to prevent the leak of the agent out of the cyst. We performed this treatment on an outpatient basis without hospitalization.ResultsDisappearance and marked reduction of the lesion were observed in all patients who had this therapy, and local scarring and deformity did not occur in any patients. As side effects, local pain at the injection site and fever (37 to 39°C) were observed in few cases of the patients who had this therapy, but such problems resolved within a few days. Dermoid cyst might be kept in mind to make differential diagnosis for ranula.ConclusionThese results may allow us to speculate that intralesional injection therapy with OK‐432 is simple, easy, safe, and effective, and it can be used as a substitute for surgery in the treatment of ranula.
Ultrasound Findings after Submandibular Sialolithotomy
Authors: Joshi Arjun S. , Sood Amit J. 
Published: February 2015

Objective1) To demonstrate the utility of ultrasound in the assessment of the submandibular gland after endoscopic‐assisted or purely open sialolithotomy. 2) To discuss limitations of using ultrasound for assessment after submandibular sialolithotomy.MethodFrom August 2009 to January 2012, 22 adult patients with symptomatic submandibular sialolithiasis underwent endoscopic‐assisted or purely open sialolithotomy in a tertiary‐level clinic setting. Pre‐ and immediate postprocedure ultrasound was performed. Examinations were analyzed for evidence of persistent obstruction.ResultsTwenty patients with symptomatic submandibular sialolithiasis underwent either endoscopic‐assisted sialolithotomy or pure open sialolithotomy for proximally located stones. Three of 22 (13%) demonstrated residual stones on ultrasound characterized by acoustic shadowing immediately after sialolithotomy and were retreated in the same setting with success. Fifteen of 22 (68%) demonstrated proximal ductal dilatation after stone removal. Eighteen of 22 (81%) demonstrated trace hyperechogenic foci without shadowing indicating air bubbles or blood. At 2 weeks, all findings had resolved. There were no instances of infection, ductal stenosis, loss of glandular function, or permanent lingual nerve paralysis with follow‐up ranging from 6 months to 1 year.ConclusionUltrasound can be used to assess for residual obstruction immediately after submandibular sialolithotomy. Only the presence of posterior shadowing reliably predicted pathology. The presence of proximal ductal dilatation and hyperechogenic foci without shadowing take longer to resolve after sialolithotomy, and should not be used to influence treatment decisions during procedures.
VH1 and CMT Web Surveys Reveal Music‐Listening Behavior
Authors: Pearce Elizabeth C. , Mainthia Rajshri , Tharpe Anne M. , Eavey Roland D. 
Published: February 2015

ObjectiveMusic‐induced hearing loss is a growing public health concern. Potential contributors include intentional exposure to loud music volume and lack of awareness about potential hearing damage. We wanted to evaluate current trends in music listening behaviors, perception of personal risk, and hearing loss education in 2 musically inclined demographics.MethodAn anonymous online 89‐question survey instrument was made available to a convenience sample of visitors on both VH1.com and CMT.com Web sites. Respondents were queried about attitudes and behaviors related to hearing protection and noise exposure. A P <. 05 value was used for independent t and z tests.ResultsTotal respondents: 1601. The minority of respondents felt hearing loss created a personal problem (19%), yet 43% had experienced hearing related issues. Respondents under 21 displayed potentially more harmful listening behaviors and symptoms of hearing loss, particularly with MP3 player use (P <. 05). Popular media was the most informative source about hearing loss; 56% learned about hearing loss on television, 36% on the Internet, and 29% in a magazine. Most respondents reported willingness to adopt ear protective behaviors if educated by a clinician (71%) or informed that even limited exposure to excessively loud music can cause permanent damage (69%).ConclusionRespondents 21 years old or younger reported significantly less education about potential hearing damage and were more likely to engage in riskier listening behavior. Healthcare providers retain significant ability to influence individual listening health and the media.
Can Biometric Measures Predict TORS Feasibility?
Authors: Arora Asit , Garas George , Kotecha Jalpa , Acharya Amish , Khemani Sameer , Kotecha Bhik 
Published: February 2015

Objective1) Investigate whether subjective evaluation of patient suitability for Transoral Robotic Surgery (TORS) is reliable. 2) Establish if TORS feasibility can be assessed using anthropometric measures and Mallampatti grade. 3) Determine which biometric characteristics warrant further clinical evaluation.MethodCadaver study (n = 42) conducted between April 2010‐2012. Seven anthropometric measurements and Mallampati grade were recorded. Three head and neck surgeons assessed TORS feasibility. Adequate visualization of tonsil, tongue base, vallecula, and epiglottis were recorded using 2 TORS mouth gags. Significant anthropometric differences between full and suboptimal visualisation groups were identified.ResultsThere was a negative correlation between subjective difficulty impression and actual transoral visualization for all anatomical regions (R2 = 0.32, P <. 05). Six anthropometric measures were identified whose mean values were significantly different between full and suboptimal transoral visualization groups. Suboptimal visualization of the tongue base was associated with shorter mean sterno‐mental (P <. 01) and cricoid‐mental (P =. 02) lengths and greater mean neck circumference (P =. 04). Suboptimal visualization of the vallecula and epiglottis were associated with a short ramus width (P =. 03) and long ramus length (P =. 05). The mean Mallampati grade was higher in the suboptimal visualization group for tongue base (P <. 01), vallecula (P <. 03), and epiglottis (P <. 04).ConclusionSubjective assessment is an unreliable predictor of TORS feasibility. Anthropometric measures of the neck, mandible, and Mallampati grade are valuable indicators which can potentially be used to devise a weighted predictive scale. Further clinical evaluation is warranted to determine the true predictive value of these anthropometric measures and Mallampati grade.
Comparative Study of Robotic versus Endoscopic Thyroidectomy
Authors: Tae Kyung , Bae Ji Yong , Jeong Jin Hyeok , Kim Kyung Rae , Choi Woong Hwan , Ahn You Hern 
Published: February 2015

ObjectiveRobotic thyroidectomy and conventional endoscopic thyroidectomy have not been thoroughly compared. In this study, we compared the potential advantages of robotic versus endoscopic thyroidectomy.MethodWe analyzed 218 consecutive patients who underwent endoscopic (105 cases) or robotic (113 cases) thyroidectomy using a gasless unilateral axillo‐breast (GUAB) or axillary (GUA) approach.ResultsBecause of the dexterity of robotic instruments and the improved surgical view, it was subjectively easier and took less time to perform a complete total thyroidectomy and central compartment neck dissections (CCND) in robotic thyroidectomy. In the case of unilateral lobectomy, endoscopic and robotic thyroidectomy had quite similar surgical outcomes. Cosmetic satisfaction was excellent in both groups.ConclusionRobotic thyroidectomy is superior to endoscopic thyroidectomy for performing total thyroidectomy and bilateral CCND. However, in terms of cost‐effectiveness, endoscopic thyroidectomy is comparable to robotic thyroidectomy in patients who undergo unilateral lobectomy.
Curcumin Inhibits UV Radiation–Induced Skin Cancer In Vivo
Authors: Phillips Jeffrey , Sonavane Kunal , Moore‐Medlin Tara , Ekshyyan Oleksandr , Clark Cheryl , Abreo Fleurette , Nathan Cherie‐Ann O. 
Published: February 2015

ObjectiveAs skin cancer incidence increases, research has focused on novel chemopreventive agents that inhibit tumor formation. In prior experimentation, curcumin, a naturally occurring food substance and anti‐carcinogenic agent, inhibited cutaneous squamous cell carcinoma xenograft growth. We hypothesize curcumin will inhibit UVB‐radiation–induced skin cancer growth in mice, approximating a human chemopreventive model.MethodA randomized experimental animal and laboratory study is presented. SKH‐1 mice were pre‐treated with oral or topical curcumin, or oral or topical control (n = 22/group), for 14 days. Mice received UVB radiation 3 times weekly for 24 weeks or were not radiated. Tumor number, volume, and onset were compared.ResultsTime to tumor onset was significantly shorter in control mice compared to mice receiving either oral (P =. 025) or topical (P =. 015) curcumin. A significant difference in the average number of tumors formed per mouse was seen, as fewer tumors were formed in the oral curcumin (P =. 01) and topical curcumin (P =. 01) groups, compared with their respective controls. Once tumors formed, no significant difference in tumor volume was noted at 24 weeks.ConclusionCurcumin appears to inhibit skin cancer formation and prolong time to tumor onset when administered by either an oral or topical route. These data suggest that curcumin may have chemopreventive potential against skin cancer necessitating future experimentation with human subjects.
fMRI Cerebral Activation during Speech in Laryngectomies
Authors: Piccioni Lucia O. , Ferrario Fabrizio , Toma Salvatore , Vezzulli Paolo , Bussi Mario 
Published: February 2015

ObjectiveWe focused our attention on the localization of the laryngeal phonatory area in a somatotopic context. This study investigates brain modification consequent to partial or complete removal of the larynx.MethodsFrom 2009 to 2011 we enrolled 18 patients, divided into 3 groups: 6 healthy volunteers, 6 subtotal laryngectomy patients, and 6 total laryngectomy patients. During fMRI recording, all subjects were trained to carry out 5 motor tasks.ResultsAnalyzing group 1, we obtained: bilateral activation in prefrontal gyrus and in cerebellar lobule VI during the phonation of the vowel E; activation of the same areas in addition to basal ganglia, cerebellar lobule VI and VIII, insular lobe, 42 Brodmann area and basal gyrus bilaterally, Rolandic operculum, and the supplementary motor area intonating vowel E. Glottal adduction during forced expiration and phonatory task activated the same areas. Phonatory tasks determined the same activation in all groups, with an extension of these areas proportional to surgical damage. In lip and tongue tasks we observed the same results in all groups.ConclusionThis study permitted the mapping of the human motor cortical areas that control intrinsic laryngeal muscles, differentiating them from those referable to the articulatory process. Studying subtotal and total laryngectomies, we identified an expansion of the laryngeal area activation, proportional to the degree of the laryngeal injury. We observed the functional recovery of brain regions considered evolutionarily ancient that are normally virtually quiescent.