bluuebunny/crossref_metadata_2025_split huggingface dataset:
A1555G Polymorphism and Aminoglycoside‐induced Hearing Loss from Intratympanic Gentamicin Therapy
Authors: Wan Tan‐Kuai , Huang Chi‐Jung , Wang Pa‐Chun 
Published: August 2013

Objectives:Intratympanic gentamicin (ITG) treatment has become a standard modality in treating patients with Ménière's disease (MD) with high success rate. However, 30% of the ITG patients may suffer from further hearing recession. The relation of a genetic variation in the mitochondrial rRNA gene, A1555G, and aminoglycoside‐induced hearing loss (AIHL) remains unknown. The aim of the present study was to evaluate whether the presence of A1555G polymorphism in the mitochondrial rRNA gene can predispose to the AIHL in MD patients following ITG.Methods:33 Ménière's disease patients received ITG therapy. Genomic DNA was extracted from their blood samples. Target fragment within mitochondrial rRNA gene was amplified by polymerase chain reaction, and genotyped by direct sequencing to search for 1555 A‐to‐G substitution.Results:33 patients (13 males and 20 females; mean age: 56.2 years old) met the inclusion criteria. None of the subjects demonstrated this specific A‐to‐G substitution. Whether the patients will suffer from AIHL is independent of the presence of A1555G polymorphism.Conclusions:ITG treatment for intractable Ménière's disease appears to be effective in the relief of vertigo. However, we disagree with the relationship between A1555G polymorphism and antibiotic‐induced ototoxicity reported by Prezant et al. There might be different significant single nucleotide polymorphisms that may predispose to the hearing loss following ITG treatment. Further genotypes involving in this treatment must be analyzed in various populations.
Fibrovascular Polyps of the Hypopharynx and Esophagus
Authors: Salazar Esperanza F. , Donovan Donald T. , Ongkasuwan Julina 
Published: August 2013

Objectives:Fibrovascular polyps of the hypopharynx and esophagus are rare, and the majority of the literature is comprised of case reports. The goals of this study are: 1) Present one of the largest series of patients from a single institution that presented with fibrovascular polyps; 2) Describe their presentation focusing on airway management and clinical demographics; 3) Discuss our surgical management and demonstrate how it has evolved from open to endoscopic approaches.Methods:A retrospective review was conducted with four patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012. Patient demographics, clinical presentations, surgical approaches, and diagnostic studies were analyzed.Results:The average age at presentation was 72 years (range 59 to 85 years). Among the four patients, two presented with airway compromise requiring tracheotomy. All patients had removal of the polyp shortly after presentation; two underwent transcervical approaches with lateral pharyngotomy/esophagotomy; and the other two had endoscopic removal. The polyps arose from the hypopharynx in three patients and upper esophagus in one. Three patients had complete resolution of their symptoms and remained disease free. One patient had recurrence of the polyp two years later and is currently being observed.Conclusions:Fibrovascular polyps are rare tumors of the hypopharynx/esophagus that occur among older patients. Although benign, they can cause life threatening airway compromise that may necessitate tracheotomy. We present four cases of fibrovascular polyps and discuss our evolving surgical management. We demonstrate that endoscopic removal is a viable option for these tumors.
Inflammatory Myofibroblastic Tumor of the Larynx
Authors: Smith Danielle P. , Coughlin Andrew M. , Qiu Suimin M. , Underbrink Michael P. 
Published: August 2013

Objectives:1) Describe a case of inflammatory myofibroblastic tumor (IMFT) of the larynx. 2) Analyze the literature regarding the disease process. 3) Discuss appropriate management options and prognosis.Methods:Retrospective review of a single case of IMFT involving the subglottic region at the University of Texas Medical Branch.Results:Here we present IMFT of the larynx, a benign condition often believed to be a malignancy due to its aggressive proliferative nature. The majority of extra‐laryngeal cases are pulmonary; however, only 25 cases in the larynx have been described. Involvement of the subglottis is even rarer, representing only 5 cases. The origin is still unknown; however, many believe IMFT to be of clonal origin with chromosomal rearrangements of 2p23 and the ALK1 gene. These abnormalities are found in up to 47% of cases either immunohistochemically or using fluorescence in situ hybridization. Microsuspension laryngoscopy with laser excision has been the mainstay of treatment, and long term results have been excellent. Our patient's tumor was ALK1 positive on immunohistochemistry, confirming the diagnosis. As observed in previous cases, our patient has responded well to conservative resection with no recurrence at this time.Conclusions:IMFT is an aggressive tumor of the larynx. However, conservative excision is adequate for tumor control and good long term survival. Knowledge of the disease is important to prevent overtreatment.
Influence of Age on Treatment with Proton Pump Inhibitor in Patients with Laryngopharyngeal Reflux Disease
Authors: Lee Young‐Chan , Kim Seung‐Woo , Kwon Kee‐Hwan , Eun Young Gyu 
Published: August 2013

Objectives:The influence of age in severity and response to proton pump inhibitor (PPI) in patients with laryngopharyngeal reflux (LPR) is unclear. Thus, we conducted a prospective cohort study to assess the difference in severity and response to PPI according to age in patients with LPR.Methods:Two hundred twenty‐nine patients with LPR who were referred to the otolaryngology clinic from November 2010 to February 2012 were enrolled in the study. All of the enrolled patients were prescribed 15mg of Lansoprazole (PPI) twice daily for three months. Data, including the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and LPR‐Health related quality of life (LPR‐HRQOL), were collected from patients at the baseline visit and at 1 and 3 months post‐baseline.Results:The older patients group (60‐79 years) showed a higher score in RSI (P < 0.001) and LPR‐HRQOL (p<0.001) at baseline than the younger subgroups. However, the RFS score showed no significant difference among age subgroups. Within each age subgroup, RSI, RFS, and LPR‐HRQOL showed significant improvement with PPI therapy; however, no difference in improvement of RSI, RFS, or LPR‐HRQOL was seen among the subgroups. The responders who had changes in RSI score at three months were found significantly more often in the younger group than the older group (P = 0.002).Conclusions:Age appears to affect the subjective symptoms and resulting impact on their QOL but not laryngeal finding in patients with LPR. Furthermore, the clinician should be aware that older patients are more likely to not respond to PPI.
Intracordal Hyaluronic Acid Injection during Spontaneous Reinnervation Stage for Unilateral Recurrent Laryngeal Nerve Paralysis
Authors: Fang Tuan‐Jen 
Published: August 2013

Objectives:The effect of intracordal hyaluronic acid (HA) injection is considered an effective temporary treatment for acute unilateral vocal fold paralysis (UVFP),but its long term benefit is not concluded. This project proposed to evaluate the long term benefit from HA injection. Study design: Prospective randomized case study.Methods:From August 2011 to January 2013, 40 consecutive subjects diagnosed with acute UVFP were enrolled. The subjects were randomized into two groups. Group A accepted transcervical HA injection at 6 months from symptoms appearing. Group B subjects accepted the conventional observation policy. All patients had performed serial videostroboscopy, acoustic voice measurements, and two questionnaires (Voice Outcome Survey and SF‐36) till 12 months.Results:Thirty‐five patients were evaluated completely and followed up regularly. Three of them returned their vocal fold motion, and one within adequate injection were excluded. There were 16 cases in group A and 15 cases in group B. At the last visit, the vocal cord position, evidenced by normalized glottal gap area; maximal phonation time, jitter, H/N, VOS showed significant improvement in both groups compared to initial evaluation. In SF‐36 measurements, 3 of 8 domains including role limitation due to physical health, vitality, and mental health improved in group A but not in group B. Data comparison between groups showed no significant differences at the end of follow‐up.Conclusions:Intracordal HA injection is an effective therapy for acute UVFP. However, the long term result is not significantly different from conventional observation policy.
Is There Any Correlation between Aerodynamic and Vocal Cord Vibration Parameters?
Authors: Matsuzaki Hiroumi , Makiyama Kiyoshi , Takane Tomoyuki , Suzuki Hirotaka 
Published: August 2013

Objectives:Investigate the correlation between vocal cord vibration parameters and aerodynamic parameters.Methods:We examined 13 patients with various voice disorders. Using the phonatory function analyzer PS77E, we measured sound pressure level (SPL), mean flow rate (MFR), expiratory lung pressure (EP), and airway resistance (EP/MFR). We used a high‐speed video (HSV) system to observe the vocal cord vibration. We obtained the image data at a speed of 2000 frames/sec, while each subject was vocalizing the vowel sound /a/. We analyzed the predetermined area using Kay Image Processing Software (KIPS) with regard to the following: 1) maximum or minimum area, maximum or minimum opening at the midpoint of the glottis from a montage with glottal area waveform (GAW) analysis, and 2) maximum or minimum opening of the glottis, dominant amplitude or frequency of the opening variation of the vocal fold, and ratio of time of glottal total closure to the entire time domain in the calculation using kymograph edge analysis (KEA). Spearman's rank correlation was used to determine correlations.Results:A correlation existed between sound pressure and posterior glottal vibration as assessed by KEA (left: P = 0.0199 and right: P = 0.0372) and central glottal vibration (left: P = 0.022 and right: P = 0.0438). Neither GAW nor KEA was correlated with both expiratory flow rate and expiratory pressure. A negative correlation was seen between airway resistance and GAW minimum opening (P = 0.0256).Conclusions:The results of the present study suggest that vocal cord parameters correlate with aerodynamic parameters.
Using Nurse Practitioners and Physician Assistants in an Academic Otorhinolaryngology Practice
Authors: Ziebarth Michelle T. 
Published: August 2013

Objectives:1) Recognize the value of the Nurse Practitioner/Physician Assistant (NP/PA) in an otorhinolaryngology practice. 2) Describe application of care models to achieve improved outcomes for patients and increased job satisfaction for providers.Methods:Single institutional evaluation of NP/PA provider integration into an academic otorhinolaryngology practice.Results:Healthcare in the United States is at a crossroads. The number of insured patients seeking care will rise dramatically over the next 2 years. The number of medical doctors is declining, and based on Accreditation Council for Graduate Medical Education (ACGME) recommendations, resident work hours are decreasing. In otorhinolaryngology accommodating the increasing needs of the population will require improved use of resources, including personnel to provide high quality, compassionate healthcare. Nurse practitioners and physician assistants are well educated and highly motivated to work alongside a collaborating physician(s) to provide this care. At Mayo Clinic, the otorhinolaryngology department employs 7 NP/PA providers. These NP/PA providers work with a variety of staff surgeons, resident surgeons, nurses, and ancillary health providers to maintain high quality, highly accessible healthcare. The care model of each individual NP/PA and collaborating physician vary in otorhinolaryngology at Mayo Clinic. However, the care models work based on the needs of the practice, the patient, and the providers.Conclusions:The NP/PA providers perform a variety of services for the patient and the collaborating physician. The care models used allow each provider (MD, NP/PA) to use their time to the best of their ability, increasing job satisfaction and thereby providing high quality, cost effective care.
Age Differences in Taste Thresholds
Authors: Ye Mikyung 
Published: August 2013

Objectives:The sense of taste is one of the most important human senses and plays a critical role in an individual's food preferences and the nutritional status. Proper gustatory function in older people is important for quality of life and enjoyment of food. The objective of this study was to investigate the effect of age on gustatory function and to establish the normative values in Korean subjects.Methods:One hundred sixty normal volunteers without smell and taste disorders were investigated. Each subject was given a questionnaire for smoking, medicine, and menstruation. Whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride.Results:Older subjects (over 50 years) showed worse taste sensitivity compared with younger subjects (age 20‐29 years). The detection threshold of all four basic tastes and the recognition threshold of salty taste of elderly participants were significantly higher than those of young participants.Conclusions:Gustatory sensitivity was found to decrease with age. Older subjects appeared to have a reduced perception of salt, which can alter eating habits, such as intake of more salty foods. Our data provide preliminary normative values for future investigation of chemosensation in the Korean population.
Objective Analysis of Motor Speech Performance in Children with Cochlear Implants
Authors: Eskander Antoine , Gordon Karen , Tirado Yamilet , Hopyan Talar , Russell Laurie , Papsin Blake C. , Campisi Paolo 
Published: August 2013

Objectives:Objectively analyze speech and articulation in children with longstanding experience using unilateral cochlear implants.Methods:Cross‐sectional study design at a tertiary pediatric hospital. Sixteen subjects (aged 8‐17 years) using unilateral cochlear implants were studied. The subjects had a median of 7 years of cochlear implant experience, with excellent audiogram and speech perception scores. Speech was objectively assessed with the Motor Speech Profile (MSP) software and Computerized Speech Lab model 4500 (KayPentax, Lincoln NJ). Results were compared to previously published normative pediatric data.Results:Diadochokinetic rates were within normal limits for 69% of children with /pa/pa/pa/ and 73% of children with /pa/ta/ka/ spoken tasks. The magnitude and rate of the second formant transition were within normal limits for 56% and 83% of children, respectively. The variability in amplitude of intonation stimulability was within normal limits for 100% of children, but variability in frequency was within normal limits in 44% of children only. The syllabic rate and duration were both within normal limits for 88% of children. Overall, subjects demonstrated excellent articulation and timing but poor frequency intonation stimulability.Conclusions:Although the majority of the measured characteristics of speech were normalized after cochlear implantation, variability in frequency during intonation stimulability testing remained outside of the normal range in 56% of subjects even with long term cochlear implant use. This limitation may be perceived as a dampening of emotional expression during speech. Novel cochlear implant software programming and auditory verbal therapy strategies may be needed to address this finding.
A Rare Cause of Hoarseness: Primary Laryngeal Aspergillosis in a Postpartum Patient
Authors: Villanueva Jose C. R. , Opulencia Alejandro , Lim William L. , Calavera Kenneth 
Published: August 2013

Objectives:1) Present a rare cause of hoarseness in a seemingly healthy, immunocompetent, postpartum patient. 2) Discuss the probable contributing factors leading to the unusual presentation of the disease process.Methods:Case report study conducted from January‐December 2012. Subject: A 28 year old, immune competent female diagnosed with primary laryngeal aspergillosis.Results:Aspergillus is a saprophyte known to be weakly pathogenic and opportunistic in human beings. For centuries since its discovery, it has mostly been regarded as a disease of the immuno‐compromised. When it does cause disease it most commonly affects only the lungs and tracheo‐bronchial tree with subsequent systemic dissemination and involvement of other organs during its fulminant stage. Primary laryngeal aspergillosis is uncommon, and an even greater rarity is to have the disease manifest in a patient with an intact immune system. Here we present a case of a young female presenting with cough and hoarseness immediately postpartum which later was identified as a case of primary Aspergillosis of the larynx. Initially she was managed with antibiotics, PPIs, and corticosteroids, but this did not resolve her symptoms. Direct suspension micro‐laryngoscopy with excision of TVF mass revealed tissue sections with characteristic appearance of Aspergillus sp.Conclusion:There has been an increasing number of reported cases of primary laryngeal aspergillosis in the immunocompetent. The possibility of a primary laryngeal aspergillosis should be one of the differential diagnoses when dealing with patients who respond poorly to conventional treatment. It should also not be quickly dismissed merely on the basis of the patient's good immune status.
The Rat as a Potential Animal Model for Dysphonia
Authors: Zolkind Paul A. , Last Jordan , Shuminov Oktay , Silverman Joshua B. , Sundaram Krishnamurthi , Stewart Mark , Kollmar Richard 
Published: August 2013

Objectives:Dysphonia, or hoarseness, is the primary complaint of patients with unilateral vocal‐fold paralysis due to damage to the recurrent laryngeal nerve (RLN). Animal models for RLN injury exist but are generally limited to histological, endoscopic, and electrophysiological approaches. As a step towards using the rat as a model system for dysphonia, we have characterized ultrasonic vocalizations in healthy adult animals.Methods:Ultrasonic vocalizations were evoked individually from adult male Sprague‐Dawley rats by manual stroking on two different days one month apart. The vocalizations were visualized and recorded by using an ultrasound microphone attached to a computer. Parameters such as duration, amplitude, pitch, and entropy were measured for each vocalization as well as the preceding silent period with Sound Analysis Pro 2011 software.Results:For a total of 980 vocalizations from five rats, the following parameter values (mean ± standard deviation) were obtained: duration, 14 ± 10 msec; amplitude, 13 ± 6 relative units; pitch, 57 ± 7 kHz; and entropy, ‐3.9 ± 1.0. No differences were noticed among animals or days. However, the vocalizations were distinct from the background noise during the preceding silent period: amplitude, ‐1.4 ± 2.9 relative units; pitch, 42 ± 6 kHz; and entropy, ‐1.2 ± 0.9. Virtually none of the vocalizations were located in the 20‐kHz band associated with distress.Conclusions:Ultrasound vocalizations can be recorded from adult rats easily and reliably. The features of the vocalizations are consistent among individuals and over time. Experiments with RLN‐lesioned animals are now underway.
Speech Range Profile for Moderate‐to‐Severe Hearing Impaired Persons
Authors: Siupsinskiene Nora , Sruogiene Inga J. 
Published: August 2013

Objectives:Analyze the differences between speech range profile (SRP) parameters in moderate‐to‐severe hearing impaired and well‐hearing persons and to establish the key parameters for speech discrimination.Methods:Data were analyzed in a retrospective study of SRPs in combination with voice range profiles (VRP) recorded at a university hospital during 2001‐2004. Standard protocols were derived from 80 adult patients (26 males, 54 females) with moderate‐to‐severe hearing loss without hearing‐aids or laryngeal pathology. Ninety‐eight non‐hearing impaired age and gender matched persons (33 males, 65 females) with normal voices were also analyzed. Eight SRP parameters were assessed: fundamental frequency (F0), maximum speaking frequency and speaking tone range; habitual intensity, maximum speaking intensity and speaking intensity range; location of F0 within VRP pitch range, and slope of speaking curve.Results:When compared to ‐normal hearing persons, both genders of hearing impaired individuals exhibited significantly decreased mean values of speaking intensity range and increased in percent of location of F0 within the VRP pitch range (P < 0.05). Overall discrimination accuracy of these two SRP key parameters was 93.3%.Conclusions.Moderate‐to‐severe hearing impaired persons demonstrated restricted speaking capabilities in comparison to non‐hearing impaired persons. Key parameters of speech range profile may be useful for assessment of hearing and speech rehabilitation efficacy.
Subglottic Air Escape Causing Subcutaneous Emphysema
Authors: Lerrick Andrew J. 
Published: August 2013

Objectives:Closure of a tracheocutaneous fistula risks air escape into the anterior neck. Vocal cord augmentation establishes a subglottic pressure gradient during exhalation. We present a patient who underwent these procedures concurrently in whom subcutaneous subsequently developed.Methods:A 66 year‐old female developed a neck abscess following a dental procedure. She presented to the ER with a compromised airway, requiring intubation. She underwent two separate neck abscess drainage procedures by OMFS. Prolonged intubation necessitated a tracheotomy, performed by cardiothoracic surgery. She was subsequently weaned and decannulated.Results:She was referred for dysphonia and a micro‐tracheocutaneous fistula. Laryngoscopy revealed left vocal cord paralysis, not thought to be iatrogenic. Fistula closure with vocal cord augmentation was proposed. Fistula tract excision was followed by a two‐layer muscle and skin closure. An air‐tight seal was confirmed on high‐pressure ventilation. Gelfoam was injected into the left vocal cord. She was discharged the morning after surgery. Twelve hours later she returned to the ER with rapid onset of cervicofacial subcutaneous emphysema. A pressure dressing was applied to the anterior neck. The subcutaneous emphysema subsided, being sub‐totally resorbed within 24 hours.Conclusions:Despite the delay in onset, once conditions developed a percentage of subglottic air preferentially escaped through the small defect in the anterior tracheal wall, rather than exclusively through the larger hemi‐glottic aperture, causing subcutaneous emphysema. Caution should be exercised in performing these procedures simultaneously.