bluuebunny/crossref_metadata_2025_split huggingface dataset:
Harmonic Scalpel in the Treatment of Snoring
Authors: Guastini Luca , Crippa Barbara , Mora Francesco , Dellepiane Massimo , Mora Renzo , Santomauro Valentina 
Published: September 2011

ObjectiveThe Ultracision Harmonic Scalpel (HS) is an ultrasonic cutting and coagulating surgical device. The mechanism of the HS is based on transforming electrical energy into mechanical movement of 55.5 kHz frequency. This work aims to report our 4 years’ experience with HS in the treatment of snoring (uvulopalatopharyngoplasty).MethodSpecific handpieces shaped like hook and blade were preferred. After tonsillectomy, 2 incisions, were made on each side of the lateral margin of the uvula, with upward direction. Thereafter, an excision of the redundant mucosa of each posterior arch and subsequent creation of neouvula by a partial uvulectomy was done.ResultsIn all the patients treated, the HS allowed rapid intraoperative management with a precise and safe cut: the HS provided excellent control without side effects on the adjacent structures and postoperative complications. Compared with other techniques (laser, cold knife dissection, etc) HS’s group experienced shorter operation time, lesser blood loss, fewer days of hospitalization, lower postoperative pain, and improvement of voice quality. No complications with regard to hemostasis or other major complication (temporary velopharyngeal insufficiency, bleeding, globus sensation, etc) were noted in the HS group.ConclusionOur experience highlights that the use of HS in uvulopalatopharyngoplasty confers some advantages over conventional methods: its use led to diminished bleeding, shorter operation time, lesser pain, better wound healing in the postoperative period, and reduction of snoring and improvement of voice quality.
Hyoid Movement as a Predictor of Aspiration in Patients with Dysphagia
Authors: Yasmeh Siamak , Arjomandi Hamid , Funamura Jamie L. , Sinha Uttam K. 
Published: September 2011

Objective1) Quantify the differences in hyoid movement in elderly patients with and without aspiration. 2) Determine whether reduced hyoid displacement is a significant predictor of aspiration in patients with dysphagia.MethodData on hyoid displacement and aspiration was collected from pre‐existing modified barium swallow (MBS) studies at USC University Hospital from the past 5 years. Patient studies were selected on the basis of bolus volume (5 and 10 mL), age (>60 years), and dysphagia symptoms at the time of the study.ResultsStudies were grouped by absence of aspiration on MBS, bolus volume, sex, and complaint of dysphagia as documented in their medical records at the time of the study. Preliminary results show that patients without aspiration or penetration (n = 2) achieved a mean hyoid displacement of 2.05 cm, whereas patients with aspiration or penetration (n = 5) achieved a hyoid displacement of only 1.53 cm.ConclusionBased on preliminary results, it appears that hyoid movement may accurately predict patients who are at high risk of aspiration and may serve as a parameter for treatment goals in these patients. However, greater sample size and establishment of controls are needed to further validate these findings.
Immune Reconstitution Causing Regression of Kaposi’s Sarcoma
Authors: Wudel Justin , Wine Todd 
Published: September 2011

ObjectiveExamine whether conservative management of invasive Kaposi’s sarcoma of the maxilla during immune reconstitution can prevent or reduce the need for surgical intervention.MethodWe report an unusual case of a patient who presented to a tertiary care medical center with newly diagnosed acquired immunodeficiency syndrome and an erosive mass of the maxilla as demonstrated by both clinical and radiographic examinations.ResultsThe patient underwent an incisional biopsy of the hard palate mass. Immunohistochemical analysis demonstrated the tumor cells to be immunoreactive with CD34 and CD31 and negative for factor VIII, consistent with the diagnosis of Kaposi’s sarcoma. Following biopsy the patient was followed with serial exams while his CD4 count and viral load were monitored throughout the initiation of HAART (highly active antiretroviral therapy). After reconstitution of the immune system and decrease in viral load, the lesion demonstrated significant regression and symptomatic improvement.ConclusionInvasive Kaposi’s sarcoma, although rare, can be a locally aggressive and destructive lesion. Treatment of this disease has centered on surgical removal, chemotherapy, and radiation therapy. However, we demonstrate a case report in which observation in the acute setting has led to significant regression of the disease during immune reconstitution.
Infected Branchial Cleft Cyst Presenting as a Recurrent Peritonsillar Abscess
Authors: Athavale Sanjay Manohar , McGuire Peter , Rangarajan Sanjeet , Langerman Alexander , Mannion Kyle 
Published: September 2011

ObjectivePeritonsillar abscess (PTA) is the most common deep infection of the head and neck in young adults. The incidence of recurrent unilateral PTA is extremely low, and a patient with recurrent unilateral PTA development deserves a more vigorous workup for other pathologic entities, including branchial cleft cysts (BCC).MethodWe describe a unique clinical case illustrating the workup and diagnosis of a patient presenting with “recurrent unilateral PTA” that actually turned out to be a second BCC. We discuss the necessity to keep a broad differential when evaluating patients presenting with “classic” symptomatology.ResultsA 40‐year‐old male presented to the emergency department with a history of 5 previous right‐sided PTAs. The patient was again treated for “recurrent PTA” due to computed tomography (CT) scan and physical examination findings. An outpatient CT scan later showed a residual fluid collection in the peritonsillar and parapharyngeal space. The patient was subsequently taken to the operating room for a definitive exploration where a second BCC was discovered and removed.ConclusionBCCs may be asymptomatic but commonly present as recurrent infected neck abscesses. In any patient who presents with recurrent unilateral PTAs, a broader differential diagnosis should be formulated (including BCC), and necessary imaging studies should be ordered to properly classify and treat these individuals.
Isthmusectomy: The Un‐thyroidectomy
Authors: Cannon C. Ron 
Published: September 2011

ObjectiveLearn the indications, surgical technique, and role of isthmusectomy in the overall surgical management of thyroid disease.MethodProspective observational case series in which 7 patients with lesions confined to the thyroid isthmus underwent isthmusectomy.ResultsAll of the patients successfully underwent isthmusectomy. There were no operative complications, and blood loss was minimal. In 6 patients benign pathology was found. The other patient had a papillary thyroid cancer and was converted to a total thyroidectomy at the same setting. None of the patients with benign disease required thyroid supplementation postoperatively.ConclusionFor lesions 3 cm and under, isthmusectomy is a safe alternative to lobectomy with isthmusectomy for lesions confined to the thyroid isthmus. The technique is straight forward and can be performed as an outpatient procedure. As the majority of the gland is preserved, postoperative thyroid supplementation is seldom required.
Left‐handed Otolaryngologists: Adaptations and Implications for Resident Training
Authors: Kuhn Maggie , Edelstein David R. 
Published: September 2011

Objective1) Describe ergonomic and procedural modifications for the left‐handed otolaryngologist. 2) Present resident and practicing otolaryngologist perspectives on handedness.MethodSurvey of otolaryngology training programs, electronic questionnaires offered to residents and established otolaryngologists, and review of the literature.ResultsApproximately 11% of the population is left‐handed, with a similar prevalence among surgeons. The otolaryngologist’s reliance on specialized equipment requires adaptations to facilitate use by left‐handed physicians. We propose modifications for the left‐handed otolaryngologist in the outpatient setting and in endoscopic sinus, otologic, head and neck, facial plastic, and upper aerodigestive procedures. Furthermore, survey results regarding handedness are presented. A minority of left‐handed otolaryngologists had specific mentoring or instruction during their training. Most surgeons, regardless of handedness, believe that proficiency with their nondominant hand is crucial and that left‐handedness does not impede successful surgical performance or residency training.ConclusionAdaptations made by the left‐handed otolaryngologist who practices in a right‐handed‐dominated field are often intuitive. However many surgeons, particularly trainees, may benefit from recommendations specifically tailored for left‐handed otolaryngologists. We offer suggestions for these individuals and present results of a survey regarding handedness among otolaryngology residents and attendings.
Lipoid Proteinosis: Case Report of Otolaryngological Findings
Authors: Dias Priscila S. , Braga Frederico B. , Sabaneeff Lidia , Milward Marina , Leite Jorge B. , Mosciaro Manuela S. , Melo Maria‐Helena 
Published: September 2011

ObjectiveLipoid proteinosis, or Urbach‐Wiethe disease, was first described in 1929. It is a rare recessive genetic disorder that causes a buildup of hyaline material in the skin and mucosa. The objective of this paper is to report a case of lipoid proteinosis, or Urbach Wiethe disease, emphasizing its otolaryngological manifestations.MethodA 38‐year‐old patient presented since young childhood with skin lesions on buttocks, face, arms, and legs and a weak cry. Currently, the patient has hoarseness that keeps her from talking on the telephone, anodontia, pale and stiff oral mucosa (specially frenulum and tongue), and narrowed nasal vestibules.ResultsThe clinical investigation included a videolaryngoscopy that showed an infiltration of the arytenoids and epiglottis. The vocal cords had normal mobility and coaptation. In order to confirm the diagnosis, a skin biopsy was performed, and the deposition of hyaline positive PAS material was found in the papillar derme. This rare disease does not have a specific treatment. The patient was treated with topical and systemic corticosteroids and also phonotherapy, obtaining some improvement. She was not interested in any surgical option. She is in clinical follow‐up in Gaffrée Guinle University Hospital.ConclusionLipoid proteinosis is a rare disease, with approximately 300 reported cases, that has a chronic and benign course, still without a specific treatment. Because of the variety of symptoms in the oral cavity, larynx, and nose, it is important that the otolaryngologist is familiar with that affection.
Loss of Cervical Lordosis and Foreign Body Ingestion
Authors: Ibrahim Shahrul Izham , Lo Stephen , Tay Sok Yan 
Published: September 2011

ObjectiveIn this retrospective study, we look at the sensitivity and specificity of the loss of cervical lordosis as a radiological sign for the presence of a foreign body in the aerodigestive tract.MethodA total of 39 cases of foreign body ingestion, confirmed with positive surgical removal in the emergency department and operating theatre were reviewed. All 39 had lateral neck x‐rays performed in the Emergency department.ResultsOf the 39 cases, 36 had loss of cervical lordosis on lateral neck x‐ray. All had foreign bodies removed that were between C4 and T level. Therefore, the sensitivity of the loss of cervical lordosis as a sign of the presence of a foreign body in the aerodigestive tract in this study is 92.31%.ConclusionWe conclude that the loss of cervical lordosis is a good sign for the presence of a foreign body in the aerodigestive tract, and we should have a high index of suspicion in these cases despite negative clinical examination.
Applicability of Questionnaire in Outcome in Rhinoplasty
Authors: Duarte Juliana Antoniolli , Macoto Eduardo , Santiago Jose , Garcia Leonardo B. , Gregorio Luis‐Carlos 
Published: September 2011

ObjectiveEvaluate the satisfaction and the actual benefit if rhinoplastic surgery, using questionnaires that assess since aspects related to appearance and function, even aspects of social order and compare them.MethodIn a cross‐sectional study of 105 patients who underwent rhinoplasty, the patients answered 2 questionnaires, the GBI (Glasgow Benefit Inventory) and the SNOT‐22 (sino‐nasal outcome test‐22). Student t test was used to compare the SNOT‐22 scores before and after surgery and Pearson correlation coefficient between SNOT‐22 and GBI scores.ResultsThese 49 patients could be reached by telephone these 21 were men (42.85%), with a mean age of 28.96 years. The SNOT‐22 were on average 17.41 points preoperatively and 13.63 in the postoperative. The results of the GBI in the postoperative period were 31.69 points on average.ConclusionThere was a high satisfaction rate of patients undergoing rhinoplasty when assessed through questionnaires GBI and SNOT‐22 separately, but a weak correlation between them.
MRSA Bacteremia Associated with Lemierre Syndrome
Authors: Kizhner Victor Zeev , Samara Ghassan J. , Panesar Rahul , Krespi Yosef P. 
Published: September 2011

ObjectiveCommunity acquired MRSA (CA‐MRSA) is a growing health concern. CA‐MRSA behaves differently between the adult and pediatric population. Lemierre’s syndrome is septic jugular thrombophlebitis affecting mainly young adults. We intend to identify a possible sub group of Lemierre’s syndrome (LS) associated with CA‐MRSA through a case report and literature review.MethodWe review a case report of an 18‐year‐old athlete admitted for increasing fever, tachycardia, tachypnea, and neck pain. MRSA bacteremia was identified, and following ARDS the patient was intubated. Neck CT showed jugular thrombophlebitis at the skull base. The patient was treated with rifampin, vancomycin, ceftriaxone, and clindamycin.ResultsFollowing intravenous antibiotic treatment the patient improved and was extubated, and subsequent CT and Doppler showed normal jugular flow. Sterilization of blood cultures predicted improvement. A literature review showed a rise in the past 2 years of LS associated with MRSA all with patients less than 18 years old.ConclusionCA‐MRSA in the pediatric population is associated with dermatologic infection and trauma. CA‐MRSA bacteremia can lead to pulmonary sequela. CA‐MRSA associated with pharyngitis, nasopharyngitis, and parapharyngeal lymphadenitis may predispose one to LS. LS can be associated with CA‐MRSA. As the CA‐MRSA carrier is predominantly nasal, pharyngitis may not be present.
Nasal Packing of Calcium Alginate after Endoscopic Sinus Surgery
Authors: Omura Kazuhiro , Asaka Daiya , Moriyama Hiroshi , Otori Nobuyoshi , Okushi Tetsushi , Nakayama Tsuguhisa , Matsuwaki Yoshinori 
Published: September 2011

ObjectiveSorbsan (calcium alginate) is an absorbent packing that shows a potent hemostatic effect and can maintain moist wound surfaces. The aim of this study was to evaluate the early symptoms and QOL with Sorbsan versus Beschitin‐F (chitin‐coated gauze) for middle meatus packing after endoscopic sinus surgery (ESS).MethodWe performed a cohort study of 40 patients who underwent ESS. The patients were randomly allocated into 2 groups who underwent insertion of either Sorbsan or Beschitin‐F into the middle meatus. A daily diary was used to record the symptoms and QOL, measured using visual analogue scales.ResultsThe scores for each of the symptoms of nasal pain, headache, nasal bleeding, and postnasal drip were statistically significantly lower in the Sorbsan group. The scores for each of the QOL parameters, including the effect on their stay in the hospital and sleep disturbance, were also significantly lower in the Sorbsan group. There were no findings of postoperative hemorrhage or local infection in either group.ConclusionSorbsan packing did not cause any major complications and has the potential to reduce nasal pain and suffering in post‐ESS patients compared with gauze packing.
Otolaryngological Features of ANCA Associated Vasculitis
Authors: Nakamaru Yuji , Fukuda Satoshi 
Published: September 2011

ObjectiveANCA‐associated vasculitis (AAV) is characterized by systemic necrotizing vasculitis. AAV is composed of proteinase 3 (PR3)‐ANCA and myeloperoxidase (MPO)‐ANCA. Because infections are a trigger of AAV, the upper airway areas are the favorite sites of AAV. In this study, we compare the otolaryngological features of AAV between patients with PR3‐ANCA and patients with MPO‐ANCA.MethodRetrospective case series study. Thirty‐four patients enrolled in this study. All patients were diagnosed with AAV at Hokkaido University between 2002 and 2009. We evaluated clinical otologic and rhinologic manifestation of AAV and compared the difference between 2 different ANCA positive patients.ResultsThe otologic symptoms were divided into 3 types: chronic otitis media (COM), secretory otitis media (SOM), and sensory nerve hearing loss (SNHL). The COM type was more frequently found in patients with PR3‐ANCA (P <. 05).ConclusionA large difference was observed in the disease spectrum between patients with PR3‐ANCA and those with MPO‐ANCA. In particular, the discrepancy in the granuloma formation between these 2 ANCAs was thought to be the main reason for these clinical feature differences in the otolaryngological field.
Outcomes of Vagal Nerve Stimulator Implantation by Otolaryngologists
Authors: Perez Angel Javier , Dyckman Damian , Schroeder Ashley A. , Clenney Timothy L. 
Published: September 2011

ObjectiveA vagal nerve stimulator (VNS) is a FDA‐approved device implanted for treatment of intractable epilepsy and major depression in adults and children. Recently, otolaryngologists are becoming more involved in the implantation and care of side effects for these devices.MethodA retrospective chart review was performed. Our local surgical database was searched for cases of VNS implantation during a period of 40 months. Fourteen cases performed by otolaryngologists were identified. Medical records were then reviewed for outcomes including medication reduction, seizure frequency and duration, device‐related complications, and surgical complications.ResultsOf the 14 cases performed by otolaryngologists over 40 months, 11 (78.6%) cases demonstrated either a decrease in medications required, seizure frequency, or duration. The most common side effect was voice alteration during device initiation. There were no early postsurgical complications.ConclusionThese data provide support for the qualification of otolaryngologists for performing VNS implantation and monitoring postoperative and laryngeal side effects of the VNS.
P63‐Mediated Cisplatin Resistance with Head and Neck Cancer
Authors: Yamashita Taku , O’Malley Bert , Li Daqing , Miyamoto Shunsuke 
Published: September 2011

Objective1) Understand the molecular pathway of cisplatin‐based chemoresistance with head and neck cancer. 2) Investigate if p63 plays an important role in regulating MRE11/RAD50/NBS1 (MRN) complex that contributes to cisplatin‐based chemoresistance.MethodBoth JHU006 and JHU020 HNSCC cell lines were characterized as either sensitive or resistant to cisplatin. MRN and p63 expression levels were examined. The p63‐mediated MRN regulation was studied by introducing mutant NBS1 and siRNA. Cell growth was evaluated in response to cisplatin treatment and regulation of p63 and MRN.ResultsIC50 to cisplatin for JHU006 and JHU020 was 8.76 and 0.61, respectively, suggesting that JHU006 is a cisplatin‐resistant cell line. Increased expression levels of MRN were found after cisplatin treatment in JHU006 as compared with JHU020. The p63 expression level, which is a positive transcriptional factor for RAD50 and MRE11, was up‐regulated after cisplatin treatment in JHU006 but not in JHU020. The knockdown of p63 resulted in the down‐regulation of MRN, and therefore there were interrupted DNA repair and sensitized resistant tumor cells to cisplatin. The introduction of mutant NBS1 could down‐regulate MRN, but was not effective on the p63 expression.ConclusionOur study suggested that p63 may play an important role in regulating cisplatin‐based chemoresistance via MRN. The understanding of the molecular pathway of cisplatin‐based chemoresistance could help us to design an efficient treatment strategy for head and neck cancer.
Rhinoscleroma in an Urban Non‐endemic Setting
Authors: Suchanova Pavlina Paja , Mohyuddin Nadia G. , Eicher Susan A. 
Published: September 2011

Objective1) Increase awareness and understanding of the clinical presentation, diagnosis, and treatment options of respiratory rhinoscleroma among otolaryngologists in nonendemic areas. 2) Review current literature, including our clinical experience, and propose a treatment algorithm for rhinoscleroma cases in a nonendemic setting.MethodReport 2 cases of nasal and 1 case of laryngeal rhinoscleroma in an urban nonendemic setting in Ben Taub General Hospital in Houston, Texas. All patients presented in the spring of 2010 and were treated medically and/or surgically with an established follow‐up of more than 6 months.ResultsRhinoscleroma is a chronic, slowly progressive, infectious disease of the respiratory tract that is rare in nonendemic countries. Increased travel from endemic areas is increasing its incidence in a nonendemic setting, and there is a need for an increased awareness of its clinical presentation and treatment options. The condition can easily mimic other pathologies and, if untreated, lead to disfiguring nasal anatomy and laryngeal stenosis. No comprehensive English review exists, as many case reports are published in their respective native languages only.ConclusionA treatment algorithm based on available literature review and our clinical experience is proposed with a full review of clinical presentation, diagnosis, and the natural course of the disease, including its histopathology.
Systematic Review of Steroid Prophylaxis for Thyroidectomy
Authors: Mascarinas Christopher A. , Aynehchi Behrad B. , Parmar Perminder S. , Rosenfeld Richard M. 
Published: September 2011

ObjectiveDetermine whether systematic review with meta‐analysis supports the use of corticosteroids to reduce postoperative nausea, vomiting, pain, and voice dysfunction after thyroidectomy.MethodA systematic review of currently available randomized controlled trials in EMBASE and PUBMED databases comparing intravenous perioperative corticosteroids with placebo to prevent postoperative nausea, vomiting, pain, or voice dysfunction was performed by 2 independent reviewers. The quality of studies was evaluated and results synthesized using standard random‐effects meta‐analysis methods.ResultsEight randomized controlled trials were eligible for review. Dexamethasone reduced the absolute incidence of postoperative nausea at 24h by 18% (95% CI, 2‐8‐27%), P <. 001, and postoperative vomiting at 24h by 27% (95% CI, 13‐40%), P <. 001 in 4 trials with 304 patients. Dexamethasone increased the absolute incidence of complete response (no episodes of nausea or vomiting) to steroids by 30% (95% CI, 7‐52%), P =. 11 in 3 trials with 246 patients. Dexamethasone reduced the absolute VAS score for pain (0‐10 scale) at 24h by 1.32 95% CI (0.49‐2.15), P =. 002 in 3 trials with 232 patients. There was insufficient data to perform meta‐analysis for voice dysfunction.ConclusionThese results argue strongly for routine use of dexamethasone during thyroidectomy because the intervention is safe and only about 2.5 patients need treatment to prevent one episode of postoperative nausea or vomiting.