bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of head rotation on upper esophageal sphincter pressure evaluated by high‐resolution manometry system
Authors: Takasaki Kenji , Umeki Hiroshi , Kumagami Hidetaka , Takahashi Haruo 
Published: January 2010

ObjectivesThis study aimed to quantify the effects of head rotation on upper esophageal sphincter (UES) pressure in healthy subjects using a novel high‐resolution manometry (HRM) system.Study DesignProspective study.SettingNagasaki University Hospital.Subjects and MethodsEighteen asymptomatic Japanese male adult volunteers were studied. A solid‐state HRM was positioned to record resting UES pressure. After endoscopically confirming on which side of the pyriform sinus the manometric sensor was positioned within the hypopharynx, we measured the maximum and mean values of the resting UES pressure and the length of the zone of the UES along the esophagus with the patients in the following positions: 1) neutral and straightforward head position (NSF), 2) turning the head in the direction of the side in which the sensor was positioned (HSS), and 3) turning the head in the opposite direction of the side with sensor (HOS).ResultsThe maximum and mean values of the resting UES pressure were statistically higher in HSS than in NSF (P = 0.0001 and P < 0.0001, respectively), and were statistically lower in HOS than in NSF (P < 0.0001 and P < 0.0001, respectively). The length of the zone of the UES was statistically shorter in HOS than in NSF (P < 0.0001), but there was no significant difference in resting UES pressure along the esophagus between HSS and NSF (P = 0.3024).ConclusionThe present study provided us with physiological information regarding normal UES pressure in relation to head rotation. This data will be of aid to future clinical and investigative swallowing studies. Additionally, the current study provides evidence of the safety and usefulness of the head rotation maneuver for dysphagic patients.
Conservative management of advanced external auditory canal cholesteatoma
Authors: Darr E. Ashlie , Linstrom Christopher J. 
Published: January 2010

ObjectiveTo investigate the spectrum of disease presentation and clinical management of primary external auditory canal cholesteatoma (EACC).Study DesignCase series with chart review.SettingSpecialty teaching hospital.Subjects and MethodsTen cases of primary EACC were identified in nine patients treated over 14 years (1995‐2009). Cases were reviewed with regard to demographics, presentation, physical examination, CT findings, and clinical management.ResultsThe most common symptoms were otalgia and hearing loss, followed by otorrhea and tinnitus. Erosion was present in the mastoid air cells in seven patients, middle ear in six, temporomandibular joint in two, otic capsule in two, and fallopian canal in one patient. Eight of nine patients were managed with serial debridement.ConclusionsEACC is associated with adjacent bony erosion, most often involving the inferior EAC. Despite the potentially destructive nature of these lesions, most cases can be successfully managed with serial debridement.
Lumen formation in three‐dimensional cultures of salivary acinar cells
Authors: Pradhan Swati , Liu Chao , Zhang Chu , Jia Xinqiao , Farach‐Carson Mary C. , Witt Robert L. 
Published: January 2010

ObjectiveDevelopment of an artificial salivary gland will benefit patients with xerostomia after radiation therapy for upper respiratory cancer. The goal is to devise a three‐dimensional (3D) culture system in which salivary cells differentiate into polarized acini that express essential biomarkers and directionally secrete α‐amylase. Differentiated acini‐like structures in a 3D biomaterial‐based scaffold will mimic salivary gland functions.Study DesignCells were seeded onto HA‐based hydrogels containing PlnDIV peptide and allowed to differentiate into acini‐like structures. Cell viability and phenotype were examined.SettingLaboratory‐based tissue procurement study.Subjects and MethodsSalivary gland tissue was obtained from patients undergoing surgery. Marker expression established the phenotype of salivary gland cells. Perlecan/HSPG2, an important component of the basement membrane, was highly expressed in salivary gland tissue. A culture system consisting of hyaluronic acid (HA) hydrogel and a coupled bioactive peptide derived from domain IV of perlecan (PlnDIV) was used. Prior studies demonstrated differentiation of acinar cells into lobular structures that mimicked intact glands when cultured on PlnDIV peptide–coated surfaces.ResultsLobular acini‐like structures formed on hydrogels and expressed tight junction components such as zona occludens 1. Acini‐like structures were stained for the presence of α‐amylase. Live/dead staining revealed the presence of apoptotic cells in the center of the acini‐like structures, indicative of lumen formation.ConclusionA novel system supporting acini‐like assembly in a 3D culture system was established. Presence of biomarkers and secretion of salivary enzymes confirms functionality in vitro. Future experiments will test the 3D system in an animal model.
Hearing impairment and poverty: The epidemiology of ear disease in Peruvian schoolchildren
Authors: Czechowicz Josephine A. , Messner Anna H. , Alarcon‐Matutti Edith , Alarcon Jorge , Quinones‐Calderon Gina , Montano Silvia , Zunt Joseph R. 
Published: January 2010

Objectives1) To measure prevalence of hearing impairment (HI) in schoolchildren living in poverty in Peru. 2) To identify risk factors for HI and assess its impact on academic performance.Study DesignCross‐sectional.SettingElementary schools in an asentimiento humano (shantytown) near Lima, Peru, October 2008 to March 2009.SubjectsSchoolchildren (n = 335), ages six to 19 years.MethodsAudiological health was assessed with pure‐tone audiometry, tympanometry, and otoscopy. The primary outcome was HI, defined as average threshold >25 dB HL for 0.5, 1, 2, and 4 kHz, in one or both ears (per World Health Organization/International Organization for Standardization). A questionnaire on health history was administered to parents. Statistical analysis included univariate analysis for χ2 values and odds ratios (ORs), and multivariate logistic regression.ResultsHI prevalence: 6.9 percent (95% confidence interval [CI] 4.2%‐9.6%). Risk factors for HI (OR, 95% CI, P value): neonatal jaundice (5.59, 1.63‐19.2, 0.015), seizure (7.31, 2.50‐21.4, 0.0013), hospitalization (4.01, 1.66‐9.68, 0.003), recurrent otitis media (5.06, 1.98‐12.9, 0.002), past otorrhea (4.70, 1.84‐12.0, 0.003), family history of HI at <35 years (2.91, 1.19‐7.14, 0.026), tympanic membrane abnormality (13.8, 4.48‐42.7, <0.001), cerumen impaction (15.8, 4.71‐53.1, <0.001), and eustachian tube dysfunction (4.87, 1.74‐13.7, <0.001). HI was an independent predictor of academic failure (3.36, 1.15‐9.82, 0.03).ConclusionsImpoverished Peruvian schoolchildren were four to seven times more likely to experience HI than children living in higher‐income countries. Untreated middle ear disease in the context of limited access to pediatric care was a major risk factor for HI. Furthermore, HI was associated with worse scholastic achievement. These results support prioritization of pediatric ear health as an essential component of the global health agenda, especially in resource‐poor countries.
Assessment of the chin in patients undergoing rhinoplasty: What proportion may benefit from chin augmentation?
Authors: Ahmed Jahangir , Patil Sachin , Jayaraj Samuel 
Published: January 2010

ObjectiveThe chin is an important determinant of the lower third of the face, carrying much significance in an esthetically balanced facial appearance. It is, however, often neglected in patients undergoing rhinoplasty procedures in the UK National Health Service (NHS). The aim of this study was to establish the percentage of a cohort of rhinoplasty patients who may also have benefited from chin augmentation.Study DesignA cross‐sectional study.Subjects and MethodsThe digital preoperative pictures of the last 100 patients who underwent rhinoplasty at our institution were retrieved. Four popular methods of assessment were used to assess the chin, that is, those advocated by Silver, Legan, Merrifield, and Gonzales‐Ulloa. All analyses were performed on Adobe Photoshop CS4 by two ENT registrars. Values were regarded as positive when there was interobserver agreement. Relevant angles were averaged.ResultsA total of 94 photographs were suitable for analysis. There were 58 males. Depending on the method of assessment, the percentage of males who fulfilled criteria for augmentation ranged from 17 to 62 percent and for females the range was 42 to 81 percent. Additionally, 21 percent of males were positive on three or more of the methods utilized. The respective figure was 58 percent for females.ConclusionSurgeons who practice rhinoplasty should consider making an objective assessment of the need for possible chin augmentation. Our study shows that as many as 81 percent of patients may benefit, although this figure varies with the method of assessment. In this study, the necessity for further analysis with a view to chin augmentation was more likely in women.
The children speak: An examination of the quality of life of pediatric cochlear implant users
Authors: Loy Betty , Warner‐Czyz Andrea D. , Tong Liyue , Tobey Emily A. , Roland Peter S. 
Published: January 2010

ObjectiveTo examine the results of health‐related quality‐of‐life questionnaire scores from profoundly deaf children fitted with at least one cochlear implant (CI) and to compare their responses with those of normal‐hearing mates of similar age and their parents.Study DesignCross‐sectional study utilizing a generic quality‐of‐life questionnaire designed to be completed by both parents and children independently of each other.SettingQuestionnaires completed at various summer camps designed for children with CIs in Texas and Colorado.Subjects and MethodsEighty‐eight families from 16 states were divided into two subgroups by age of cochlear implantation: an eight‐ to 11‐year‐old group and a 12‐ to 16‐year‐old group. The KINDL‐R Questionnaire for Measuring Health‐Related Quality of Life in Children and Adolescents was distributed, and CI participants completed the questionnaire independently of their participating family member.ResultsCI users in both age groups scored similarly to their normal‐hearing peers and their parents. Younger CI users scored their family domain lower compared with their normal‐hearing peers. Teen CI users scored the school domain lower compared with their parents. Among CI participants, earlier implantation and longer CI use resulted in higher quality‐of‐life scores.ConclusionChildren with CIs experience quality of life similar to that of normal‐hearing peers. Parents are reliable reporters on the status of their child's overall quality of life.
Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss
Authors: She Wandong , Dai Yanhong , Du Xiaoping , Yu Chenjie , Chen Feng , Wang Junguo , Qin Xiaoming 
Published: January 2010

ObjectiveTo investigate the effectiveness and safety of intratympanic methylprednisolone perfusion (IMP) through a microcatheter in patients with sudden sensorineural hearing loss (SSNHL) who failed a conventional treatment.Study DesignProspective clinical study.SettingThis study was conducted in Nanjing Drum Tower Hospital, Nanjing University Medical School.Subjects and MethodsPatients who had failed a minimum 10‐day conventional treatment were included. Twenty‐six patients in the study group (SG) received methylprednisolone perfusion through a microcatheter placed into the tympanum once a day for 10 days and the conventional treatment. Twenty‐three patients who received a second conventional treatment (no steroid) served as the comparison group (CG). All patients were followed up for three months after the end of treatment.ResultsThe effective rates for SG and CG were 50 percent (61.9% when only patients with an interval from onset to IMP ≤ 60 days were included) and 21.7 percent, respectively (χ2 = 4.194, P = 0.041). The pure‐tone average improvement was 20.2 ± 15.6 dB in SG, and 9.2 ± 13.7 dB in CG (z = 2.51, P = 0.011). In SG, hearing improvement at low frequencies was better than that at high frequencies. The interval from onset to IMP affected the efficacy of IMP.ConclusionIMP through a microcatheter is a promising treatment for refractory SSNHL. The data suggest that the treatment may be more effective when administered at the earlier stages of SSNHL when the conventional treatment has failed.
A prospective study of vitamin intake and the risk of hearing loss in men
Authors: Shargorodsky Josef , Curhan Sharon G. , Eavey Roland , Curhan Gary C. 
Published: January 2010

ObjectiveHearing loss is the most common sensory disorder in the United States, afflicting more than 36 million people. Higher intakes of vitamins C, E, beta carotene, B12, and folate have been proposed to reduce the risk of hearing loss.Study DesignWe prospectively evaluated the association between intake from foods and supplements of vitamins C, E, beta carotene, B12, and folate, and the incidence of hearing loss.SettingHealth Professionals Follow‐up Study.Subjects and MethodsA total of 26,273 men aged 40 to 74 years at baseline in 1986. Participants completed questionnaires about lifestyle and medical history every two years and diet every four years. Information on self‐reported professionally diagnosed hearing loss and year of diagnosis was obtained from the 2004 questionnaire, and cases were defined as hearing loss diagnosed between 1986 and 2004. Cox proportional hazards multivariate regression was used to adjust for potential confounders.ResultsThere were 3559 cases of hearing loss identified. Overall, there was no significant association between vitamin intake and risk of hearing loss. Among men aged ≥60 years, total folate intake was associated with a reduced risk of hearing loss; the relative risk for men aged ≥60 years old in the highest quintile compared with the lowest quintile of folate intake was 0.79 (95% confidence interval 0.65‐0.96).ConclusionsHigher intake of vitamin C, E, beta carotene, or B12 does not reduce the risk of hearing loss in adult males. Men aged ≥60 years may benefit from higher folate intake to reduce the risk of developing hearing loss.
Do abstracts in otolaryngology journals report study findings accurately?
Authors: McCoul Edward D. , Vengerovich Gennadiy , Burstein David H. , Rosenfeld Richard M. 
Published: January 2010

ObjectivesAlthough published abstracts have the advantage of being prominent and concise, their quality in the otolaryngology literature has not been studied. We sought to understand the limitations of relying on abstracts as the sole source of information about published research. In addition, we sought to identify specific opportunities for improving the quality of published articles and their associated abstracts.MethodsStudies of original research published in four major otolaryngology journals from January 2008 to June 2008 were included. Each study article and abstract was reviewed separately for 12 domains relating to study design, results, and conclusions. Good inter‐rater reliability was established as part of the validation process.ResultsFour hundred eighteen articles were identified for study, which included 75 percent clinical research and 25 percent basic science. The most common omissions in the abstract when compared with the complete article were study limitations (91% left out of abstract), geographic location (79%), confidence intervals (75%), dropouts or losses (62%), and harms and adverse events (44%). Conversely, the abstract often included information about research design (99%), sample size (92%), source of the data (81%), and quantitative results (67%). These results did not differ significantly with regard to article type, journal, or level of evidence.ConclusionsReaders of otolaryngology journals may form biased or inappropriate conclusions if they read only the abstract of a study, particularly with regard to study limitations, adverse events, and subject dropouts or losses. These results highlight the perils of using the abstract as a sole source of information.
Propofol‐induced sleep: Polysomnographic evaluation of patients with obstructive sleep apnea and controls
Authors: Rabelo Fábio A.W. , Braga Adriano , Küpper Daniel S. , De Oliveira José A.A. , Lopes Fernando M. , de Lima Mattos Pedro Luiz Vaz , Barreto Shirley G. , Sander Heidi H. , Fernandes Regina M.F. , Valera Fabiana C.P. 
Published: January 2010

ObjectiveThe localization of upper airway obstruction in patients with obstructive sleep apnea (OSA) may optimize treatment. Nasoendoscopy during propofol sedation allows such an evaluation, but the effect of this drug on respiratory patterns and muscle relaxation is unknown. The objective of the present study was to determine through polysomnography whether propofol would change sleep parameters.Study DesignProspective study of subjects submitted to polysomnography under sedation with propofol.SettingTertiary referral center.Subjects and MethodsFifteen non‐obese subjects (4 controls/11 OSA patients) were submitted to two diurnal polysomnograms (90‐120 minutes of sleep), with and without the use of propofol. The parameters presence of snoring, apnea‐hypopnea index (AHI), oxygen desaturation, and sleep architecture were compared.ResultsThe use of propofol did not induce snoring in the control subjects, whereas 100 percent of the OSA patients snored. AHI and mean oxygen saturation (SaO2) did not differ significantly between examinations with and without sedation. However, minimum SaO2 differed significantly (P < 0.05) with sedation, being lower during propofol sedation. Propofol also significantly changed the sleep architecture, with a significant increase in N3 sleep (P < 0.005) and total abolishment of rapid eye movement sleep (P < 0.0005) during propofol sedation.ConclusionsThese preliminary results allow us to infer that sedation with propofol changes sleep architecture but permits respiratory evaluation, because the main respiratory parameters evaluated in OSA are maintained. These preliminary results support the view that nasoendoscopy under propofol sedation is a promising examination for management of this disease.
A randomized, prospective, controlled study of forearm donor site healing when using a vacuum dressing
Authors: Chio Eugene G. , Agrawal Amit 
Published: January 2010

Objective1) Compare skin graft healing of the radial forearm free flap (RFFF) donor site when using a negative pressure dressing (NPD) versus a static pressure dressing (SPD). 2) Examine the association of graft size and medical comorbidities with healing of RFFF donor site.Study DesignRandomized, controlled trial.SettingTertiary care hospital.Subjects and MethodsAfter the study was approved, consenting adults undergoing RFFF for head and neck reconstructions were randomized into two arms: SPD and NPD groups. Fifty‐four patients were enrolled from March 2007 to August 2009. Pre‐ and postoperative data were collected, including medical comorbidities, graft size, and area of graft failure/tendon exposure. Data were collected at two postoperative time points.ResultsThe overall wound complication rate was 38 percent (19/50). Wound complications at the first postoperative visit (44.4% [12/27] SPD and 30.4% [7/23] NPD) were not significantly different between groups (P = 0.816). Similarly, wound complications at the second visit (68.8% [11/16] SPD and 80% [12/15] NPD) were not significantly different (P = 0.55). Percentage of area of graft failure between the groups also showed no difference (4.5% SPD vs 7.2% NPD, P = 0.361). The association of graft size with wound complications was analyzed by dividing the data set into three groups (<50 cm2, 51‐100 cm2, and >100 cm2). This difference was not found to be significant (P = 0.428). Finally, when evaluating comorbidities, 50 percent (8/16) of subjects with comorbidities experienced complications compared with 32.4 percent (11/34) without comorbidities, also not reaching significance (P = 0.203).ConclusionsAlthough an attractive option for wound care, the NPD does not appear to offer a significant improvement over an SPD in healing of the RFFF donor site.
Prevalence of penetration and aspiration on videofluoroscopy in normal individuals without dysphagia
Authors: Allen Jacqui E. , White Cheryl J. , Leonard Rebecca J. , Belafsky Peter C. 
Published: January 2010

ObjectiveTo determine the prevalence of penetration and aspiration on videofluoroscopic swallow studies (VFSS) in normal individuals without dysphagia.Study DesignCase series with planned data collection.SettingA tertiary urban university hospital.Subjects and MethodsNormal adult volunteers without dysphagia, neurological disease, or previous surgery underwent VFSS. Studies were recorded and then reviewed for evidence of penetration or aspiration. The degree of penetration was assessed with the penetration‐aspiration scale (PAS). The effect of age, bolus size, and consistency was evaluated.ResultsA total of 149 VFSS (596 swallows) were reviewed. The mean age of the cohort was 57 years (±19 years); 56 percent were female. Only one (0.6%) individual aspirated on VFSS. Seventeen (11.4%) individuals demonstrated penetration. The mean PAS for the entire cohort was 1.17 (±0.66). Prevalence of penetration by swallow was 2.85 percent (17/596). Prevalence of penetration was 9.3 percent in elderly individuals aged >65 years and 14.3 percent in adults aged <65 years (P = 0.49). Prevalence of penetration on a liquid bolus was 3.4 percent (15/447) and on paste was 1.3 percent (2/149) (P > 0.05). Prevalence of penetration for a bolus <30 cc was 2.34 percent (7/298) and for a bolus >30 cc was 5.4 percent (8/149) (P > 0.05).ConclusionAspiration on VFSS is not a normal finding. Penetration is present in 11.4 percent of normal adults and is more common with a liquid bolus.
From virtual reality to the operating room: The endoscopic sinus surgery simulator experiment
Authors: Fried Marvin P. , Sadoughi Babak , Gibber Marc J. , Jacobs Joseph B. , Lebowitz Richard A. , Ross Douglas A. , Bent John P. , Parikh Sanjay R. , Sasaki Clarence T. , Schaefer Steven D. 
Published: January 2010

ObjectiveEstablish the feasibility of a predictive validity study in sinus surgery simulation training and demonstrate the effectiveness of the Endoscopic Sinus Surgery Simulator (ES3) as a training device.Study DesignProspective, multi‐institutional controlled trial.SettingFour tertiary academic centers with accredited otolaryngology‐head and neck surgery residency programs.SubjectsTwelve ES3‐trained novice residents were compared with 13 control novice residents.MethodsSubjects were assessed on the performance of basic sinus surgery tasks. Their first in vivo procedure was video recorded and submitted to a blinded panel of independent experts after the panel established a minimum inter‐rater reliability of 80 percent. The recordings were reviewed by using a standardized computer‐assisted method and customized metrics. Results were analyzed with the Mann‐Whitney U test. Internal rater consistency was verified with Pearson moment correlation.ResultsCompletion time was significantly shorter in the experimental group (injection P = 0.003, dissection P < 0.001), which, according to the rater panel, also demonstrated higher confidence (P = 0.009), demonstrated skill during instrument manipulation (P = 0.011), and made fewer technical mistakes during the injection task (P = 0.048) compared with the control group. The raters' post hoc internal consistency was deemed adequate (r > 0.5 between serial measurements).ConclusionThe validity of the ES3 as an effective surgical trainer was verified in multiple instances, including those not depending on subjective rater evaluations. The ES3 is one of the few virtual reality simulators with a comprehensive validation record. Advanced simulation technologies need more rapid implementation in otolaryngology training, as they present noteworthy potential for high‐quality surgical education while meeting the necessity of patient safety.