bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Epley and Semont Maneuvers to Treat Benign Paroxysmal Positional Vertigo
Authors: Duarte Juliana Antoniolli , Palombo Alexandre , Dorigueto Ricardo Schaffeln , Gananca Fernando Freitas , Chen Vitor Guo 
Published: September 2011

ObjectiveCompare the efficacy of Epley and Semont maneuvers to treat benign paroxysmal positional vertigo (BPPV).MethodRetrospective study conducted by analysis of medical records of 139 patients with a diagnostic hypothesis of ductolithiasis of posterior semicircular canal. Patients were treated by maneuvers repeated weekly until the abolition of nystagmus.ResultsIt took an average of 1.29 Epley maneuvers and 1.13 Semont maneuvers to eliminate the positional nystagmus (P =. 086).ConclusionSemont maneuver tended to a lower average number of therapy sessions.
Radical Parotidectomy: Reconstruction and Facial Reanimation
Authors: Ramos Nadia Hassamo , Alexandre Carlos , Antunes Luis 
Published: September 2011

Objective1) Report a viable reconstructive alternative after parotid gland mucoepidermoid carcinoma resection, rendering a large facial defect and facial nerve paralysis. 2) Demonstrate the combination of temporalis muscle pedicled flap and microvascular fasciocutaneous radial forearm flap, fulfilling 3 purposes: bulk restitution, facial paralysis reanimation, and adequate skin replacement for acceptable aesthetics.MethodFacial defect was left after radical parotidectomy with facial nerve sacrifice, as well as masseter muscle, mandibular periosteum, and skin removal. Reconstruction of the large defect was achieved recurring to temporalis muscle transposition combined with fasciocutaneous radial forearm flap. Facial artery and vein were used for microvascular sutures.ResultsThe necessity of the head and neck surgeon to make aggressive interventions has enabled the usage of flaps for reconstruction of significant facial defects. Satisfactory results require careful 3‐dimensional thought, adequate texture matching as well as functional restoration. The results showed that temporalis muscle transposition was a successful method for bulk restitution and reanimation of permanent facial paralysis in the resting position, including both eyelid and mouth, by tension provided to orbicularis ori and orbicularis oculi muscles. Fasciocutaneous radial forearm flap provided the best possible tissue color and contour restoration of skin due to its thin, pliable tissue.ConclusionRadial forearm flap and temporalis muscle transposition combined offered a viable reconstructive option after radical parotidectomy resulting in acceptable aesthetic and functional outcomes. Radial forearm flap was a good choice for skin restoration. Temporalis muscle transposition proved to be adequate both for bulk restitution as for reanimation of facial paralysis.
Do‐It‐Yourself Grommet
Authors: Maung Kyaw Htin , Stafford Nicholas D , Tun Thein 
Published: September 2011

ObjectiveIn the absence of a health care budget enabling the import of ready‐made aural grommets, Myanmar (Burma) ENT surgeons have come up with an ingenious home‐grown solution. We describe how they make their grommets from raw materials, bought from the local market.MethodA polythene tube is cut into 7.5 mm sections. Each piece is mounted on the tip of a 21‐gauge needle, gently touched against the side of a flame, partially melted, and rolled leading edge while maintaining lumen. The tube is turned around, and the process is repeated.ResultsIt takes less than 3 minutes to make a grommet. As many as are required can be made instantly. Any defective grommet is discarded. Newly made grommets are threaded onto the needle and placed in a sterilizing solution for future use. Myanmar Audit data showed the average in‐situ life for the grommets ranged between 6 to 10 months. Incidence of otorrhea and persistent perforation after grommet extrusion are 5% and 3% respectively.ConclusionLocal audit data confirms that these grommets are safe to use. In Myanmar (Burma), annual per capita spending on health care is $394 (2.8% of GDP). As survival and functionality are the main priorities, obviously there have not been any randomized controlled trials so far for clinical effectiveness.
Dysphonia and Hearing Loss: A Cross‐sectional Analysis
Authors: Bush Carrie , Postma Gregory , Weinberger Paul M. , McKinnon Brian J. 
Published: September 2011

ObjectiveAlthough multiple theories in the past have linked hearing loss to dysphonia, clear evidence of an association is lacking. It is well known that both hearing loss and dysphonia contribute to decreased quality of life. The objective of this study is to elucidate the association of hearing loss with dysphonia.MethodPatients presenting with hearing loss from March 2007 to present were included. All patients underwent formal audiologic testing and completed the Voice Handicap Index ‐ 10 (VHI‐10) survey. SPSS 13.0 software was then used to interrogate all gathered data. Statistical analysis was performed using the Mann‐Whitney test.ResultsA total of 48 patients are enrolled in the study to date. Fourteen of these patients were noted to have normal speech reception threshold on audiogram. Nineteen patients were noted to have a speech reception threshold consistent with mild hearing loss, 8 patients had a moderate hearing loss, and 7 patients had a severe hearing loss. On statistical analysis there was a trend toward association of hearing loss (P <.2) and dysphonia. Among groups of patients, those with moderate loss were noted to have the highest VHI‐10 scores (P =. 1).ConclusionAt present, there is no statistically significant association with hearing loss and dysphonia in our study. Interestingly, there is a trend toward an increased VHI‐10 score in patients with hearing loss, most notably in patients with moderate hearing loss. Continued patient enrollment will improve statistical power.
Efficacy of Diffusion‐Weighted Magnetic Resonance Imaging in Middle Ear Cholesteatoma
Authors: Suzuki Mikio , Kyuuna Asanori , Meda Hiroyuki , Ganaha Akira 
Published: September 2011

ObjectiveEvaluate the usefulness of diffusion‐weighted magnetic resonance imaging (DWI) in the diagnosis of middle ear cholesteatoma.MethodWe performed DWI on 73 patients suspected of having middle ear cholesteatoma, including 21 revision cases. Magnetic resonance imaging was performed with 1.5 T units using diffusion‐weighted spin‐echo‐type echo planar imaging.ResultsOf 73 participants, 59 had cholesteatoma. Positive DWI findings were observed in 42 subjects and negative findings in 31 subjects. The sensitivity, specificity, and positive and negative predictive values of DWI for cholesteatoma were 69.4%, 92.8%, 97.5%, and 41.9%, respectively. In the case of 34 patients who were positive for cholesteatoma on both otoscopic and CT examinations, 33 were diagnosed with cholesteatoma. Of the remaining 39 subjects with one or both negative results for cholesteatoma, the sensitivity, specificity, positive predictive value, and negative predictive value of DWI were 57.6%, 92.3%, 93.7%, and 52.1%, respectively.ConclusionSince DWI clearly showed high specificity and positive predictive value, it is useful for diagnosing middle ear cholesteatoma, including postoperative recurrent cholesteatoma of 5 mm diameter or larger. DWI could sufficiently detect cholesteatoma with one or both negative results on otoscopic and CT examinations.
Regional Flap Reconstruction of a Neck Defect in an Infant
Authors: Scott Andrew R. , Parekh Anish , Vecchiotti Mark A. , O’Leary Miriam A. 
Published: September 2011

Objective1) Describe the use of a lower island trapezius myocutaneous flap to reconstruct a large posterior neck and occiput wound in an 18‐month‐old child. 2) Review prior uses of regional myocutanous flaps for soft tissue reconstruction in infants and small children.MethodCase report and literature review.ResultsWhile there is an increasing body of literature documenting the safe and effective use of free tissue transfer in the pediatric age group, there is little published on the use of regional myocutaneous flaps for reconstruction of larger ablative defects. We report on the use of a lower island trapezius myocutaneous flap to reconstruct a large posterior neck and occiput wound in an 18‐month‐old child. The case is described in detail and the literature reviewed.ConclusionTechniques for regional reconstruction of large neck defects in infants have not been widely described. The lower island trapezius myocutaneous flap allowed for transfer of a large volume of skin and soft tissue, improving functional outcome and limiting development of scar contracture.
Evaluation of a New Coupler for the Floating Mass Transducer
Authors: Yamada Hiroyuki , Goode Richard L. 
Published: September 2011

ObjectiveOptimal placement is an important factor in the acoustic performance of the Vibrant Soundbridge Floating Mass Transducer (FMT) in the round window niche (RW). The purpose of this study was to evaluate the acoustic performance of a new modified FMT designed to optimally contact the RW.MethodTesting of the modified FMT without fascia and with fascia between the RW membrane and the device was performed in six human temporal bones. A small hole was made on the promontory to expose the endosteum. Cochlear fluid displacement was measured through the hole using a laser Doppler vibrometer.ResultsThe mean cochlear fluid response of the FMT placed on the RW without fascia was equivalent to a 76.3 to 111.6 dB SPL input at the tympanic membrane at 0.5 to 8.0 kHz. The mean cochlear fluid response of the FMT placed on the RW with fascia produced a response of 87.5 to 119.1 dB SPL at the same frequencies. There was a tendency for the FMT placed on the RW with fascia to provide better transmission at several frequencies between 0.5 and 8.0 kHz than without fascia. However, this did not reach statistical significance.ConclusionIn this temporal bone model, the modified FMT placed on the RW provide similar and reasonable performance both with and without fascia in the RW niche. It appears superior to a conventional FMT used in the RW and is easier to insert.
Facial Schwannoma Treatment via Cyberknife or Decompression
Authors: Herman Bjorn S. , Zeitler Daniel M. , Telischi Fred F. , Channer Gyan A. , Angeli Simon I. 
Published: September 2011

ObjectiveMicrosurgical excision of facial nerve schwannomas frequently results in facial paresis or paralysis of House‐Brackmann Grade III or higher. This study’s objectives are: 1) describe alternatives to microsurgical excision of facial nerve schwannomas, specifically wide fallopian canal decompression and Cyberknife radiosurgery; and 2) describe clinical outcomes of these alternative therapies.MethodThis is a case‐control study of all patients undergoing excision, wide fallopian canal decompression, or Cyberknife radiosurgery at a tertiary academic referral center between 2002 and 2011. Main outcome measures were pre‐ and posttreatment facial nerve function, tumor control, and speech reception thresholds.ResultsEleven patients were identified (3 wide decompression, 2 Cyberknife treated, 4 observation, and 2 microsurgical excision), and mean posttreatment follow‐up was 35 months. When compared with excision, all of the cases undergoing nonexcision treatments resulted in facial nerve function stable or improved, no tumor growth, and no changes in speech reception thresholds.ConclusionWhile surgical excision of facial nerve schwannomas may be indicated in cases of poor facial function and impending complications, wide bony decompression, observation, and Cyberknife radiosurgery should be considered as alternative treatments to excision for patients with normal or good facial function who wish to maintain preoperative hearing thresholds.
Fascial and Periosteal Flaps for Postoperative Otitis Media
Authors: Yabe Tako 
Published: September 2011

ObjectiveIt is very important to maintain a stable reconstructed posterior canal wall in the posterior canal wall reconstructed tympanoplasty for the postoperative chronic otitis media (OM) case. The authors treat reconstructed posterior canal wall with the temporal fascial flap (TFF) and the temporal periosteal flap (TPF).MethodIn order to investigate the blood supplies of TFF and TPF, we employed Laser Doppler blood flow meters and measured that in 15 cases of postoperative chronic otitis media.ResultsBoth blood supplies were comparatively well, and TFF’s blood supplies were statistically better than those of TPF.ConclusionThese findings suggested that the TFF and TPF were reliable sources of local well‐vascularized tissue to be extremely pliable and facilitate creation of a stable posterior canal wall in the case of postoperative OM.
Hearing Loss and Cochlear Pathology in a Type II Diabetic Mouse Model
Authors: Miller Sean , Boettcher Flint , Phillips Grady , Anne Gratton Michael 
Published: September 2011

Objective1) Determine whether a type II diabetic mouse model demonstrates hearing loss. 2) Examine cochlear ultrastructure of a type II diabetic mouse model for evidence of pathology.MethodThe Leprdb/Leprdb (db/db) mouse has a leptin receptor point mutation which manifests as polyphagia, hyperglycemia, and obesity, mimicking type II diabetes. Db/db and wild type mice from the parent strain underwent auditory brainstem response measurements followed by cochlear ultrastructure analysis using scanning and transmission electron microscopy.ResultsAt 12 weeks of age, the mutant animals demonstrate a profound hearing loss from 8 to 32 kHz, which is in contrast to published data of a 10 dB shift at 8 kHz and 30 dB shift at 16 to 32 kHz for age‐matched, wild type C57BL/6J counterparts. In addition, fine structure analysis reveals evidence of morphological alterations in multiple locations within the cochlea, including loss of neuron density in the spiral ganglion, stria vascularis edema, and endothelial abnormalities within strial capillaries. Age‐matched controls are without similar ultrastructural changes. Scanning electron microscopy reveals no evidence of hair cell loss or other identifiable abnormalities.ConclusionThis is the first demonstration of cochlear pathophysiology in a genetically derived type II diabetic mouse model. Use of the db/db mouse provides an opportunity to investigate the underlying mechanism of type II diabetes associated hearing loss.
Hearing Outcomes in Canal Wall Down Mastoidectomy with Cartilage Tympanoplasty
Authors: Thorpe Eric , Marzo Sam J. 
Published: September 2011

Objective1) Measure the overall postoperative hearing after both canal wall down mastoidectomy and cartilage tympanoplasty. 2) Assess the air‐bone gap postoperatively in patients after both canal wall down mastoidectomy and cartilage tympanoplasty.MethodA retrospective review of all patients who underwent canal wall down mastoidectomy with a cartilage tympanoplasty during the time period of 2000 to 2010. Cases of the appropriate surgery were chosen by operative reports. Indications for surgery largely included cholesteatoma, chronic otitis media, or both.ResultsA total of 39 patients were found to have the procedure in question with 30 patients having full audiograms for review. Pre‐ and postoperative pure tone averages (PTA) along with air‐bone gaps (ABG) were reviewed at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz. Postoperative PTA showed an improvement of 7.2 dB over preoperative PTA. Postoperative ABG showed an improvement of 4.53 dB over preoperative ABG. The ABG improvement was found to be statistically significant with a P value of. 0285.ConclusionThe results of this study demonstrate that hearing results following a canal wall down mastoidectomy along with a cartilage tympanoplasty not only have acceptable hearing results but also actually show an improvement over preoperative audiological function.
High and Ultra High Hearing Loss in Tinnitus Patients
Authors: Yeo Sang‐Won , Bae Seong‐Cheon , Park Kyong‐Ho , Park Shi‐Nae 
Published: September 2011

ObjectiveInvestigate the incidence of high‐ (>2 kHz; HFHL) and ultra‐high‐frequency (>8 kHz; UHFHL) hearing loss in tinnitus patients with subjectively normal hearing, and to evaluate their effects on the clinical and audiological features of the patients.MethodThe sample included 85 patients with sensorineural tinnitus who had normal hearing sensitivity in frequencies from 250 Hz to2 kHz, and who had received extended high‐frequency audiometry between July 2009 and February 2010. We investigated the incidence of HFHL and UHFHL in the subjects and analyzed their significance.ResultsThe incidence of HFHL and UHFHL in the subjects was 88%. The proportion of patients with UHFHL, in the subjects who had normal hearing sensitivity up to 8 kHz, was about 74%. The patients with normal hearing sensitivity at all test frequencies were significantly younger and had greater otoacoustic emission responses, and mean loudness of tinnitus as measured by tinnitus matching was significantly lower than the patients with HFHL and UHFHL. However, other analysis about clinical aspects of HFHL and UHFHL did not show any significance.ConclusionEven if the patients with tinnitus do not feel any hearing impairment subjectively, most of them have high‐ and ultra‐high‐frequency hearing loss. But their effects on the clinical features of the patients are vague.
Improvement in Hyperacusis with Tinnitus Retraining Therapy
Authors: Thong Jiun Fong , Wong Mei Ching , Junaidah S. , Chan Yew Meng 
Published: September 2011

ObjectiveDecreased sound tolerance and hyperacusis are frequently found in patients who complain of tinnitus. This study aims to investigate the efficacy of Tinnitus Retraining Therapy (TRT) in patients with hyperacusis.MethodProspective study of patients with hyperacusis presenting to the tinnitus clinic in a tertiary referral otorhinolaryngology unit. Hyperacusis was confirmed with loudness discomfort level (LDL) measurements. Audiometry was performed in all patients. Improvement of hyperacusis following TRT was measured by structured interview with aid of questionnaires and visual analogue scores.ResultsA total of 197 patients were studied. Improvement was achieved in 39%. Environmental sound (70%), Viennatone broadband noise generator (18%) and Marsona sound generator (5%) were used. 18% had hearing aids (HA) fitted even though 73% had hearing loss. Patients who opted for HA complained of worse effects of hyperacusis on life. Age, gender, and presence of hearing loss were similar in patients who did and did not improve. Duration of treatment was longer in patients that improved (P <. 01). Improvement with Viennatone was significantly higher than with environmental sounds alone (49% vs 35%, P <. 05), especially when used in presence of hearing loss (61%).ConclusionModest proportion of patients with hyperacusis improved with TRT. Use of broadband noise generators and longer duration of therapy appear to give better success rates. Overall success of TRT in patients with hyperacusis may also be related to underlying medical problems such as thyroid conditions and multiple sclerosis.
Influence of VA Hemodynamics on Orthostatic Vertigo
Authors: Sawai Yachiyo , Hosoi Hiroshi , Fujita Nobuya , Yamanaka Toshiaki 
Published: September 2011

ObjectiveOrthostatic vertigo (OV) is believed to occur because of hypoperfusion of the brain with orthostatic decrease in blood pressure (BP). We investigated the relationship between the orthostatic hypotension (OH) and orthostatic decrease in vertebral artery blood flow velocity (VAFV) in order to determine whether these 2 factors could trigger OV.MethodIn 251 subjects, BP and extracranial doppler sonography spectrum of the VA were recorded in the supine and standing positions. Subjects were categorized into the OH and non‐OH groups, and the orthostatic decrease in VAFV in patients with and without OV was evaluated in each group.ResultsThe OH and non‐OH group comprised 40 and 211 patients, respectively. The OH group included 29 patients with OV and 11 patients without OV. The non‐OH group included 150 patients with OV and 62 patients without OV. In the OH group, the OV patients exhibited a marked orthostatic decrease in VAFV as compared with those without OV. In the non‐OH group, the orthostatic decrease in VAFV was significantly greater in OV patients than in those without OV.ConclusionOur results suggest that decrease in VAFV induced by standing could trigger OV, irrespective of OH status.
Is Mastoid Pressure Dressing Necessary?
Authors: Okur Erdogan , Aycicek Abdullah , Altuntas Ali , Isikli Huseyin , Yidiz Huseyin , Cem Miman Murat , Kahveci Orhan K. 
Published: September 2011

ObjectiveAssess whether mastoid pressure dressing is necessary after ear surgery to prevent complications such as hematoma or protruding ear.MethodThirty‐seven patients were included in the study. Of the 37 patients, 17 were in the mastoid dressing group and 20 were in the no‐mastoid dressing group. We measured the distance from mastoid scalp to helix rim at the most posterior level of upper auricular rim in the operated and non‐operated ears.ResultsFor mastoid to helix distance of the operated ears of the patients, there was no statistically significant difference between the mastoid dressing group and the no‐mastoid dressing group. We found a significant difference for the measured distance between operated and nonoperated ears of the mastoid dressing group, the mean value of distance in the operated ears being lower than that in the nonoperated ones (P >. 05).ConclusionThis study showed that mastoid to helix distance did not change significantly when the mastoid dressing was not applied, while mastoid dressing seemed to decrease the mastoid‐to‐helix distance. For his reason, the application of a mastoid pressure dressing following ear surgery seems to be unnecessary and may contribute to increased wound morbidity.
Lower Cranial Nerve Function Following Jugular Foramen Tumor Resection
Authors: Porter Ryan G. , Chan David , Ravindra Vijay M. 
Published: September 2011

ObjectiveDescribe the presentation, tumor characteristics, and postoperative lower cranial nerve function following surgery for jugular foramen tumors.MethodThirty jugular foramen tumor resections performed between 1989 and 2009 were reviewed. The mean age was 48.2 years (range, 18.6‐77.7 years) at time of presentation. Surgical approaches included infratemporal fossa (70%), retrosigmoid (23%), transtemporal (20%), transcondylar (17%), and transcervical (17%). The mean follow‐up was 4.6 years.ResultsCombined surgical approaches were used in over 50% of the cases, and 60% underwent preoperative tumor embolization. Tinnitus was the most common presenting symptom, and middle ear or neck mass was the most common presenting sign. The most common diagnosis was paraganglioma. Six patients required tracheotomy, and 8 had feeding tubes at discharge. Fifty‐seven percent of patients underwent speech or swallow therapy, 43% were treated with vocal cord injections, and 17% underwent medialization thyroplasty. Cerebrospinal fluid leak was uncommon (13%), and meningitis occurred in 1 patient. Normal or near‐normal facial nerve function was maintained in 89% of patients.ConclusionResection of jugular foramen tumors carries a significant risk of lower cranial nerve dysfunction; however, long‐term speech, airway, and swallowing morbidity can be minimized with contemporary ancillary surgical procedures.