bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Erdosteine against Cisplatin‐Induced Ototoxicity
Authors: Waissbluth Sofia , Dupuis Isabelle , Daniel Sam J. 
Published: September 2011

ObjectiveCisplatin is a commonly used chemotherapeutic agent. One of its major dose limiting side effects is ototoxicity. No treatment has yet been approved for this condition. The objective of this study was to determine the potential protective effect of a systemic administration of erdosteine against cisplatin‐induced ototoxicity.MethodGuinea pigs were assigned to 4 groups, each receiving a different concentration of intraperitoneal erdosteine: 0, 100, 200, and 500 mg/kg/d for 4 days. All of the animals received 12 mg/kg/d of intraperitoneal cisplatin. Auditory brainstem response (ABR), scanning electron microscopy, and outer hair cell counts were performed.ResultsSignificant otoprotection was observed in groups receiving 200 and 500 mg/kg/d of erdosteine as demonstrated by high frequency (25 kHz) ABR threshold shifts. These findings are supported by outer hair cell counts by scanning electron microscopy. Guinea pigs receiving 100 mg/kg/d did not present otoprotection.ConclusionA systemic administration of erdosteine appears to provide a significant otoprotective effect at the basal area of the cochlea for cisplatin‐induced ototoxicity in a guinea pig model.
The EarLens Photonic Transducer: Extended Bandwidth
Authors: Perkins Rodney C. , Fay Jonathan , Nilsson Michael J. , Puria Sunil , Levy Suzanne P. C. 
Published: September 2011

ObjectiveLight pulses transmitted through the external auditory canal are captured by a photodetector on a tympanic membrane contact transducer creating a current, which activates a micro‐motor. The hypothesis that an extended bandwidth (10 kHz) contact transducer residing on the tympanic membrane will improve speech understanding in noise is tested.MethodReception thresholds of sentences (RTS) were measured with target speech at ‐45° and two talkers at +45°, simulating a photonic transducer on (1) normal and (2) hearing‐impaired subjects. HINT sentences and masking speech materials were recorded at 24‐kHz bandwidth and low‐pass filtered at 4, 6, 8, and 10 kHz.ResultsFor normal hearing subjects (n = 12), the mean RTS was ‐17.4, ‐19.1, ‐19.3, and ‐20.7 dB for 4, 6, 8, and 10 kHz respectively. For hearing impaired subjects (n = 12), the RTS unaided full bandwidth was ‐10.0 dB and ‐10.0, ‐11.9, ‐12.2, and ‐12.4 dB for aided 4, 6, 8, and 10 kHz respectively. The results indicate significant improvements of 3.3 dB (P <. 001) in normal hearing and 2.4 dB (P =. 02) for hearing impaired subjects for the 10 kHz vs the 4 kHz bandwidths. Initial measurements with the IDE‐approved photonic hearing device are consistent with the simulation study.ConclusionThe results suggest that acoustic cues above 4 kHz in a hearing device can greatly enhance the ability to hear target speech in noisy environments. This opens up possibilities for a unique hearing system using only light to transmit sound to vibrate the tympano‐ossicular system.
The Efficacy of a Vibrotactile Neurofeedback Training in Stance and Gait Conditions for the Treatment of Balance Deficits
Authors: Basta Dietmar , Ernst Arne 
Published: September 2011

ObjectiveConventional vestibular rehabilitation strategies mostly require a long lasting intensive training and are not successful in many patients. Newly developed neurofeedback training procedures seem to be more effective. The present study was aimed at investigating the efficacy of a new vibrotactile neurofeedback method for the treatment of vestibular disorders.MethodOne hundred and five patients with a peripheral or central vestibular disorder performed neurofeedback training in stance and gait tasks with the Vertiguard‐RT device (2 weeks, 10 min/d). The patients received a feedback signal at the hip in that direction, which showed a higher body sway than the preset threshold.ResultsThe mean reduction of sway was 30.0% in pitch and 31.0% in roll direction. Significant improvements were also observed in platform stability measurements (composite score of the Sensory Organization Test) and in the Dizziness Handicap Inventory/Vertigo Symptom Scale. No significant changes occurred in the double blinded placebo group.ConclusionThe present data shows that the vibrotactile neurofeedback method improves the balance in everyday‐life conditions significantly with minimal efforts for the patients. The method seems to be well suited for home or group training since the tasks are easy and all relevant values are stored in a small body‐worn device.
The Efficacy of Ear Canal Irrigations with Isopropyl Alcohol
Authors: Silverstein Herbert , Van Ess Mark J. , Wycherly Benjamin , Alameda Yadiel A. 
Published: September 2011

ObjectiveTo assess the efficacy and safety of 70% isopropyl alcohol (IPA) as a weekly irrigant to reduce cerumen accumulation, using a unique closed tip irrigator bottle.MethodProspective crossover study. Forty ears randomly divided into 2 groups. Group 1 instilled IPA weekly for 2 months, followed by 2 months of no cleaning. Group 2 did the opposite. Cerumen occlusion graded 0 to 4 (0%, 25%, 50%, 75%, 100%) followed by cerumenectomy at 0, 2, and 4 months.ResultsThe mean grade at the initial evaluation in Group 1 was 3.1 (range, 2‐4) and in Group 2 was 3.3 (range, 3‐4) (P =. 33). After the first 2 months, there was a significant difference between those who used the IPA (Group 1) vs those who did not (Group 2) (P <. 0002). There was also a significant difference within both groups between using the IPA for 2 months and not cleaning for 2 months (P <. 02 Group 1, P <. 01 Group 2). All subjects tolerated IPA with no complaints or side effects, and there were no cases of canal irritation.ConclusionWeekly irrigation with 70% IPA is safe and reduces the accumulation of cerumen in the external auditory canal. Routine use of IPA may decrease the number of patient visits for cerumen related issues.
The New Baha Implant: A Prospective Osseointegration Study
Authors: D’Eredita Riccardo 
Published: September 2011

ObjectiveAssess stability of a new design titanium implant (Cochlear Baha BI300) in bone anchored hearing aid (Baha) recipients over time in a prospective, nonrandomized, one‐group study at a tertiary care institution.MethodTwelve patients who underwent one‐stage Baha surgery over 4 months have been analyzed. Implant stability was measured with Implant Stability Quotient (ISQ) measurement tests. Patients were tested at surgery and every week after, for 1 year. Two‐tailed Student test was calculated for all comparisons. P <. 05 was considered significant.ResultsThe new implant showed a steep increase of ISQ values over the first 2 weeks and reached stable ISQ values 3 weeks after surgery. No significant difference on ISQ values was evident between children and adults. Complete healing time was obtained in 8 days on average (range, 7‐12 days; median, 7.6). Neither implant extrusion nor skin revision surgery was observed in our patients during the first year of follow‐up.ConclusionIn our hands this new implant revealed stability and fast integration. The data from the present study suggest the new implant may be suitable for early loading protocols.
Maximum Extremes in Otolaryngology Resident Surgical Case Numbers
Authors: Rosenberg Tara L. , Franzese Christine B. 
Published: September 2011

Objective1) Understand the significance between the mean and maximum case numbers for surgical procedures among otolaryngology residents nationwide. 2) Understand potential weaknesses of the ACGME resident case log system and possible errors contributing to case inflation. 3) Understand when excessive case load transforms education into service.MethodRetrospective review of otolaryngology resident national data reports from the ACGME resident case log system for 6 academic years (2004‐2010). Maximum, mean, and standard deviation about the mean for total number of cases and for specific surgical procedures were compared. Tracked CPT codes, “unbundling,” and mechanisms for data entry were reviewed.ResultsThe total case numbers for residents graduating from 2005 to 2010 remained fairly constant and ranged from a mean of 1699.5 ± 424.2 in 2007 to 1772.2 ± 517 in 2010. The maximum value for total number of cases increased from 3559 in 2007 to 4857 in 2010, and these values surpass the mean by 5 to 6 standard deviations in most years. Comparison of case numbers for other procedures such as parotidectomy, thyroidectomy, mastoidectomy, and endoscopic sinonasal surgeries, among others, yielded similar results.ConclusionLarge differences between mean and maximum case numbers for resident surgical procedures exist and are expanding. Educational benefit derived from such excessive case load, if accurate, is unclear. Critical examination of the ACGME resident case log system and investigation of resident case log documentation habits are needed to improve accuracy.
Visualization of Endolyphatic Hydrops in Patients with Ménière’s Disease by Locally Enhanced Inner Ear MRI: Correlation with Audiovestibular Function
Authors: Gürkov Robert , Louza Julia , Strupp Michael , Flatz Wilhelm , Krause Eike 
Published: September 2011

ObjectiveThe pathophysiologic role of endolymphatic hydrops in Ménière’s disease is still unresolved. The aim of this study was to determine whether the degree of endolymphatic hydrops as it is detected in vivo in patients with definite Ménière’s disease correlates with audiovestibular function.MethodIn this prospective study, 37 patients with definite Ménière’s disease were examined with intratympanic contrast enhanced temporal bone MRI. The degree of hydrops was then compared with hearing levels, SP/AP ratios, interaural amplitude ratios of vestibular evoked myogenic potentials and horizontal semicircular canal paresis.ResultsThere was a significant correlation between the degree of hydrops on the one hand and the averaged hearing level at 0.25 to 1 kHz and 0.5 to 3 kHz (r = 0.71, P <. 01) and the vestibular evoked myogenic potential interaural amplitude ratio (r = ‐0.44, P <. 05) on the other hand. A trend toward a correlation was found between the hydrops and the caloric response; no correlation was found between the hydrops and the SP/AP ratio.ConclusionThe degree of endolymphatic hydrops correlates with a progressive loss of auditory and sacculus function in patients with Ménière’s disease.
Water‐Soluble Coenzyme Q10 in Chronic Hearing Loss
Authors: Guastini Luca , Crippa Barbara , Mora Francesco , Salzano Francesco‐Antonio , Mora Renzo , Santomauro Valentina 
Published: September 2011

ObjectiveQ‐TER is a multicomposite water‐soluble formulation of CoQ10; in particular, Q‐TER consists of a mixture of maltodextrin, acting as a carrier, of CoQ10 molecules of sucrester, which serves as bioactivator. The purpose of this study was to evaluate the efficiency of Q‐TER in subjects with chronic sensorineural hearing loss.MethodA total of 80 patients affected by chronic sensorineural hearing loss were included. The patients were divided, at random, into 2 numerically equal groups (A and B). Group A underwent therapy with Q‐TER, 160 mg, once a day for 30 days; group B received placebo, once a day for 30 days.ResultsBefore, at the end, and 6 months after the end of the treatment, all patients underwent: pure tone audiometry, transient evoked otoacoustic emissions (TEAOE) and otoacoustic products of distortion (DPOAE), auditory brainstem response and speech audiometry. Compared with group B, at the end of the treatment in group A the pure tone audiometry showed a significant (P <. 05) improvement of the audiometric thresholds at the 1.000, 2.000, 4.000, and 8.000 Hz. This improvement was confirmed by the data obtained with the speech audiometry and in the last check. We found no significant differences in the others parameters and in group B.ConclusionIt is quite early to be enthusiastic. There must be more studies with controlled results. However, this kind of therapy for chronic hearing loss seems to be interesting, especially to stop hearing decay. It is also remarkable that good results are found one month after the beginning of the treatment.
Anatomic Variants on Congenital Computed Tomography in Congential Aural Atresia
Authors: Dedhia Kavita , Egloff Ann Marie , Branstetter Barton , Yellon Robert F. 
Published: September 2011

ObjectiveReport incidence of anatomic variants in temporal bone CT scans with congenital aural atresia (CAA) or external auditory canal stenosis (EACS). Anatomic variants include: inferiorly displaced tegmen, malleus/incus complex (MIC) directly lateral to stapes, facial nerve obstruction at oval window (OW) and middle ear, middle ear area, incudostapedial (IS) joint angle.MethodProspective anatomic study of 134 CT scans (102 children, 32 bilateral) of CAA/EACS, graded by a blinded neuroradiologist. Both Jahrsdoerfer and absence or presence of new/refined anatomic considerations were graded. There were 32 atresiaplasty and 70 nonsurgical patients. Surgical and audiological data were reviewed retrospectively for anatomic correlations related to outcomes.ResultsPrevalence of anatomical variants: inferiorly displaced tegmen X (X%), MIC directly lateral to stapes Y (Y%), facial nerve obstructed access to oval window Z (Z%), and middle ear B (B%). Large MIC obstructing stapes access (5/7 patients) with increased intra‐operative difficulty. Mean middle ear area DD (range, 0.07 to 0.86mm2) and mean IS joint angle FF (range, 50°‐147°). Trend toward improved outcomes with: normal tegmen, facial nerve favorable to OW, or non‐obstructing MIC. No statistically significant clinical correlations for anatomic factors including Jahrsdoerfer grading.ConclusionLarge obstructing MIC increases the difficulty of atresiaplasty. There is a trend showing improved outcomes with normal tegmen, facial nerve favorable to oval window, or nonobstructing MIC. A larger atresiaplasty cohort is needed since the number of cases was insufficient to demonstrate statistical significance. Nonetheless, the frequency of these new/refined anatomic variants has been more clearly delineated. The presence of these anatomic variants may possibly influence the decision for or against atresiaplasty.
Free Tissue Transfer for Cranio‐orbitofacial Defects
Authors: William John Caroline M. , Schaheen Basil , Krein Howard , Curry Joseph , Heffelfinger Ryan 
Published: September 2011

Objective1) Examine the outcomes and complications from a single institution experience with free tissue transfer for craniofacial defects involving the orbit. 2) Discuss an algorithm for free flap reconstruction of the orbit and peri‐orbital structures.MethodA review of 42 patients who underwent free flap reconstruction for orbital or peri‐orbital defects between September 2006 and January 2011 was performed at a tertiary care facility. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow‐up.ResultsForty‐four cases were identified; thirty‐five required orbital exenteration. Periorbital defects included those resulting from significant soft tissue or bony removal from the midface, scalp, or skullbase. We present an algorithm for management of such defects. Free flaps used included anterolateral thigh (31), radial forearm (10), latissimus (2), and rectus abdominus (1). Additional reconstructive techniques were performed concurrently in 23 cases, and 4 patients required revision procedures. Fifteen (36%) patients experienced a complication with flap loss occurring in 2 (4.8%). Mean hospital stay and duration of follow‐up were 9.9 days and 13 months, respectively.ConclusionFree tissue transfer allows for the safe and effective reconstruction of complex defects of the orbit and periorbital structures. Reconstructive choice is dependent upon the extent of soft tissue loss, midfacial bone loss, and skullbase involvement. The anterolateral thigh provides a versatile option to reconstruct the many cranio‐orbitofacial defects encountered.
Outcomes of Balloon Dilation of Pediatric Subglottic Stenosis
Authors: Howell Rebecca Jackson , Whigham Amy S. , Zalzal George H. , Pena Maria T. , Choi Sukgi S. , Preciado Diego A. 
Published: September 2011

Objective1) Report outcomes of balloon dilation in the endoscopic management of pediatric SGS. 2) Determine the role of balloon dilation in both primary vs adjuvant therapy.MethodRetrospective review of treatment with noncompliant, high‐pressure balloons for SGS in the past 2 years at a tertiary pediatric hospital. Fifty‐one dilations in 28 children with SGS were performed. Mean age was 39.2 months. Mean SGS grade was 2.40.ResultsOverall, 18 (64.2%) had successful balloon treatment. Fifteen children had primary and 13 had secondary balloon dilation. Those with primary, 10 (66.6%), were able to avoid open reconstruction/tracheotomy, and 5 were temporized (36 days average) until definitive open reconstruction. Those with secondary, 9 (69.2%), were able to decannulate. Eight of 10 failed balloon dilations had concomitant airway pathologies, compared with only 6 of 12 where treatment was successful (P =. 02). There was no statistical association in successful vs failed treatment by age (49.6 vs 29.3, P =. 43), degree of stenosis (2.39 vs 2.60, P =. 41), presence of lung disease (33.3% vs 70%, P =. 07) or soft nature of stenosis (61.1% vs 40%, P =. 28).ConclusionBalloon dilation plays an important role in the primary or adjuvant management of pediatric SGS. Presence of concomitant airway lesions is significantly associated with balloon dilation treatment failure. Meticulous surveillance of the dilated airway is necessary given this failure rate.
Patient and Family Satisfaction in a Pediatric Otolaryngology Clinic
Authors: Zopf David A. , Thorne Marc C. 
Published: September 2011

ObjectiveIdentify factors related to patient and family satisfaction in an academic pediatric otolaryngology clinic. Suggest strategies to improve patient and family satisfaction in this setting.MethodReview of an ongoing continuous quality improvement (CQI) effort. Patients/families were surveyed following each visit between May and December 2010. Linear and multiple linear regression were used to evaluate relationships between wait times in the reception area and examination room, assessment of the provider, and clinic volume with overall satisfaction.ResultsDuring the study interval, 754 clinical encounters in the pediatric otolaryngology clinic resulted in 528 responses for a response rate of 70%. Linear regression showed a significant relationship between each of the independent variables and overall satisfaction, with the greatest variance in overall satisfaction explained by satisfaction with the provider, followed by wait time in the examination room, wait time in the reception area, and clinic volume (r2 0.53, 35, 26,. 01, respectively). Multiple linear regression showed that clinic volume was not associated with overall satisfaction independent of the other variables.ConclusionVariations in satisfaction with the provider accounted for the greatest amount of variance in overall satisfaction. The identification that variation in examination room wait times explained a larger portion of the variance in overall satisfaction has led to efforts to minimize this aspect of the patient and family experience.
Pediatric Diadochokinetic Rates: Establishing a Normative Database
Authors: Maturo Stephen C. , Hill Courtney , Hartnick Christopher J. , Bunting Glenn 
Published: September 2011

Objective1) Establish the first comprehensive pediatric normative database for diadochokinetic rates (DDK) using the Voice Evaluation Suite, a computerized voice analysis program. 2) Analyze normal DDK rates for age and gender differences.MethodObservational design analyzing DDK rates on 335 children ages 4 to 18 years with normal voices. Data was collected over a 6‐month period from July to December 2010 in a pediatric otolaryngology clinic. Main outcome measures included age, gender, Pediatric Voice Related Quality of Life screening, and DDK rates.ResultsThe mean DDK rates of each age and gender are presented. There was no statistically significant difference between boys and girls of the same age (P <. 05). There was a statistically significant difference in children ages 4 to 11 years when compared with children ages 12 to 18 years (P <. 001).ConclusionPediatric DDK rate is similar between boys and girls of the same age. Faster DDK rates are seen in children over 12 years of age, regardless of gender, when compared with those children younger than 12 years. The normative data presented represents the most comprehensive DDK database in the English language.
Predictors of Tonsillectomy after Previous Adenoidectomy for Upper Airway Obstruction
Authors: GovAri Eliav , Mills Jonathan , Basler Keith 
Published: September 2011

Objective1) Characterize risk factors for subsequent tonsillectomy in pediatric patients undergoing primary adenoidectomy for upper airway obstruction.2) Compare rates of subsequent tonsillectomy between adenoidectomy patients with and without upper airway obstruction.MethodA retrospective cohort of patients undergoing adenoidectomy without tonsillectomy at the University of Missouri between 1995 and 2010 was examined using billing records and selected chart review. A nested case‐control study with detailed chart review was then conducted to determine predictors of subsequent tonsillectomy in patients with upper airway obstruction.ResultsOf 1291 patients identified in the retrospective cohort, 7.8% later underwent tonsillectomy. Using a fitted multiple logistic regression model, age less than 3 years (P =. 027), female sex (P <. 0001), and upper airway obstruction (P =. 001) were all found to be significant predictors of subsequent tonsillectomy. In the nested case‐control study, potential predictors investigated included adenoidectomy indications, symptoms, smoke exposure, weight, comorbidities, and adenoid and tonsil size at the time of adenoidectomy. Of these, only tonsil size was significant, with each increase in size of 1 (eg, from 2+ to 3+) associated with an increased odds of future tonsillectomy of 2.5 (P =. 01).ConclusionPatients undergoing adenoidectomy for upper airway obstruction are at increased risk of subsequent tonsillectomy when compared with those with other indications. Within this subgroup of patients with upper airway obstruction, young age, female sex, and large tonsil size may further increase the risk of subsequent tonsillectomy after previous adenoidectomy.
Socioeconomic Factors in Pediatric Neck Abscesses
Authors: Johnson Romaine F. , Jiang Zi Yang 
Published: September 2011

ObjectiveSocioeconomic status has been associated with increased risk of developing some infectious diseases. Our objective was to study the relationship of socioeconomic status in children with neck abscesses to see if potentially a similar relationship exists.MethodWe studied a population of children with neck abscesses at a tertiary care pediatric hospital in Dallas, Texas. The patients’ demographic, clinical, and economic data were analyzed to see if socioeconomic status was different when compared to Texas and US averages. Controls for population and hospital averages were instituted.Results200 children with cervical neck abscesses were analyzed. The median household income of the cohort was calculated to be less than US and Texas averages based on US census data. Forty‐eight percent were enrolled in Medicaid at the time of presentation. Twenty‐one percent were uninsured or self‐payers. These proportions were higher when compared with the United States and the state of Texas, although in line with the hospital’s payer mix. The rate of pre‐admission antibiotic usage and duration of illness before seeking treatment did not vary significantly among the patients studied.ConclusionChildren with neck abscesses in this cohort tended to live in areas with lower household incomes. The payer mix was different when compared with the US and Texas but not the study hospital. Insurance status did differ in initial medical care choice (PCP vs ER) but not overall outcomes.