bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voice and Swallow after Supracricoid Partial Laryngectomy
Authors: Clayburgh Daniel R. , Schindler Joshua S. 
Published: September 2011

Objective1) Evaluate the long‐term voice and swallowing outcomes of supracricoid partial laryngectomy (SCPL). 2) Determine the effect of prior radiation therapy on voice and swallow outcomes.MethodA retrospective chart review was performed on all patients that received SCPL at our institution between 2006 and 2010. Multiple parameters measuring voice and swallowing outcomes were recorded where available and descriptive statistics performed. Chi‐square and Student t‐test analysis were performed with P <. 05 used to denote significance.ResultsFourteen patients were identified, including 2 cricohyoidopexies and 11 cricohyiodoepiglottipexies. Mean follow‐up was 650 ± 470 days. Decannulation occurred at 30 ± 16 days and feeding tube removal at 87 ± 43 days postoperatively. All patients tolerated regular diets and thin liquids. Maximum phonation time was 10.6 ± 6.1 sec, F0 was 161.7 ± 75.7 Hz, VHI was 35.6 ± 16.1, and CAPE‐V dysphonia score was 56.3 ± 11.0. Comparing previously irradiated patients with those without prior radiation, there was no difference in time to feeding tube removal (100 ± 18 vs 79 ± 8 days, P =. 32), maximum phonation time (9.3 ± 2.1 vs 12.6 ± 3.9 sec, P =. 49) or VHI score (32.5 ± 9.4 vs 49.3 ± 1.8, P =. 17), but F0 was significantly higher (235.5 ± 27.3 vs 115.1 ± 9.8 Hz, P =. 01).ConclusionSCPL is well tolerated; patients have excellent swallowing and serviceable voice postoperatively. Preoperative radiation therapy appears to raise F0; otherwise voicing and return of swallow function is similar to those patients who have not been irradiated. Prospective studies may define other prognostic markers for voice and swallow outcomes after SCPL.
Microscopically Assisted Open Structure Rhinoplasty
Authors: El‐Guindy Ahmed S. 
Published: September 2011

ObjectiveEvaluate the use of the operating microscope during open structure rhinoplasty for achievement of preoperative goals precisely and accurately.MethodA retrospective study was conducted on 82 patients with nasal aesthetic deformities and functional deviations for whom open rhinoplasty was done in tertiary care center. The operative microscope was used throughout operative steps. Results were checked against patients’ expectations and satisfaction and against conformance to aesthetic measures and functional parameters.ResultsA total of 91.4% of the surgeries met patients’ expectations while 93.3% fulfilled patients’ satisfaction. A total of 85.4% of cases conformed to aesthetic nasal measures while 92.7% to functional clinical parameters.ConclusionThe use of the operative microscope afforded a better illumination especially in the depth, stereoscopic vision, and magnification that allowed accurate dissection and better preservation. It is user friendly, superb in photo documentation, and unpreceded in training courses as it offers to trainees an image identical to what the surgeon sees.
A New Classification of Laryngeal Synkinesis
Authors: Yumoto Eiji , Nishimoto Kohei , Sanuki Tetsuji , Kumai Yoshihiko , Toya Yutaka 
Published: September 2011

Objective1) Develop a new classification of laryngeal synkinesis in patients with unilateral vocal fold paralysis (UVFP) based on images of the vocal fold using 3‐dimensional computed tomography (3DCT) 2) Compare synkinesis type based on 3DCT image analysis with recruitment in electromyography during phonation.MethodRetrospective. Subjects included 50 patients with UVFP who underwent framework surgeries between 2000 and 2010. Three‐dimensional images during phonation and inhalation preoperatively were assessed focusing on thickness of the affected fold to classify synkinesis. Recruitment of thyroarytenoid muscle was rated and compared with synkinesis type.ResultsTwo subjects were excluded because of poor performance during scanning. Three synkinesis types were identified. The affected fold in 12 subjects showed some degree of thickening during phonation. The affected fold of the remaining 36 was thin during phonation. Thickening of the affected fold was evident during inhalation in 20 of the 36 subjects, while the affected fold in the rest (16 subjects) remained to be thin. Thirty‐one subjects underwent electromyography. Those with the latter 2 types of synkinesis had a tendency of less recruitment compared with those with the former type of synkinesis.ConclusionThe use of the new classification of laryngeal synkinesis facilitates understanding of behavior of the affected vocal fold in patients with UVFP. The number of subjects who underwent electromyography was not sufficient to draw a conclusion about the relation between synkinesis classification and recruitment.
A Novel Approach to Tracheocutaneous Fistula Closure
Authors: Taraska Allison , Weisberger Edward , Ting Jonathan Y. , Royer Mark , Moore Michael 
Published: September 2011

Objective1) Describe a novel, 3‐stage approach to closure of a large tracheocutaneous fistula (TCF) and augmentation of an adjacent area of tracheal stenosis. 2) Present pre‐, intra‐, and postoperative photographs to illustrate surgical technique. 3) Discuss postoperative patient care considerations. 4) Review other techniques described for similar defects.MethodCase report of patient receiving treatment from May 2010 to present. The patient presented with a 1.4 by 1.6 cm TCF and adjacent tracheal stenosis. This was repaired in a 3‐stage approach culminating in radial forearm free flap (RFFF) with banked conchal cartilage and buccal mucosal graft for tracheal closure.ResultsThis case resulted in successful closure of a 1.4 by 1.6 cm TCF in a previously radiated patient using a novel, 3‐stage approach. The initial stage involved implanting a conchal cartilage graft in the left radial forearm. During the second stage a buccal mucosal graft was implanted to cover the conchal cartilage graft after removing the hair‐baring skin. The third stage involved transfer of the RFFF with cartilage and mucosal graft for closure of the TCF, augmenting the support with an absorbable miniplate. The patient had no issues with breathing, speaking, or wound healing immediately or at four months postoperative.ConclusionLarge TCFs in irradiated patients present a unique surgical challenge. This case illustrates successful closure of an extensive TCF involving anterior trachea and partial bilateral sidewalls. The unique graft allowed for structural support with hairless mucosal lining on a fasciocutaneous flap.
CXCL12‐Induced Angiogenesis in Laryngo‐Hypopharyngeal Squamous Cell Carcinoma
Authors: Tan Ching‐Ting , Ko Jenq‐Yuh , Li Kai‐Chun , Kuo Min‐Liang , Huang Ying‐Hsuan 
Published: September 2011

ObjectiveThe success of solid tumor metastasis is dependent upon angiogenesis, and our previous result revealed that the CXCL12/CXCR4 axis could induce laryngeal and hypopharyngeal SCC (LHSCC) cells to produce angiogenic factors. Therefore, in this study, we will further elucidate the mechanisms of CXCL12‐induced angiogenesis in LHSCC cell lines.MethodIHC staining and RT‐PCR were used to clarify the relationship of CXCR4 and angiogenesis. The Agilent oligoarray was used to study the angiogenesis profile, and investigate the relative contribution of different angiogenic factors. A mouse tumorigenicity model, the signal transduction pathways and the blocking effects of different antagonists were investigated.ResultsIHC staining and RT‐PCR revealed positive correlation of CXCR4 and CD31. Specific CXCR4 inhibitor AMD3100, neutralized antibody, 12G5, and shRNA could block the CXCL12‐induced angiogenesis. Agilent oligoarray and RT‐PCR discovered that CXCL12 induced IL‐8 expression. The expression could be blocked by specific CXCR4 inhibitors. Using IL‐8 neutralized antibody also effectively block the angiogenesis. Signal transduction study revealed that phosphorylation of Akt involved in the CXCL12/CXCR4 regulation of IL8 secretion.ConclusionUnder such an investigation, a better understanding of angiogenic signaling and regulatory mechanisms in LHSCC were obtained and that may have benefit in searching for a new therapeutic agent to block this pathway as an adjuvant therapy for LHSCC might reduce the metastasis and improve the survival rates.
Dysphonia as the Only Presentation of Laryngeal Tuberculosis
Authors: Mano Patrícia , Ramírez Edna P. , Lima Marcos , Albertino Rafael , Simen Raphaella , Bissoli Rodolfo , Simas Tiago 
Published: September 2011

ObjectiveReport a case of laryngeal tuberculosis in an immunocompetent patient who showed no changes in chest radiograph.MethodCase report of laryngeal tuberculosis. Clinical findings are discussed and a review of the literature is made.ResultsThe authors describe a case of laryngeal tuberculosis in a 50‐year‐old male patient who presented with a 3‐month history of dysphonia, without improvement or worsening, with no other systemic signs or symptoms. ENT examination was unremarkable. Laboratory tests were normal, and sputum smear was negative for AFB. Laryngoscopy revealed a tumor in the left vocal cord, from which a biopsy was obtained, and AFB staining was positive. After being treated with DOTS (Directly Observed Treatment Short‐course) therapeutic regimen for nine months, patient showed improvement in symptoms.ConclusionThe authors emphasize the importance of suspecting the diagnosis of tuberculosis in patients who show malignant appearance lesions during laryngoscopic examination, even in the absence of classic clinical symptoms. Histological examination is essential for final diagnosis. Only early diagnosis and treatment are able to cure disease and prevent future complications.
Effects of Hepatocyte Growth Factor Injection and Reinjection
Authors: Garcia Roberta Ismael Dias , Tsuhji Domingos Hiroshi , Imamura Luiz F. , Bissoli Rui , Mauad Thais 
Published: September 2011

ObjectiveThe study sought to assess the effects of HGF injection and reinjection coinciding with its peak of activity on collagen density, vessel density, inflammatory reaction in the lamina propria, and mean epithelial thickness in the injured rabbit vocal fold.MethodFourteen rabbits were subdivided in group 1 that received HGF injections into the right vocal fold and 2 that received bilateral HGF injections and reinjection into the right vocal fold 10 days after. Left vocal folds were controls. Histological assessment was performed at 30 and 40 days respectively.ResultsIn both groups, collagen density was lower in the right vocal folds than in the left folds (P =. 018). Vessel density was higher in the right vocal folds in group 2 (P =. 018). Differences about mean epithelial thickness and inflammatory reaction in the lamina propria are not statistical significance.ConclusionIn the scarred rabbit vocal fold, HGF injection is associated with decreased collagen density in the lamina propria, whereas reinjection after 10 days produces decreased collagen density and higher vessel density.
Efficacy of Amitriptyline for Chronic Laryngitis
Authors: Stein Daniel , Noordzij Jacob P. 
Published: September 2011

Objective1) Evaluate effectiveness of amitriptyline for the treatment of chronic laryngitis. 2) Compare the effectiveness of amitriptyline by gender, age, and race.MethodA retrospective chart review identified patients treated with amitriptyline for laryngitis in an academic otolaryngology practice. Subjects who had documented compliance with medication and follow‐up evaluation within three months after initiation were included. Symptoms, demographic information, and response to therapy were abstracted from their records.ResultsA total of 66 subjects were identified, consisting of 48 women and 18 men. Those of African descent constituted 42%, with Hispanic 27%, white 20%, Asian 6%, and other 5%. Response to treatment was complete in 32%, partial in 24% and without improvement in 36%, with the remaining 8% unable to tolerate treatment. Overall, 56% of subjects improved (95% confidence limit 43.3% to 68.3%). No significant differences in response rates were seen based on gender (P =. 289), age (<60 vs 60+) (P =. 149) or race (P =. 254).ConclusionWe found a substantial rate of improvement with amitriptyline treatment among individuals with chronic laryngitis, with most subjects tolerating this treatment. No significant differences in efficacy were seen among racial, age and gender subgroups. A prospective randomized trial of this therapy appears warranted.
High‐Speed Camera Observations of Vocal Nodules
Authors: Iwata Yoshihiro , Toda Hitoshi , Sakurai Kazuo , Naitou Kensei , Horibe Seji , Yoshioka Satoshi , Okada Tatuyoshi 
Published: September 2011

ObjectiveWe compared the vocal fold vibration pattern among normal subjects and vocal nodules. Observation of the movement to the vocal cord mucosa using a high speed camera, examining a mechanism of abnormal vibration by observing the motion of the vocal process was intended to clarify the cause of vocal nodules.MethodFive normal speech and 8 patients with vocal nodules were compared. High‐speed cameras recorded the vocal cord vibration. Easy phonation, 3000 fps or 3333 fps. We are in the position of the vocal process 3 consecutive images of the period, direction, investigated the symmetry of left and right.ResultsIn normal vocal cords vocal process was symmetrical. (5/5 case) Swings from side to side width and vocal process was about the same for both sides. The direction of extension of the vocal process was assembled in the center of the vocal cords membranes. (5/5 case) The midline of the laryngeal vocal nodules vocal process was in a different position on the left and right (7/8 case). Swings were different width of the vocal process (6/8 case). The direction of extension of the right and left vocal process was different.ConclusionIn the normal group, parallel to the vocal cords vibrate in contact throughout the mucosa. Vocal nodule group was lateralized position of the vocal process. We thought to focus on one part of the mucous membrane contact between vocal cords. It was considered one of the pathogenesis of vocal nodules.
Indications for the Use of Botox in Laryngology: A Review
Authors: Tan Melin , Woo Peak , Chinosornvatana Nina 
Published: September 2011

ObjectiveBotox causes chemical denervation by inhibiting release of acetylcholine from nerve terminals. In laryngology, Botox was initially introduced in patients with spasmodic dysphonia. Since then, its role has expanded to other disorders of laryngeal muscle hyperfunction. We aim to identify expanded indications of Botox in laryngology and review the literature.MethodWe performed a retrospective review of all patients treated with Botox injection in the senior author’s (PW) laryngology practice from 1998 to 2010. Indications were categorized and outcomes were analyzed.ResultsA total of 257 patients received laryngeal injections of Botox. Of these, 57 patients (22.2%) were indicated for reasons other than spasmodic dysphonia. Twenty‐nine (50.9%) were female and 28 (49.1%) were male. Age range was 15 to 72 years with a mean of 40 years. Eighteen (31.6%) patients were treated for paradoxical vocal fold motion, 14 (24.56%) were treated for contact granuloma, and 10 (17.54%) were treated for vocal fold paralysis with aberrant re‐innervation. Other indications included tremor, loud voice, mutational voice disorder, and spasticity. Twenty‐nine (49.15%) patients benefited from multiple injections.ConclusionThe use of Botox for the intrinsic musculature of the larynx can be considered for a wide spectrum of pathology involving vocal fold hyperfunction.
Investigation of Triamcinolone in Acute Phonotrauma
Authors: Hall Joseph E. , Suehiro Atsushi , Rousseau Bernard , Branski Ryan C. , Garrett C. Gaelyn 
Published: September 2011

ObjectiveInvestigate the effects of triamcinolone on transcript levels of the inflammatory markers (COX‐2, TGF‐β1, IL‐1β) and tight junction proteins (zonula occludin‐1 (ZO‐1), occludin, E‐cadherin, β‐catenin) in an in vivo model of acute phonotrauma. We hypothesized that triamcinolone downregulates inflammatory mediator gene expression and upregulates tight junction gene expression.MethodEight New Zealand white rabbits received intralaryngeal triamcinolone acetonide at the following concentrations: saline control, 100 µg/25 µL, 400 µg/25 µL, and 800 µg/25 mL followed by 30 minutes of raised intensity phonation. Quantitative polymerase chain reaction (qPCR) was used to investigate gene expression levels of inflammatory markers and epithelial tight junction proteins.ResultsResults of qPCR revealed dose‐dependent changes in COX‐2, TGF‐β1, and IL‐1β. Higher concentrations of triamcinolone showed an inverse relationship with transcription of these gene products. For tight junction proteins, qPCR showed upregulated gene expression of ZO‐1, occludin, and E‐cadherin in rabbits receiving 100 µg/25 µL triamcinolone compared to controls. However, higher concentrations of triamcinolone resulted in decreased levels of tight junction gene expression.ConclusionTriamcinolone is used for treatment of laryngeal disorders. However, the anti‐inflammatory properties of triamcinolone have not been demonstrated in the larynx. Results of this experiment provide support for the hypothesis that triamcinolone downregulates inflammatory mediator gene expression and upregulates tight junction gene expression at lower concentrations in acute phonotrauma.
KTP Laser Safety and Efficacy in Benign Laryngeal Lesions
Authors: Sheu Mike C. , Pollack Aron , Amin Milan , Mallur Pavan , Branski Ryan C. , Sridharan Shaum , Paul Benjamin C. 
Published: September 2011

ObjectiveThe potassium titanyl phosphate (KTP) laser is increasingly used to treat polyps, granulomas, and similar laryngeal mucosal lesions and has been shown to be safe and effective in case series. In this study we introduce a method to quantify the safety and efficacy of the KTP laser in laryngeal procedures.MethodPre‐and post‐KTP laser treatment videos were obtained from 3 institutions. The change in size of the laryngeal lesions was measured using a novel objective computerized method. A select number of videos were evaluated by blinded reviewers and rated for measures of safety.ResultsMore than 120 larynges underwent treatment for mucosal lesions including polyps, granulomas, and leukoplakia. Regardless of lesion type, there was a decrease in size based upon objective computer measurements, with all approaching or meeting statistical significance. Long‐term follow‐up was indicative of persistent lesion regression. Interrater reliability was good. Nineteen larynges were evaluated for safety based upon mucosal wave and glottic closure, with >90% of evaluations reporting preservation or improvement. Internal validity was good.ConclusionKTP laser in laryngeal mucosal lesions is safe and effective based upon our safety rating instrument and computerized lesion measurement system. This system can be reliably used as an objective measure of lesion of regression post therapy and for scientific evaluation of KTP laser efficacy in laryngeal procedures.
Laryngeal Diseases in Patients Referred to Videolaryngoscopy
Authors: Azevedo Julia , Cruz Camilla , Mury Isabelle , Osorio Marcio , Steffen Ricardo E. , Quintão Everson 
Published: September 2011

ObjectiveThe aim of the study was to characterize common laryngeal conditions in patients referred to videolaryngoscopy in the otorhinolaryngology department of a reference tertiary hospital in Rio de Janeiro, Brazil.MethodPatients’ records from a database of laryngeal endoscopic records from January 2000 to January 2010 were reviewed for the diagnosis of the common conditions: vocal paralysis/paresis, laryngopharyngeal reflux, laryngotracheal stenosis and, benign or malignant neoplasms, including papilloma and laryngeal dystonia/spasmodic dysphonia. Patients’ age, gender, profession, and smoking status were analyzed.ResultsA total of 3755 patient records were analyzed. Median age was 56 years (IQR 45‐66). The majority of patients was female (63.7%). Smoking habits were reported by 23.6% of patients. Voice professionals accounted for 10.9% of all patients. The most common condition found was benign/malignant neoplasms, which accounted for 15.5% of all the diagnoses, followed by laryngopharyngeal reflux (13.8%) and vocal cord and laryngeal paralysis (6.4%). Other disorders accounted for the remainder of diagnoses.ConclusionBenign and malignant neoplasm was the most common diagnosis found, accounting for 15.5% of the disorders diagnosed. Prompt diagnosis and treatment is essential for improved patient prognosis. Smoking was also found in a high number of patients. Smoking cessation programs should work closely with otorhinolaryngology services.
Narrow Band Imaging
Authors: Kim Grace G. , Leahy Kevin , Mirza Natasha 
Published: September 2011

Objective1) Investigate a novel technology called narrow band imaging (NBI) in the detection of laryngopharyngeal reflux (LPR). 2) Compare mucosal abnormalities using NBI to conventional fiberoptic white‐light laryngoscopy.MethodA prospective case‐control pilot study on the usage of NBI to identify mucosal abnormalities in patients with LPR at a tertiary referral center from July 2010 to February 2011. RFS scores were calculated using white‐light endoscopy. NBI was used to characterize endoscopic findings. Video images were reviewed by two blinded laryngologists.ResultsTwelve adult patients with LPR based on RSI scores and 11 normal adult controls were included. Reflux symptom index (RSI) greater than 13 and reflux finding score (RFS) greater than 11 were significantly correlated. NBI findings were graded on 2 vascular patterns and number of laryngeal sites involved. NBI was scored on a scale of 0 to 2 based on degree of color compared with background. Subsites were graded as 1 for 1 subsite and 2 for 2 or more subsites. Higher RFS were associated with lacey and punctuate patterns, as well as increased number of laryngeal sites involved.ConclusionThis pilot study has demonstrated various vascularity and morphologic patterns in mucosa visualized on NBI examination of patients with LPR. Preliminary results indicate that NBI may be a useful aid in the diagnosis of LPR, but a larger study size and standardized methods of quantification of LPR changes are recommended.
Nasalance Scores for Normal‐Speaking Turkish Population
Authors: Akcam Timur , Birkent Hakan , Arslan Huseyin , Gerek Mustafa , Karakoc Omer 
Published: September 2011

ObjectiveObtain normative nasalance scores for adult and children subjects speaking Turkish language, and obtain a reference for normality when nasality is evaluated.MethodMean nasalance scores were obtained from 35 normal‐speaking children and 125 adults during the repetition of 3 passages that were categorized according to the amount of nasal consonants (oral, oro‐nasal, and nasal passages). The Nasometer (model 6200) was used to obtain nasalance scores for the three reading passages.ResultsGroup mean ± standard deviation nasalance scores of children for oral passage, oronasal passage, and nasal passage were 15.23 ± 4.87, 37.69 ± 4.42, and 49.00 ± 6.99, respectively. Nasalance scores for the adult group were 15.77 ± 13.15, 38.46 ± 11.11, and 49.49 ± 10.28, respectively. There were significant differences in mean nasalance scores for oral versus nasal materials both for children and adult groups.ConclusionThe present study provides normative nasalance scores for Turkish‐speaking children and adults. The results indicated acceptable differentiation between oral and nasal materials.