bluuebunny/crossref_metadata_2025_split huggingface dataset:
NBI HDTV Magnifying Endoscopy in Laryngeal Papillomatosis and Laryngeal Spinocellular Cancer
Authors: Zabrodsky Michal , Betka Jan , Plzak Jan , Lukes Petr 
Published: September 2011

ObjectiveNBI (Narrow Band Imaging) helps to visualize subtle changes in microvascular architecture linked to neoangiogenesis. Combination of NBI with HDTV (high‐definition television) and magnifying endoscopy provides best sensitivity and specificity. The most frequent false positive results were reported in laryngeal papillomatosis where the micro‐vascular pattern could be misinterpreted as neoplastic.MethodPatients with clinical diagnosis of papillomatosis or laryngeal cancer were included in the study. NBI HDTV camera head was used in combination with rigid magnifying telescope during microlaryngoscopy. Type and extent of micro‐vascular mucosal changes were recorded. Mucosal lesions were removed radically and histologically evaluated and correlated with clinical findings.ResultsPreliminary results show that increased neoangiogenesis is present in both laryngeal papillomatosis and laryngeal SCC. The presence of prolonged and enlarged capillary loops was observed in both groups. This yields difficulties in differentiation between both entities.ConclusionThe discrimination of papillomatosis and early stage of laryngeal SCC is difficult even when NBI HDTV magnifying endoscopy is used. Creation of special classification of capillary loop changes in laryngeal mucosa is needed.
Nasoseptal Flap Reconstruction of Secondary Palatal Defects
Authors: Kim Grace G. , Zanation Adam M. , McKinney Kibwei A. , Stadler Michael E. 
Published: September 2011

Objective1) Describe a novel operative technique using a posteriorly pedicled nasoseptal flap (NSF) for reconstruction of secondary palatal defects. 2) Report initial outcomes of patients with secondary palatal defects who underwent NSF palatal reconstruction.MethodCase series of 5 patients who underwent NSF for repair of secondary palatal defects at a tertiary referral center from October 2008 to October 2010. A NSF pedicled on the posterior nasoseptal artery was used for coverage of palatal defects. Clinical outcomes and images will be presented.ResultsTwo patients had secondary palatal defects from prior tumor resection, 1 patient had a traumatic injury, 1 patient had granulomatous disease, and 1 patient had a palatal defect after Le Fort I advancement. Area of defects ranged from 0.5 to 7cm2. Initial outcomes reveal that all defects less than 1cm in width (n = 3) closed successfully and defects larger than 2cm in width (n = 2) did not completely close. There were no intraoperative complications. All patients had complete intranasal healing by 6 weeks postoperatively. There were no postoperative bleeding, infectious, or wound complications, as well as no cerebrospinal fluid leaks.ConclusionSecondary palatal defects are challenging and reconstruction with vascularized tissue is desirable. A posteriorly pedicled nasoseptal flap offers a novel option to repair palatal defects. The success rate for small defects is promising with minimal donor site morbidity.
Pharyngeal Pooling in Patients with Zenker’s Diverticulum
Authors: Onkasuwan Julina , Yung Katherine , Courey Mark S. 
Published: September 2011

ObjectiveDetermine if patients with a diagnosis of Zenker diverticulum are more likely to have pooling of secretions in the left piriform sinus on in‐office endoscopy compared with patients with non specific dysphagia without motion abnormality or known neurologic disorder.MethodA retrospective review was performed of patients evaluated at a subspecialty swallowing clinic, over a 5‐year period, with radiographically confirmed Zenker’s diverticulum. A control group with dysphagia due to radiographically confirmed esophageal dysmotility, prominent cricopharyngeal bar, or stricture was identified. Two blinded laryngologists reviewed the recorded laryngoscopies.ResultsA total of 29 Zenker patients were identified; 7 were excluded due to previous surgery. Of the 22 remaining patients, the mean age was 68.45 years (range, 26‐95 years). Fourteen (59.09%) of the Zenker diverticulum patients had greater pooling in the left versus right piriform sinus. The average age of the 16 control patients was 61.31 years (range, 18‐84 years). One of the 16 (6.25%) had greater pooling in the left piriform (2‐tailed t test, P < less than. 0005). While the sensitivity of this physical examination finding in identifying patients with Zenker diverticulum is 60.09%, specificity is 93.75% and the positive predictive value is 92.86%.ConclusionIncreased pooling in the left compared with the right piriform, on in‐office endoscopy, is significantly associated with the presence of a Zenker diverticulum. This information can sharpen clinical acumen in evaluating patients with dysphagia. In turn, it will help the clinician counsel the patient regarding diagnosis and radiographic imaging.
Posterior Glottic Stenosis: Is Remobilization Possible?
Authors: Eisenbeis John Francis , Zaveri Rishi 
Published: September 2011

ObjectiveSurgical management of posterior glottic stenosis (PGS) should ideally result in vocal cord remobilization, rather than airway expansion via destructive glottic procedures. This study (1) presents surgical management of 10 cases of PGS, and (2) discusses a treatment algorithm for PGS which focuses on vocal cord remobilization.MethodTen cases of PGS with bilateral vocal fold immobility were retrospectively reviewed. Tracheotomy was initially performed to provide an adequate airway. Further interventions instituted focused on vocal cord remobilization. The main outcomes considered included decannulation, number and type of procedures performed, vocal cord mobility, voice quality, and exercise tolerance.ResultsTen cases were reviewed. One patient was successfully decannulated without surgical intervention. Of the 9 patients requiring surgical intervention, 4 patients required a single procedure to be decannulated, and 4 patients required multiple interventions to be decannulated. The one patient not decannulated had an adequate glottic airway with limited arytenoid mobility, however, was not decannulated due to pending renal transplant. Six patients underwent midline thyrotomy with resection of posterior glottic scar and arytenoid remobilization. In all 6 of these patients some degree of vocal fold mobility was reestablished. Voice quality and exercise tolerance was adequate to excellent in all patients.ConclusionPatients with PGS can be decannulated through surgical intervention; however, following a treatment algorithm focusing on vocal cord remobilization may establish vocal fold mobility, and thus improve voice and airway dynamics.
Primary Natural Killer T Cell Lymphoma of the Supraglottis
Authors: Friedmann David , Troob Scott H. , Suurna Maria V. , Liu Cynthia 
Published: September 2011

ObjectiveDescribe an especially rare case, primary natural killer (NK) T Cell lymphoma of the supraglottis. Because of its unique presentation and infrequent occurrence, treatment in this case was delayed while awaiting a definitive diagnosis. Presentation of this case and the review of the literature should aid in the differential diagnosis.MethodThe patient’s medical records including his clinical history, laboratory, radiologic, and pathologic data were reviewed. Additionally, a literature search was performed for cases of laryngeal lymphoma, with special attention to NK T‐cell type.ResultsA 22‐year old male from South America presented with 2 months of odynophagia, hoarseness, fever, hemoptysis, night sweats, and a 70‐pound weight loss. Work up for tuberculosis, HIV, and serologies for systemic granulomatous conditions were negative. Otolaryngologic evaluation demonstrated normal‐appearing nasal mucosa and oral cavity. Laryngoscopy revealed a thickened epiglottis with polypoid mucosa of the vallecula and the supraglottis. Biopsy of the epiglottis demonstrated NK T cell lymphoma, nasal‐type with CD3 and CD56 positivity and histologic features of an aggressive EBV‐associated form. Imaging and bone marrow biopsy confirmed its confinement to the supraglottis. He is currently undergoing concurrent chemo‐radiation therapy.ConclusionLymphoma of the larynx represents 1% of malignant laryngeal tumors. Primary laryngeal NK T cell lymphoma with disease isolated to the larynx is exceptionally rare and has not previously been reported. Medical work up to rule out infectious or inflammatory lesions along with directed biopsies should help in the diagnosis.
Quality of Voice and Quality of Life after Injection Augmentation of the Vocal Cord with Polydimethylsiloxane (VOX‐Implants)
Authors: Weber Nathalie Isabelle , Sittel Christian , Koelmel Jan‐Constantin , Stegmann Monika 
Published: September 2011

ObjectiveEvaluate quality of life as well as quality of voice before and after endoscopic injection augmentation with Polydimethylsiloxane (VOX‐Implants) for unilateral neurogenic vocal fold immobility.MethodProspective study. Evaluation of 14 patients undergoing injection laryngoplasty (VOX‐Implants) under general anesthesia. Evaluation of the following parameters concerning the patients voice (preoperatively, postoperatively): glottic closure (videostroboscopic and flexible‐videoendoscopic), voice range profile, maximum phonation time, Dysphonia index (according to Friedrich) and Roughness‐Breathiness‐Hoarseness‐Scale (RBH‐Scale). Quality of life was assessed using Voice‐Handicap‐Index (VHI‐12).ResultsPostoperatively an improvement was evident in all observed parameters. A sufficient glottic closure during phonation could be accomplished in all patients. The voice range profile increased about 3.65 half‐tones. After injection laryngoplasty maximum phonation time was 6.9 seconds longer than preoperatively. The Friedrich Dysphonia‐Index was 2.4 before and 1.3 after augmentation. Postoperatively RBH‐scale was lower than before the operation. Voice‐Handicap‐Index (VHI‐12), a parameter for experienced voice handicap in private life, could be declined to 15.7 points postoperatively. In our study no substance‐associated complications were observed.ConclusionInjection laryngoplasty with Polydimethylsiloxane (VOX‐Implants) is an effective instrument to improve the quality of voice as well as the quality of life in patients with an unilateral vocal fold paralysis. Polydimethylsiloxane is a safe substance for injection laryngoplasty and provides satisfying results in the reestablishment of patients communication ability.
Orthodromic Temporalis Tendon Transfer: An Anatomic Study
Authors: Parker Noah P. , Dresner Harley S. , Eisler Lindsay S. , Walsh William E. 
Published: September 2011

Objective1) Understand the relationship of anatomic structures at risk for injury during the transfacial orthodromic temporalis tendon transfer procedure (OTTT) for facial reanimation. 2) Define the anatomic limitations of the OTTT without temporal releasing incisions of the muscle origin or perioral lengthening materials.MethodTen fresh cadavers were used to perform 20 hemi‐face dissections. Detailed measurements and photographic documentation examined the parotid duct (PD), masseteric artery (MA), inferior alveolar nerve (IAN), and internal maxillary artery (IMA) relative to surgical landmarks. The perioral reach of the mobilized temporalis tendon was measured and photographically documented.ResultsMeasurements revealed a consistent relationship between the PD and a reproducible reference line. The PD was located within the superior dissection field in all dissections. The IAN was consistently located over a centimeter from the TT insertion on the medial mandible and from the anterior ascending ramus. The MA consistently coursed within millimeters of the most inferior portion of the sigmoid notch within the substance of the masseter muscle. The IMA consistently coursed superiorly from posterior to anterior just medial to the mandible. All tendons (100%) reached beyond the melolabial crease to the perioral musculature for orthodromic resuspension.ConclusionReproducible PD‐reference line measurements allow for pre‐incision PD localization. Consistent relationships between the tendon, PD, neurovascular structures, and bony landmarks underscore that deliberate soft tissue retraction and subperiostial elevation minimizes injury risk. The mobilized tendon appears to achieve adequate length for resuspension without temporal releasing incisions or perioral lengthening materials.
Thyroid Perichondrial Flaps for Sub‐Glottic Reconstruction
Authors: Prosser John D. , Bush Carrie , Postma Gregory N. , Weinberger Paul M. 
Published: September 2011

ObjectiveTechniques available for reconstruction of the crico‐tracheal region in adults are currently suboptimal. We sought to 1) Understand the anatomic basis for the thyroid perichondrial flap, 2) Describe the technique of harvesting and intraluminal placement, and 3) Learn the limitations of defects for which it can be used.MethodIn fresh cadaveric specimens, the perichondrium of the outer layer of the thyroid cartilage was elevated by tracing the superior, medial and lateral borders of each thyroid cartilage ala. The inferiorly based flap was then placed into the airway through the cricothyroid membrane. The extent of coverage was measured.ResultsCurrent results are limited to female cadaveric measurements only. The extent of thyroid perichondrial flaps were 1.7 and 1.8 cm on the right and left respectively. The flaps were able to completely cover the cricoid cartilage and extended to but did not cover the first tracheal ring. Once placed intraluminally the flaps extended 2.5 and 2.6 cm below the true vocal cords on the right and left respectively. Using both flaps enabled coverage of the entire anterior 180 degrees of the airway lumen.ConclusionThe thyroid perichondrial flap is technically feasible and can provide coverage of anterior airway defects up to approximately 2.5 cm below the true vocal cords. This flap could enable transfer of vascularized tissue to aid in crico‐tracheal reconstruction. Further work in male cadavers as well as animal studies are in progress.
Validation of the SVHI into Portuguese from Portugal
Authors: Capucho Maria Clara , Ruah Carlos , da Silva José Madeira , Escada Pedro Alberto 
Published: September 2011

Objective1) Evaluate the validity of the translated and culturally adapted version of the Singing Voice Handicap Index (SVHI) into Portuguese from Portugal. 2) Add another language to the list of the translated versions of this widely used voice questionnaire for singers.MethodIn a parallel group design, 50 singers with different laryngeal pathologies and 25 singers with no laryngeal pathology completed the Portuguese version of the SVHI. Internal consistency reliability, test‐retest reliability and construct validity were assessed as well as group differences.ResultsStatistical analyses demonstrated high internal consistency reliability (Cronbach Alpha r = 0.93), test‐retest reliability (Spearman correlation = 0.84, P <. 01,) and construct validity (Spearman correlation = 0.62, P <. 01) values. The control group received significantly lower scores than the pathological group (P <. 05).ConclusionThe Portuguese version of the SVHI was shown to be a reliable and valid measure of voice handicap among Portuguese singers and can be added to the list of translated versions of this widely accepted and originally created American English voice evaluation instrument.
Ventricular Fold Phonation: Viscoelastic Properties and HSDI
Authors: Kimura Miwako , Imagawa Hiroshi , Tayama Niro , Chan Roger W. , Mau Ted 
Published: September 2011

ObjectiveDetermine the functional biomechanical properties of the human false vocal fold mucosa at phonatory frequencies, in comparison with those of the true vocal fold cover; and to quantify the vibration patterns of ventricular fold phonation with HSDI (high speed digital imaging).MethodViscoelastic shear properties of false fold specimens were quantified as functions of frequency, with measurements of elastic shear modulus (G′) and dynamic viscosity (h′) at up to 250 Hz using a simple‐shear rheometer. Ventricular fold phonation of three subjects was analyzed by HSDI (high speed digital imaging) through kymography and laryngotopography.ResultsAll specimens showed similar frequency dependence of their viscoelastic properties, with G′ gradually increasing with frequency and h′ monotonically decreasing with frequency. G′ and h′ of the false fold mucosa were generally higher than those of the true vocal fold cover, although the differences did not reach statistical significance. Kymographic and laryngotopographic analysis of high speed digital images revealed vibration of the false fold mucosa for subjects undergoing ventricular fold phonation. The vibratory frequencies were lower than typical fundamental frequencies for phonation.ConclusionThese findings showed false folds could function as a secondary sound source. These preliminary data suggested that the false fold mucosa could serve as replacement material for patients with unrepairable vocal fold cover damage.
3D CT Images of Congenital Anomalies
Authors: Durakovic Nedim , Lee Daniel J. 
Published: September 2011

ObjectiveRetrospectively determine the value of 3D reconstructions in addition to traditional 2D axial and coronal plane CT studies of pediatric cochlear implant candidates.MethodPediatric cochlear implant candidates with preoperative CT scans were identified, and 3D reconstructions were created. Three readers were blinded to clinical data and interpreted the 2D axial and coronal scans. A separate set of interpretations was made with the addition of 3D reconstructions.ResultsBetween 1995 and 2009, 36 pediatric patients undergoing cochlear implantation with preoperative CT imaging were identified. Structures analyzed included the Vestibular Aqueduct, Cochlear Nerve Canal, Cochlea, and Vestibule. Visualization of congenital malformations was scored on a 3‐point scale (1, visualized; 2, unsure; 3, not visualized). Wilcoxon signed rank test was used to compare the 2 interpretations. The addition of 3D reconstructions to 2D axial and coronal CT images is expected to improve visualization of malformations in cochlear implant candidates. This information is valuable for evaluation of cochlear implant candidates outside of the academic center setting and in resident training.ConclusionThree‐dimensional CT reconstructions are complimentary in identification of congenital malformations in cochlear implant candidates.
3D Imaging of the Membranous Labyrinth: Normal Anatomy and Pathological Conditions
Authors: Tanioka Hisaya , Kaga Kimitaka 
Published: September 2011

ObjectiveThe standard for studying temporal bone anatomy has been histopathological sectioning for microtome following chemical fixation and deossification of the temporal bone specimen. We can directly synthesize the membranous labyrinth from the conventional CT exam. We evaluated normal anatomy and pathological conditions of the membranous labyrinth.MethodWe studied 20 normal subjects, 20 hyperlipidemias, 20 DMs, 4 Ménière diseases, and 2 congenital malformations. To develop a 3D reconstructed image of the membranous labyrinth based on HR‐CT, the axial data were applied to create 3D images on the CT work station for postprocessing with factory presets.Results3D visualization of different structures of the membranous labyrinth allowed display of correct anatomy of high detail in all normal subjects. We could observe the cochlear duct, ductus reuniens, saccule, utricle, and ampullae. Otherwise, pathological conditions were revealed as irregular shape of the cochlear duct and/or small or large saccule or utericle. On unilateral Ménière disease, we could find the enlargement of the utricle. The radiation exposure was 0.15mSv.ConclusionOur method shows promise for observation of the membranous labyrinth. The pathological conditional images showed abnormal shape in comparison with normal conditions. We got a new diagnostic method for vertigo, disequilibrium, hearing loss, and tinnitus.
3D Volumetric Conformal Analysis of Vestibular Schwannomas
Authors: Walz Patrick , Robinett Zachary , Kirsch Claudia , Bush Matthew L. , Welling D Bradley 
Published: September 2011

ObjectiveCompare 3D conformal volumetric analysis (3DCVA) versus traditional linear measurements on serial MRI imaging of vestibular schwannomas (VS) for determination and assessment of accurate tumor volume and growth rates.MethodRetrospectively identified VS patients followed with serial 0.7‐3.0 Tesla MRI were included. Maximal linear dimensions were obtained from gadolinium‐contrasted T1 sequences from 3 serial MRI scans per RECIST guidelines. Volumetric analysis was performed with semiautomated 3DCVA. Annual tumor growth rate and percentage change were compared for linear and volumetric measurements.ResultsThe average time span during which the serial MRI scans were obtained was 2.86 years in this initial retrospective analysis of 11 patients. The linear growth measurements averaged 0.5 mm/y, corresponding to a 6.4% average change per year. With 3DCVA the average tumor growth rate was 5mm3/y, corresponding to 3.7 mm/y growth in each dimension. There was an average increase in tumor volume of 29% per year with 3DCVA, compared with 6.4% with linear measurements. The difference in percentage change per year between methods was significant when compared with paired 2‐tailed t‐test (P =. 036).ConclusionVS assume complex configurations. In this initial retrospective study, linear measurements may underestimate true tumor growth compared to 3D conformal volumetric analysis. 3DCVA may provide a more robust tool in assessing tumor volume, growth rate, and volume change for a more accurate reflection of tumor progression compared to linear measurements.
A New Electroneurography Method in Facial Palsy
Authors: Haginomori Shin‐ichi , Kanazawa Atsuko , Mori Atsuko , Ichihara Takahiro , Kawata Ryo 
Published: September 2011

ObjectiveWe compared electroneurography (ENoG) performed in patients with facial palsy using the new midline method and standard method in terms of the relationship between the ENoG value and clinical course. We also established a new criterion with the midline method for predicting prognosis in facial palsy using the ENoG value.MethodENoG was performed using the midline method, in which the recording electrodes were placed on the midline of the face, and the standard method, which has been used universally. The relationship between the ENoG values and the period to full recovery from the facial palsy was compared.ResultsSixty‐four patients with facial palsy were enrolled. The midline method had a stronger negative correlation in the relationship between the ENoG value and period to full recovery from palsy than the standard method. We also proposed a new ENoG value‐based criterion for prognostic diagnosis using the midline method: 1) ENoG value of > 60% predicts complete recovery from the palsy within 2 months; 2) ENoG value of > 10% and < 60% predicts recovery from the palsy within 6 months; and 3) ENoG value of <10% forecasts 50% of patients cannot reach complete recovery.ConclusionThe novel midline ENoG method we proposed here has advantages over the standard method in terms of ease of electrode setting, and the ENoG value may be a useful prognostic factor.