bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between Nasal Valve Changes and Nasalance of the Voice
Authors: Gerek Mustafa , Durmaz Abdullah , Tosun Fuat , Birkent Hakan , Aydin Umit , Hidir Yosuf 
Published: September 2011

ObjectiveInvestigate the effect of nasal valve changes on nasalance of the voice by using an external nasal dilator strip that widens the nasal valve area.MethodHealthy volunteers who had normal nasal and laryngeal findings were enrolled into the study. All volunteers received acoustic rhinometry and nasometry before and while wearing a commercially available external nasal dilator strip. The data with and without nasal strip were compared.ResultsTwenty‐five subjects were enrolled into the study. After application of the nasal strips, statistically significant increases were observed in the minimal cross‐sectional area of the nasal valve. However, there were no significant changes in nasalance measurements.ConclusionDespite increasing the nasal valve area, application of nasal strips did not cause a significant change in nasalance scores, showing no relationship between the nasal valve changes and nasalance of the voice.
Rosai‐Dorfman Disease with Isolated Laryngeal Involvement
Authors: Kaden Andreas , Illing Elisa , Porter Paul , Halum Stacey L. 
Published: September 2011

ObjectiveRosai‐Dorfman (RD) disease is also known as sinus histiocytosis with massive lymphadenopathy (SHML) because of its characteristic lymph node involvement. It is exceedingly rare for RD to present with isolated, recurring laryngeal involvement without lymphadenopathy. This case presentation highlights this rare scenario, and difficulty in managing recidivistic laryngeal involvement.MethodCase presentation with review of literature.ResultsA 45‐year‐old woman presented to our laryngology clinic with dysphonia from a recurring right hemilaryngeal mass. Prior removal and analysis showed inflammatory mass and work‐up for sarcoidosis and Wegner was negative. Videostroboscopy showed large right submucosal fullness of right true vocal fold and this was confirmed on imaging. She underwent removal of the mass and pathologic diagnosis remained inconclusive. After 6 months the mass recurred and repeat pathologic analysis was consistent with RD disease. After multiple recurrences requiring emergent intervention and limited response to steroids, radiation therapy was initiated.ConclusionRosai‐Dorfman disease is a rare disease of massive lymphadenopathy and histiocytosis. The presentation with exclusive laryngeal involvement is rare, and due to extensive surrounding fibrosis and inflammation, histopathologic diagnosis was difficult. This case demonstrates that radiation therapy should be considered if surgical excisions and steroids are inadequate.
Spasmodic Dysphonia Translocated via Reinnervated Ansa Cervicalis
Authors: DeConde Adam , Armin Bob B. , Berke Gerald S. , Long Jennifer L. 
Published: September 2011

ObjectiveIllustrate the first reported case of recurrent adductor spasmodic dysphonia (ADSD) after bilateral selective laryngeal adductor denervation‐reinnervation (SLAD‐R) surgery presenting with dystonia of the strap muscles and adductors of the larynx.MethodA 40‐year‐old man presented with ADSD. The patient underwent a bilateral SLAD‐R surgery 10 years ago after botulinum toxin failure. The laryngeal dystonia was quiescent until 2 years ago when the patient noted worsening tension in his voice temporally associated with muscle spasm of his anterior neck.ResultsThe patient elected to undergo re‐exploration of his neck with lysis of his ansa cervicalis reinnervation. The operation revealed bilaterally intact neurorrhaphies between the superior root of the ansa cervicalis and the distal recurrent laryngeal nerves. Electrical stimulation of the superior roots of the ansa cervicalis produced laryngeal adductor activity as evidenced by an electromyography nerve monitor and by palpation of the arytenoids cartilage. The neurorrhaphies were sectioned and postoperatively the patient’s dystonias immediately resolved.ConclusionWe present a case of demonstrated functional activity of nerves used for reinnervation in SLAD‐R surgery for spasmodic dysphonia. Unfortunately in this case, the disease recurred through aberrant activity mediated via the translocated ansa cervicalis nerves.
Surgical Treatment of Laryngeal Papillomatosis Using NBI
Authors: Imaizumi Mitsuyoshi , Tani Akiko , Omori Koichi , Suzuki Teruhisa , Okano Wataru , Tada Yasuhiro 
Published: September 2011

ObjectiveMultiple laryngeal papillomatosis has a high rate of recurrence after surgery. Narrowband imaging (NBI) is a novel optical enhancement technology used for the diagnosis. This is the first report to date to indicate the availability of the combination of laryngomicro surgery and videoendoscopic surgery for laryngeal papillomatosis using NBI technology.MethodThe patients were 34‐year‐old and 30‐year‐old men. Both cases underwent surgery in another hospital. However, because of recurrence, they were subsequently referred to our department for further evaluation. Examination in our outpatient clinic revealed papilloma‐like mucosal changes, and recurrent multiple laryngeal papillomatosis was diagnosed in both cases.ResultsIn laryngomicroscopic surgical findings, the presence of papillomas was confirmed by NBI, and the papillomas were removed using an XPS Micro Debrider and a CO2 laser. Using the NBI system, the border between the normal mucosa and the papillomas could be clearly identified, allowing precise resection. Two months later, CO2 laser resection using a laryngeal flexible endoscope under topical anesthesia was undertaken in an outpatient setting for recurring or remaining papilloma lesions. Further treatment on the lesions has been carried out several times to date using NBI. The lesions have now been eradicated without further recurrence.ConclusionHerein we reported 2 cases of multiple laryngeal papillomatosis that were treated by tumor resection using NBI. Clearer identification of the tumor border was obtained by this technique, thus allowing minimally invasive resection. This paper demonstrates the applicability of the NBI system to the identification and resection of laryngeal papillomatosis.
The Use of Lesion Localization Needles in Tracheal Resection
Authors: Ferguson Louisa , Sandhu Guri , Sarju Vasani 
Published: September 2011

ObjectiveWe propose the use of a localization needle (X‐Reidy Lesion Localization needle ) to mark the position of tracheal lesions under direct vision. We believe this technique allows an accurate way of localizing difficult tracheal lesions.MethodX‐Reidy Localization single needle is generally used to localize non‐palpable breast lesions prior to surgical excision. We place the wire through the skin and into the tracheal lumen using suspension laryngoscopy and supraglottic jet ventilation technique at the beginning of the procedure.ResultsLesions obstructing the trachea can often be difficult to diagnose and can masquerade as asthma or chronic bronchitis. When the lesion is found to be malignant or definitive surgery is appropriate for benign lesions we perform tracheal resection and defining the portion of the trachea to excise is imperative. This method allows us to dissect down directly onto the portion of the trachea from which the lesion arose, which is not always clinically obvious from the external approach.ConclusionTumors of the upper airway are most often malignant, although in themselves are rare, accounting for less than 1% of all malignancies. Among the inflammatory strictures, postintubation injuries remain common in developed countries. This method of localizing tracheal lesions, we believe is of benefit to the surgeon.
Transoral Endoscopic Coblation for Early Glottic Carcinoma
Authors: Zhang Qingfeng , Liu Delong , Timms Michael S. 
Published: September 2011

ObjectiveInvestigate a new application for radiofrequency ablation in head and neck surgery, for early glottic carcinoma, the short‐term efficacy of the surgery was observed.MethodThree patients with early glottic carcinoma (T1 2, Tis 1) were successfully treated using transoral endoscopic coblation (TEC). The technique is described in detail, highlighting the main benefits of this approach as compared with existing techniques.ResultsAdequate removal of disease was achieved without complications and no recurrence was observed in the study period.ConclusionShort‐term observation exceeding 2 years suggests that the coblation appears to be an attractive evolving, reliable and safe modality for early glottic carcinoma, although current probe size is not enough small. This should be regarded as a pilot study.
Treatment of Epiglottic Cyst by Radiofrequency Snare
Authors: Zhou Annie 
Published: September 2011

ObjectiveEpiglottic cysts are common in clinic and are excised by operation. Our department adopts domestic radiofrequency therapy apparatus which is low in cost. At the same time, the radiofrequency ablation of the radiofrequency treatment group has the function of stopping bleeding and reducing recurrence.MethodAll 40 patients were divided into 2 groups according to random numerical expressions. The epiglottic cyst of the 20 patients in the treatment group was excised by radiofrequency snare and that of patients in the control group was excised by routine operation.ResultsThe postoperative pathological diagnosis of the 40 patients was in accordance with epiglottic cyst. The curative rate in radiofrequency treatment group is 100% and in routine operation group is 95%.ConclusionWith our operation, the thrombus formation and the vascular occlusion have good anastalsis. The snare can be freely operated under the under self‐retaining laryngoscope to ablate masses, which maximally protects the surrounding normal tissues.
Ultrasonic Aspirator‐Assisted Laryngeal Framework Surgery
Authors: Daniero James , Spiegel Joseph , Boon Maurits 
Published: September 2011

Objective(1) Demonstrate the utility of the ultrasonic surgical aspirator in minimizing the risk and simplifying laryngeal framework surgery. (2) Determine the benefits using of this technique in the setting of resident education.MethodCase series using the SONOPET ultrasonic surgical aspirator (MIWATEC Co., Ltd.) to enable precise dissection of laryngeal cartilage without thermal or mechanical injury to the surrounding soft tissue or mucosa. We describe the first application of this technology in the in vivo larynx for type I thyroplasty and laryngofissure approaches.ResultsLaryngeal framework surgery using current techniques have the limitations of difficulty incising calcified cartilage, mechanical chatter, thermal injury, and soft tissue damage. The ultrasonic surgical aspirator was used in four medialization thyroplasty procedures and two laryngofissure approaches for open laryngoplasty without intraoperative or postoperative complications. No infections or inadvertent soft tissue damage were observed. There were no complications of implant placement or with early healing. Finally, a very slight learning curve exists for its use in resident performed procedures and time to perform cutting tasks was faster than standard techniques.ConclusionThe ultrasonic surgical system may be used as an alternative to standard surgical technique, surgical drill, or oscillating saw for laryngeal framework surgery. Limited learning curve exists and our results indicate that the device can be used safely and in a reasonable amount of time.
Vocal Problems: Teachers’ Attitudes and Healthseeking Behavior
Authors: Charn Tze Choong , Mok Paul Kan‐Hwei 
Published: September 2011

ObjectiveTeachers are at high risk for vocal disorders due to their intrinsic occupational requirements. Numerous studies have reported on the prevalence and risk factors. Less is known about teachers’ ideas and attitudes. We aimed to explore teachers’: 1) attitudes towards voice problems and 2) health seeking behavior.MethodA cross‐sectional study was conducted by cluster sampling method across 6 primary schools in Singapore in 2008. 214 full time teachers were recruited. Self‐administered questionnaires were answered during each school’s teachers meeting after informed consent.ResultsA total of 89.9% of teachers agree that losing one’s voice is an occupational hazard. A total of 92.8% agree that their profession depends on the health of their voices. A total of 79.6% think that attending voice workshops will help to prevent voice problems. A total of 65.4% have had taken medical leave for voice problems in the past 12 months, of which 9.3% of them had taken 6 days or more of leave. A total of 81.7% consulted a general practitioner, 3.6% an otolaryngologist, 0% a speech therapist, and 14.8% others.ConclusionThe surveyed teachers have very similar demographics compared with the national teaching population and are hence broadly representative. The results showed that teachers do value their voices and deem them essential for carrying out their professional duties. Productivity losses to the education system and emotional losses are real entities.
Otoplasty: An Alternative Approach
Authors: Guilemany José M. , Gomez‐Vieira Álvaro , Montero Cristobal Langdon 
Published: September 2011

ObjectiveAn alternative approach to perform otoplasty by combining cartilage excision, Mustarde technique and modified Furnas technique.MethodPostauricular skin excision including subcutaneous tissue and postauricularis muscle was created to expose the deep surface of auricular cartilage. The anterior surface of the cymba and cavum conchae is marked. Posterior cartilage island excision is made in the cymba and cavum conchae leaving at least 5 mm of the helix root.ResultsThe antihelix surgical procedure consists of a classical Mustarde suturing to recreate the fold of the new antihelix. Finally, stabilization of the conchal cartilage is achieved by 2 nonabsorbable sutures (cymba, cavum conchae) to the mastoid fascia with superior and inferior vectors to improve the prominence of the helix to the scalp. Our preference for skin closure is polypropylene 5‐0 suture.ConclusionThis combined technique is safe and easy to perform, with a good cosmetic outcome. The advantages are: 1) Avoid leaving a wrinkled appearance in the anterior conchal skin, and 2) Accomplish a better conchomastoid complex stabilization.
A Prospective Study of an iPhone‐Assisted Particle Repositioning Maneuver for BPPV
Authors: Organ Brock , Bromwich Matthew A. 
Published: September 2011

ObjectiveDetermine if the use of an iPhone application (DizzyFIX ‐ Clearwater Clinical Ltd) designed to assist in the performance of the particle repositioning maneuver (PRM) for benign paroxysmal positional vertigo (BPPV) had a significant impact on medical students’ performance.MethodStudy design: Randomized, single‐blinded, prospective trial. Setting: Tertiary Care Hospital. Participants: Medical students. Intervention(s): Forty‐one participants performed the PRM and were scored by a blinded observer. Twenty‐one participants used the application while the remainder used a sham. Main outcome measure(s): PRM score, graded on an 11‐point scale, and total time.ResultsParticipants randomized to the iPhone application group scored higher on their observed performance of the PRM than the placebo group (P <. 0001) with a mean difference of 4.98 points. Participants randomized to the placebo group consistently performed the maneuver faster (P <. 0001) than those who had a functional iPhone application. The average placebo participant performed the maneuver in only 79.9 seconds while participants in the test group averaged 245.8 seconds. In summary, initial testing demonstrated that participants using the DizzyFix iPhone application conducted the PRM more accurately and slowly than the participants using a placebo.ConclusionThe use of this new iPhone application enables senior medical students to perform a more correct PRM than without assistance. This application represents a significant improvement from written instructions and standard medical school training.
Accuracy of Tinnitus Matching Using a Web‐Based Protocol
Authors: Ziai Kasra , Djalilian Hamid R. , McGuire John , Brunworth Joseph D. 
Published: September 2011

Objective1) Learn whether a web‐based protocol can be used to match tonal tinnitus. 2) Compare the accuracy of a web‐based protocol with tinnitus matching using an audiometer.MethodTwenty subjects had tinnitus frequency matching using an audiometer in an anechoic chamber using a standard protocol. The subjects then matched their tinnitus at a desktop computer in an examination room using a web‐based protocol with a multiple choice and a slider. Octave challenge testing was performed.ResultsThe age ranged between 30 and 77 years (median age, 53.5 years). Median tinnitus frequency was 6000 Hz (range, 2000‐12000 Hz) using the audiometer and multiple choice self‐directed protocol. Using the slider, the median frequency was 5925 Hz (range, 1850‐16000 Hz). The patients with tinnitus frequency of over 12000 Hz experienced a higher level of satisfaction with their tinnitus match when using the computer‐based slider system. Five patients (25%) experienced octave confusion (matched to a frequency one octave below or above) when performing self‐directed multiple choice tinnitus matching. These patients accurately matched their tinnitus frequency after the octave challenge step.ConclusionA web‐based protocol for tinnitus frequency matching is as accurate as a standard protocol. Patients with very high frequency tinnitus preferred a web‐based slider. Patients may inaccurately identify their tinnitus frequency as one octave above or below. An octave challenge test is necessary for a patient‐directed tinnitus frequency matching.
Age and Time Interval Differences in Recurrent and Residual Cholesteatoma Rates for Canal Wall Up Tympanomastoidectomy
Authors: Herman Bjorn S. , Anderson Joshua , Angeli Simon I. 
Published: September 2011

Objective1) Evaluate whether residual or recurrent cholesteatoma found during second‐look tympanomastoidectomies correlates with age. 2) To evaluate whether there is a difference in residual or recurrent cholesteatoma found during second‐look tympanomastoidectomies done before and after 9 months since the initial procedure.MethodThis is a longitudinal study of second‐look tympanomastoidectomies performed at a tertiary‐care center between 2002 and 2010. Demographic and clinical data was collected prospectively. Statistical analyses were performed to determine whether patient age and time interval between initial and second look procedures correlated with residual or recurrent cholesteatoma.ResultsSeventy‐two patients qualified for the study. Residual cholesteatoma was more frequent in children (<15 years) than adults (P =. 026, Fisher exact test). There was a tendency for recurrent cholesteatoma to occur more frequently in adults than in children. Recurrences tended to occur more frequently in cases with larger canal wall defects. The time interval between the primary and revision surgery did not influence the rate of residual or recurrent cholesteatoma.ConclusionYounger patients have a higher risk of residual cholesteatoma, possibly secondary to more technically challenging anatomy and surgeon preference to maintain an intact canal wall. Time between primary and revision surgery could be abbreviated or prolonged, since this interval did not influence residual and recurrent cholesteatoma rates.
Prevention of Head and Neck Keloid with 5% Imiquimod Cream
Authors: Karimi Kian , Jadidian Armon , Adelson Robert 
Published: September 2011

ObjectiveRetrospectively review the charts of patients from the University of Florida Facial Plastic Surgery Clinic over the past 4 years in order to evaluate the efficacy of keloid prevention after surgery with application of 5% imiquimod cream topically to excised areas.MethodRetrospective chart review. Classification of keloid subsite in the head and neck, and recurrence rates as documented in electronic encounters will be analyzed. Patients that have not followed up for greater than 3 months will receive a phone call for follow up.ResultsThe main result measured will be recurrence rates of head and neck keloid that have undergone surgical excision of these lesions followed by application of 5% imiquimod cream for 6 weeks. This will be obtained from retrospective review of clinic charts from the University of Florida patient database in addition to phone calls to previously treated patients that have not been seen in clinic for greater than 3 months.ConclusionPending results and analysis, we hypothesize that application of 5% imiquimod cream following surgical excision of head and neck keloid leads to lower recurrence rates than what is quoted in the literature.
Auditory‐Vestibular Outcomes in Superficial Siderosis
Authors: Sydlowski Sarah 
Published: September 2011

Objective1) Identify otologic clinical presentation of superficial siderosis of the central nervous system (SSCN). 2) Use audiologic assessment batteries to analyze variable presentation of SSCN. 3) Highlight the importance of site of lesion testing to identify and develop clinical management plans for affected individuals.MethodTen participants with SSCN were recruited in 2009. Prospective study measures included audiologic and evoked potential battery, including audiometry, speech testing, immittance, otoacoustic emissions, auditory brainstem (ABR) testing, and vestibular evoked myogenic potential (VEMP). Analysis resulted in development of typical audiologic clinical presentation for this disorder.ResultsThis is the largest prospective audiovestibular study of SSCN to date. SSCN is a neurodegenerative disorder resulting from chronic, episodic subarachnoid hemorrhage, and hemosiderin deposition. Diffuse symptoms, including hearing loss, tinnitus, gait ataxia, and disordered balance result from preferential demyelination of the auditory‐vestibular nerve and cerebellum. Sensorineural hearing loss was present in 100% of participants and may be due to cochlear and/or retrocochlear involvement. Study results suggest clinically characteristic findings that are relevant for otolaryngologists, otologists, and audiologists. SSCN may be underdiagnosed due to clinical presentation that resembles presbycusis and a long asymptomatic phase up to 30 years.ConclusionCharacteristic otologic findings in SSCN include hearing loss, tinnitus, and balance and/or gait disorder. Despite proclivity for audiovestibular damage, SSCN is not well‐recognized by hearing health professionals. Due to certain involvement of central and peripheral auditory‐vestibular structures, understanding of clinical presentation, typical progression, and audiovestibular prognosis is critical.
Cervical VEMP: Its Sensitivity and Specificity
Authors: Isaradisaikul Suwicha , Navacharoen Niramon , Hanprasertpong Charuk 
Published: September 2011

Objective1) Analyze the sensitivity and specificity of cervical vestibular evoked myogenic potential (VEMP) in evaluation vestibular function. 2) Compare the cervical VEMP response in normal volunteers and vertiginous patients.MethodA prospective study in 50 normal subjects and 50 vertigo patients was conducted at Chiang Mai University Hospital from February to December 2009. Cervical VEMP responses using air‐conducted 500‐Hz tone‐burst stimuli with the subjects in a sitting position and head turned to contralateral shoulder were analyzed.ResultsAverage age and men‐to‐women ratio in the normal group (44.0 ± 9.3 years; 12:38) and in the vertigo group (44.7 ± 9.8 years; 17:33) were not different. The rate of absent response between normal ears (15%) and disease ears (47.4%) showed a significant difference (p value < 0.0001).ConclusionTo identify vestibular dysfunction using cervical VEMP, the absence of response was the most diagnostic parameter. Other vestibular test batteries should be added to confirm the cervical VEMP responses.