bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vocal Nodules and Edema May Be Due to Vibration‐Induced Rises in Capillary Pressure
Authors: Czerwonka Lukasz , Jiang Jack J. , Tao Chao 
Published: February 2009

AbstractHypothesis: Vocal fold vibration may physically raise intravascular pressure to levels high enough to damage capillaries and result in leakage of erythrocytes. This type of injury is commonly seen in benign vocal fold lesions and is not well explained.Study Design: Theoretical, retrospective.Methods: The relationship of intravascular pressure to vibration frequency and amplitude is derived and confirmed with a physical blood vessel model, then applied to published human measurements to estimate human intravascular pressures.Results: Vocal fold intravascular pressure is predicted to have a quadratic dependence on both frequency and amplitude. During speaking, the pressure may rise to over 20 cmH2O, and may reach levels far higher for screaming and singing. Such pressure magnitudes are known to trigger inflammatory cascades and can lead to fluid leakage. They also have the potential for pharmacologic control with β‐agonists.Conclusions: Intravascular pressure likely rises significantly during vocal fold vibration and may lead to the type of injury seen in benign vocal fold lesions. The results support voice therapy aimed at reducing vibratory amplitude. More vibratory amplitude measurements need to be performed in a wider range of subjects before the full range of human vocal fold vascular pressures can be estimated.
Relation of Distortion Product Otoacoustic Emission With Tinnitus
Authors: Ami Mazita , Abdullah Asma , Awang Mahamad A. , Liyab Borhan , Saim Lokman 
Published: February 2009

AbstractObjective: To investigate cochlear outer hair cell function based on distortion product otoacoustic emission (DPOAE) in patients with tinnitus.Study Design: This is a case control study.Subjects and Methods: The subjects are patients who attended the Otorhinolaryngology Clinic in Hospital Universiti Kebangsaan Malaysia over a period of 19 months from April 2005 until October 2006. All patients underwent a full ENT assessment and had tympanometry, pure tone audiometry, and DPOAE tests. The UKM Research and Ethics Committee reviewed and approved the study proposal prior to commencement of this study.Results: The study population included 49 patients. They consisted of 16 patients (32 ears) with tinnitus and reduced hearing, 13 patients (26 ears) with tinnitus and normal hearing, 7 patients (13 ears) without tinnitus with reduced hearing, and 13 patients (26 ears) without tinnitus with normal hearing. Statistical analysis showed significant differences (P = .00) of mean DPOAE levels between the four groups of patients.Conclusion: Our results suggest that reduced outer hair cell activity, as detected by reduced DPOAE levels, may manifest as tinnitus even before there is a shift on hearing threshold. We also postulate that further reduction of cochlear outer hair cell activity, as shown by further reduced DPOAE levels, may actually terminate the source of tinnitus.
Accuracy of Self‐Report in Detecting Taste Dysfunction
Authors: Soter Ana , Kim John , Jackman Alexis , Tourbier Isabelle , Kaul Arti , Doty Richard L. 
Published: February 2009

AbstractObjective: To determine the sensitivity, specificity, and positive and negative predictive value of responses to the following questionnaire statements in detecting taste loss: “I can detect salt in chips, pretzels, or salted nuts,” “I can detect sourness in vinegar, pickles, or lemon,” “I can detect sweetness in soda, cookies, or ice cream,” and “I can detect bitterness, in coffee, beer, or tonic water.” Responses to an additional item, “I can detect chocolate in cocoa, cake or candy,” was examined to determine whether patients clearly differentiate between taste loss and flavor loss secondary to olfactory dysfunction.Methods: A total of 469 patients (207 men, mean age = 54 years, standard deviation = 15 years; and 262 women, mean age = 54 years, standard deviation = 14 years) were administered a questionnaire containing these questions with the response categories of “easily,” “somewhat,” and “not at all,” followed by a comprehensive taste and smell test battery.Results: The questionnaire items poorly detected bona fide taste problems. However, they were sensitive in detecting persons without such problems (i.e., they exhibited low positive but high negative predictive value). Dysfunction categories of the University of Pennsylvania Smell Identification Test (UPSIT) were not meaningfully related to subjects' responses to the questionnaire statements. Both sex and age influenced performance on most of the taste tests, with older persons performing more poorly than younger ones and women typically outperforming men.Conclusion: Although it is commonly assumed that straight‐forward questions concerning taste may be useful in detecting taste disorders, this study suggests this is not the case. However, patients who specifically report having no problems with taste perception usually do not exhibit taste dysfunction. The difficulty in detecting true taste problems by focused questionnaire items likely reflects a combination of factors. These include the relatively low prevalence of taste deficits in the general population and the tendency of patients to confuse loss of olfaction‐related flavor sensations with taste‐bud mediated deficits.
The Quartile Benefit Plot: A Middle Ear Surgery Benefit Assessment Scheme
Authors: Schmerber Sébastien , Karkas Alexandre , Righini Christian A. , Chahine Karim A. 
Published: February 2009

AbstractObjective: The purpose of this study is to present a new method for the assessment of hearing improvement following stapes surgery, taking into account additional, previously omitted evaluation criteria.Study Design: Retrospective.Methods: A quartile plot, based on the currently used Glasgow benefit plot, is structured to include two additional criteria of hearing assessment, namely the absence of postoperative sensorineural hearing loss and the closure of the air‐bone gap to <10 dB. Pre‐ and postoperative hearing results of 132 patients diagnosed with bilateral otosclerosis and treated with bilateral stapes surgery were plotted on both the classical Glasgow benefit plot and the new quartile benefit plot. The difference in success assessment due to stricter assessment criteria is demonstrated.Results: Functional success rate following bilateral stapes surgery as plotted on the traditional Glasgow benefit plot was 51.5%. Success rate for bilateral stapes surgery assessed on the new quartile plot with the addition of the two new criteria was 38.64%. The difference in success rates was found to be statistically significant.Conclusion: The basis of benefit assessment in stapes surgery solely on the mean deficit in air conduction results in overestimation of success rate. This study demonstrates that results that appear satisfactory when judged by the Glasgow benefit plot are of modest success when assessed by the new quartile plot. The quartile benefit plot presented in this paper provides a strict measure of presentation and evaluation of stapes surgery results.
Validation of a Networked Virtual Reality Simulation of Temporal Bone Surgery
Authors: O'Leary Stephen J. , Hutchins Matthew A. , Stevenson Duncan R. , Gunn Chris , Krumpholz Alexander , Kennedy Gregor , Tykocinski Michael , Dahm Marcus , Pyman Brian 
Published: February 2009

AbstractObjectives: To assess the content validity and concurrent validity of a haptically (force feedback) rendered, virtual reality simulation of temporal bone surgery.Methods: Eleven naive surgical trainees were given a 1‐hour lesson on the operation, cortical mastoidectomy, in the virtual environment with the trainer on a networked simulator and then asked to perform this procedure on a real temporal bone.Results: The simulator was found to be a convincing representation of temporal bone drilling and could be said to exhibit face validity. The simulator was an effective means of teaching both the surgical anatomy and the surgical approach as judged by oral assessments made before and after the virtual reality training session. The trainees were successful in identifying most surgical landmarks during their first temporal bone dissection, and over two thirds found the landmarks at the correct time during the procedure. Some trainees exhibited acceptable or better technique with the drill despite this being their first temporal bone dissection. Subjective assessments indicated a high level of acceptance of simulated surgery for training, and there was perceived value in specific enhancements of the virtual environment that facilitated learning. Particular enhancements of value were the networked simulation, the option to make the model semitransparent to reveal anatomic relationships, and error reporting when the sigmoid sinus or facial nerve was injured.Conclusions: Virtual reality simulation of temporal bone surgery was an effective method for teaching surgical anatomy and planning and was well accepted by trainees.
Growth Promoting Treatment Normalizes Speech Frequency in Turner Syndrome
Authors: Andersson‐Wallgren Gunnel , Ohlsson Ann‐Christine , Albertsson‐Wikland Kerstin , Barrenäs Marie‐Louise 
Published: February 2009

AbstractObjective: To assess objective and subjective voice parameters among Turner syndrome (TS) women in relation to genotype, hearing, growth, and previous treatment with growth hormone (GH) and androgen given that lowering of speaking fundamental frequency (SFF) during treatment is regarded as a negative side effect.Study Design: Cross‐sectional, controlled for karyotype and age.Methods: Voice function was studied objectively (SFF) and subjectively (questionnaire) in 117 women with TS.Results: SFF did not differ between treated and nontreated participants or between patients with a spontaneous versus induced puberty. SFF was dependent on karyotype but not age. Subjective voice change was reported four times more often among treated compared with nontreated TS women (odds ratio [OR] = 4.4; 95% confidence interval [CI]: 0.9–20.10), whereas voice and articulation problems were reported three times more often among untreated compared with treated cases (OR = 2.9; 95% CI: 1.0–8.3). Voice symptoms were over‐represented among patients having micrognathia (OR = 6.0; 95% CI: 1.6–22.3), hearing loss (OR = 8.6; 95% CI: 1.7–43.1), and monosomy (OR = 6.2; 95% CI: 0.8–36.2) but not among those with an arched palate.Conclusions: When given to TS girls, GH (33–66 μg/kg/d) and androgen (0.05 mg/kg/d) normalized SFF and reduced voice and articulation problems in adulthood. The TS phenotype includes important voice and speech problems, which in turn are associated with hearing problems, although genotypic, monosomic, and isochromosome patients have more voice problems and also more high‐pitched voices than mosaic patients. Most TS women, despite their karyotype or age, exhibit a higher frequency of pitched voice than non‐TS women.
Optimization of Autologous Muscle Stem Cell Survival in the Denervated Hemilarynx
Authors: Halum Stacey L. , Hiatt Kelly K. , Naidu Moumita , Sufyan Ahmed S. , Clapp D. Wade 
Published: February 2009

AbstractObjective: Current treatments for vocal fold paralysis are suboptimal in that they fail to restore dynamic function. Autologous muscle stem cell (MSC) therapy is a promising potential therapy for vocal fold paralysis in that it can attenuate denervation‐induced muscle atrophy and provide a vehicle for delivery of neurotrophic factors, thereby potentially selectively guiding reinnervation. The goal of this project was to characterize optimal conditions for injected autologous MSC survival in the thyroarytenoid (TA) muscle following recurrent laryngeal nerve (RLN) injury by local administration of adjuvant factors.Study Design: Animal experiment.Methods: Unilateral RLN transection and sternocleidomastoid muscle (∼1 g) biopsies were performed in 20 male Wistar rats. One month later, 106 autologous MSCs labeled via retroviral‐enhanced green fluorescent protein (EGFP) transduction were injected into the denervated hemilarynx of each animal with one of four adjuvant therapies: cardiotoxin [(CTX) 10−5 M], insulin‐like growth factor‐1 [(IGF‐ 1) 100 μg/mL], ciliary neurotrophic factor [(CNTF) 50 μg/mL], or saline. Animals were euthanized 1 month later and larynges harvested, sectioned, and analyzed for MSC survival.Results: All specimens demonstrate extensive MSC survival, with fusion of the MSCs with the denervated myofibers. Based on mean fluorescent intensity of the laryngeal specimens, IGF‐1 and CNTF had the greatest positive influence on MSC survival. Myofiber diameters demonstrated myofiber atrophy to be inversely related to MSC survival, with the least atrophy in the groups having the greatest MSC survival.Conclusions: Autologous MSC therapy may be a future treatment for vocal fold paralysis. These findings support a model whereby MSCs genetically engineered to secrete CNTF and/or IGF‐1 may not only promote neural regeneration, but also enhance MSC survival in an autocrine fashion.
Outcomes and Efficacy of Newborn Hearing Screening: Strengths and Weaknesses (Success or Failure?)
Authors: Korres S. , Nikolopoulos Thomas P. , Peraki E. E. , Tsiakou M. , Karakitsou M. , Apostolopoulos N. , Economides J. , Balatsouras D. , Ferekidis E. 
Published: February 2009

AbstractObjective: To assess the outcomes of neonatal hearing screening with regard to the final diagnosis in a very large number of newborns and investigate related strengths and weaknesses of the program.Subjects: In this study, 76,560 newborns were assessed.Method: All neonates were assessed using transient evoked otoacoustic emissions (TEOAEs).Results: From the 76,560 neonates screened, 1,564 (2%) failed the test. According to the screening protocol, all parents of failed neonates were asked to bring their children 1 month following discharge to repeat the test. Of the 541 (34.6%) newborns who repeated the test, 303 (56%) were found normal and 238 (44%) again failed TEOAE. The latter children were referred to two special public centers for full audiology evaluation. In addition, 124 neonates were also referred due to other reasons revealed in the screening process (family history, high levels of bilirubin, etc.). Of the 362 children who were referred to the two special audiology centers, 113 (31.2%) were evaluated by these two centers. In addition, 42 children who had failed initial screening and did not show up for a follow‐up appointment to repeat TEOAE were also assessed in the same centers. Of the 155 children who had a special audiologic evaluation, 56 (36.1%) were found to have hearing loss (HL) and 99 (63.9%) normal hearing. In detail, 28 had bilateral sensorineural HL greater than 40 dB, 10 had unilateral sensorineural HL greater than 40 dB, and 18 had otitis media with effusion or other conductive HL.Conclusions: Derived from the present study: 1) repeated testing of “failed” newborns in the maternity hospital and before discharge leads to an acceptable referral rate of 2%; 2) the 1‐month follow‐up of “failed” newborns further limits the false positive results but leads to high rate of newborns lost to follow‐up; 3) a dedicated secretariat system should be implemented to follow‐up each “failed” newborn and remind parents about their follow‐up appointments; and 4) additional measures such as detailed educational material and parental friendly approach should also be implemented.
Failed Tube Extrusion is Not a Random Event in Children or Their Siblings
Authors: Azadarmaki Roya , Gaughan John P. , Isaacson Glenn 
Published: February 2009

AbstractObjectives/Hypothesis: It has been assumed that prolonged retention of tympanostomy tubes was random, with an incidence of 4% to 12% per tube. We have noticed patterns of tube retention that suggested a genetic predilection. We undertook this study to validate or disprove this impression. Such information may shed light on the physiology of tube extrusion and may help better define the risks of tympanostomy tube placement.Study Design: Retrospective, single‐surgeon, statistical analysis.Methods: A computerized database of approximately 10,000 pediatric otolaryngology patients was queried. We identified all children treated by the senior author during a 6‐year period who underwent tube removal for failed extrusion 24 or more months after placement. Siblings with retained tubes and individuals requiring bilateral tube removal were further analyzed: 1) using the law of multiplication of independent factors, the chance of retaining tubes in both ears of an individual was compared with the observed rate of bilateral retention by calculating the difference in Poisson rates; 2) the rate of siblings who retained one or both tubes was compared with nonsiblings who retained one or both tubes using the Z test for independent proportions.Results: The observed rate of bilateral retention (228/6,000 = 0.038) far exceeded the theoretical rate (0.0682 = 0.0046; P < .001). Siblings were more likely to retain tubes than nonsiblings (difference = 0.042; P = .085). This difference was more pronounced in unilateral (difference = 0.048; P = .014) than in bilateral retention (difference = 0.005; P = .856).Conclusions: Tympanostomy tube retention is not a random occurrence. Patterns of nonextrusion in individuals and siblings suggest a genetic mechanism. Implications for patient counseling and research are discussed.
Secreting Jugulotympanic Paraganglioma With Venous Involvement into the Thorax
Authors: Daramola Opeyemi O. , Shinners Michael J. , Levine Samuel C. 
Published: February 2009

AbstractParagangliomas are highly vascular tumors that arise from chief cells in extra‐adrenal paraganglia of the autonomic nervous system. Jugulotympanic paragangliomas involve the middle ear and jugular fossa. Secreting jugulotympanic paragangliomas with thoracic extension are rare. We report a case with unexpected involvement of the internal jugular vein. Otolaryngologists should be aware that the jugulotympanic paragangliomas traverse variable anatomic pathways. Multiple imaging options, including magnetic resonance venography, are useful and should include the neck for definitive characterization of tumor anatomy. Patients with refractory hypertension and masses suspicious for paraganglioma should be examined for functional tumors.
Chondrosarcoma of the Hyoid Bone: Imaging, Surgical, and Histopathologic Correlation
Authors: Saki Nader , Akhlagh Soheila Nik , Mostofi Neptone Emad , Ahmadi Khashayar 
Published: February 2009

AbstractObjectives/Hypothesis: Rare diseases must be diagnosed with great caution, so we present this case to familiarize clinicians with the presentation and treatment of chondrosarcoma of the hyoid bone, a rare disease.Study Design: Case report and review of the literature.Methods: We report one case of chondrosarcoma of the hyoid bone which presented with upper midline neck mass. In addition, we review the literature published in English regarding chondrosarcoma of the hyoid bone.Results: Chondrosarcoma of the hyoid bone is a rare disease of which only 14 cases have been reported until now. Patients with this disease have no sexual or racial preponderance, and most presented with a mass in the upper neck which has splotchy calcification in radiologic imaging without enhancement. The preferred treatment is wide excision.Conclusion: Because chondrosarcoma have indolent growth, are locally noninvasive, and appear encapsulated during operation, they may be mistaken for a benign mass and conservatively resected. On the other hand, incomplete tumor resection may lead to recurrence, which is associated with increased risk of dedifferentiation and histologic grading of tumor. Surgeons should approach this surgery with caution.
Relationship Between Rhinitis Duration and Response to Nasal Decongestion Test
Authors: Ciprandi Giorgio , Pistorio Angela , Tosca Mariangela , Cirillo Ignazio 
Published: February 2009

AbstractObjectives/Hypothesis: Nasal obstruction depends on allergic inflammation. Decongestion tests evaluate the reversibility of nasal airflow limitation. It has been previously reported that duration of persistent allergic rhinitis (PER) may involve important functional consequences. The purpose of the study was to evaluate the impact of the duration of rhinitis on the response to nasal decongestion test in a cohort of patients with PER.Methods: A total of 312 patients with moderate‐severe PER were prospectively and consecutively evaluated: 234 males and 78 females, mean age 23.6 years. A detailed clinical history was taken and complete physical examination, nasal endoscopy, skin prick test, rhinomanometry, and nasal decongestion test were performed for all patients.Results: A strong inverse correlation was observed (Pearson's r = −0.81) between rhinitis duration (years) and posttest percentage change of nasal airflow values.Conclusions: The duration of PER may induce a progressive impairment of the response to nasal decongestion test.
Impact of Second Primary Tumors on Survival in Head and Neck Cancer: An Analysis of 2,063 Cases
Authors: Rennemo Erlend , Zätterström Ulf , Boysen Morten 
Published: February 2009

AbstractObjective/Hypothesis: To investigate the impact of second primary tumors on prognosis for patients with head and neck squamous cell carcinoma (HNSCC).Study Design: Prospectively recorded data on HNSCC patients treated at an academic tertiary referral center.Methods: An analysis of 2,063 patients treated over a 15 year period for tumors of the upper aerodigestive tract, with a minimum follow‐up of 10 years.Results: A total of 351 (17%) patients developed a second primary, mean time to diagnosis of the second tumor being more than 4 years from the date of the initial tumor. Median overall survival from the date of the first tumor among patients who later developed a second primary was 6 years versus 3 years among all other patients (P < .05). During the first 6 years after treatment of the initial tumor, cancer specific survival was better in the second primary group. After diagnosis of a second primary tumor, median survival was 12 months. A positive correlation was found between second primaries and stage I/II primary disease, low patient age, and initial tumors of the larynx and oral cavity.Conclusions: The group of patients with the highest risk of a second primary tumor was younger patients with limited initial tumors. A high proportion of patients who later developed a second primary were complete responders after treatment of the first tumor. However, prognosis was poor after the actual diagnosis of the second primary tumor.