bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physiologic Model of Oropharyngeal Swallowing Revisited
Authors: Martin‐Harris Bonnie , Michel Yvonne , Castell Donald O. 
Published: August 2005

Objective:The purposes of this investigation were to determine whether the temporal onsets of swallow events segment into oral and pharyngeal phases, to test the interdependence of temporal onsets of swallow events, and to determine the influence of age on total swallow duration.Study Design and Setting:The onsets of swallowing and respiratory measures were studied in 76 healthy normal individuals.Results:Confirmatory factor analysis revealed a 2‐factor solution but did not support the hypothesized 2‐phase structure (ie, oral and pharyngeal). Two of the onsets, apnea onset and apnea offset, formed a single factor that explained 12.6% of the variation among the 11 onset times. The other 9 onsets formed a second factor that explained 66.4% of the variation. Age accounted for modest variation in total swallow duration.Conclusions:The two factors, oropharyngeal and respiratory, explained 79% of the variation among the 11 onset times.Significance:This finding speaks to the overlap between the initiation of oral and pharyngeal components of swallowing in adults and highlights the artificiality of separating the swallowing continuum into isolated phases.
A Simple and Valuable Approach for Measuring Customer Satisfaction
Authors: Kinney William C. 
Published: August 2005

OBJECTIVE:To determine the financial impact of poor customer satisfaction and the value of information gained from using a 1‐question customer‐satisfaction survey in a medical setting.STUDY DESIGN AND SETTING:A single‐question customer‐satisfaction survey was collected from customers presenting to an academic otolaryngology head and neck surgery outpatient clinic.RESULTS:The overall response rate was 25%, overall net promoter score was 67.3%, lowest net promoter score occurred on Wednesday and Friday, overall net potential referrals were 872, and potential lost revenue from dissatisfied customers equaled $2.3 million.CONCLUSION:A single‐question customer‐satisfaction survey may help identify areas of customer dissatisfaction that lead to a significant source of lost revenue.SIGNIFICANCE:The competitive forces in today's health care environment require medical practices to address issues related to customer satisfaction.
Transpalatal Advancement Pharyngoplasty Outcomes Compared With Uvulopalatopharygoplasty
Authors: Woodson B. Tucker , Robinson Sam , Lim Hyun J. 
Published: August 2005

Objective:Uvulopalatopharyngoplasty (UPPP) success rates in patients classified with Friedman stage 3 is reported as 8%. Surgical failure may result from persistent obstruction at the palate, which may be addressed by pharyngoplasty with palatal advancement (PA). The effectiveness of PA versus UPPP was evaluated by using polysomnographic outcomes in a retrospective cohort of patients classified with Friedman stage 3.Methods:Surgical records were reviewed for PA (n = 47) and UPPP (n = 124). Clinical records were reviewed and reclassified by Friedman stage. Respiratory data were collected from overnight polysomnography. Statistical analysis was conducted of continuous variables (ANOVA), categorical variables (χ2), and adjusted odds ratios by using logistic regression.Results:PA (n = 30) and UPPP (n = 44) did not differ in baseline apnea hypopnea index (AHI), age, or BMI. Both PA (48.3 ± 24.6 to 19.8 ± 16.8 events per hour, P < 0.000) and UPPP (47.9 ± 30.0 to 30.9 ± 24.2 events per hour, P < 0.000) improved with surgery. In the PA group, final AHI was lower (17.1 ± 30.1 versus 28.5 ± 25.6, P < 0.04) and postoperative change was greater (30.9 ± 24.2 versus 19.8 ± 16.8, P < 0.02). For patients with Friedman stage 3, odds ratio of having an AHI of <20 events per hour and a greater than 50% reduction with PA compared with UPPP was 3.80 (95% CI, 1.41‐10.29, P < 0.013). Adjusted for age, body mass index, preoperative apnea severity, and tongue‐base surgery, OR was 5.77 (95% CI of 1.80‐17.98).Conclusions:Polysomnographic outcomes using AHI support the use of palatopharyngoplasty using palatal advancement as an effective treatment of obstructive sleep apnea. PA may offer benefit over UPPP alone in patients classified with Friedman stage 3.
Diagnosis and Management of Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo
Authors: White Judith A. , Coale Kathleen D. , Catalano Peter J. , Oas John G. 
Published: August 2005

Objective:Describe the diagnosis, treatment, and outcome of a group of 20 patients with lateral semicircular canal benign paroxysmal positional vertigo (LSC‐BPPV).Study Design and Setting:Retrospective review of 20 patients with LSC‐BPPV (10 with geotropic and 10 with apogeotropic nystagmus) presenting to a tertiary balance center. Diagnosis was confirmed with infrared nystagmography in Dix‐Hallpike positioning tests and supine positional tests. Patients were treated with one or more particle repositioning maneuvers.Results:Addition of supine positional nystagmus tests to Dix‐Hallpike positioning testing improves sensitivity in the diagnosis of LSC‐BPPV. Treatment outcomes in the apogeotropic LSC‐BPPV group were poorer than the geotropic LSC‐BPPV group.Significance:Adding supine positional testing to routine vestibular diagnostic testing will increase the identification of LSC‐BPPV. Apogeotropic LSC‐BPPV is more challenging to treat.
Symptom and Disease Severity Differences Between Nasal Septal Deviation and Chronic Rhinosinusitis
Authors: Bhattacharyya Neil 
Published: August 2005

OBJECTIVE:To determine whether patients with chronic rhinosinusitis (CRS) exhibit more severe sinonasal symptom scores as compared with patients with nasal septal deviation (NSD) alone.METHODS:Two patient cohorts were prospectively identified: patients undergoing surgery for NSD alone and those undergoing endoscopic sinus surgery for CRS without NSD. Patients in the NSD group were required to have normal paranasal sinus CT scans, whereas patients in the CRS group were required to have radiographic evidence of CRS. All patients completed the Rhino‐sinusitis Symptom Inventory (RSI). Statistical comparisons were conducted between cohorts with respect to RSI symptom domains and medical resource utilization.RESULTS:A total of 42 patients were identified in the NSD group (mean age, 40.8 years) and 155 patients were identified in the CRS group (mean age, 44.9). Patients with CRS demonstrated higher severity scores for the nasal symptom domains (60.3 [CRS] versus 53.9 [NSD], P = 0.037). Oropharyngeal symptoms and total symptoms were also worse for the CRS group versus the NSD group (29.8 versus 23.1, P = 0.014 and 43.0 versus 37.0, P = 0.030). Facial and systemic symptom scores did not differ between groups. Patients with CRS demonstrated significantly higher utilization rates for topical nasal steroids (21.2 versus 12.2 weeks, P = 0.006) and oral antibiotics (7.9 weeks versus 2.1 weeks, P < 0.001), but not for oral antihistamines (P = 0.420).CONCLUSIONS:Although patients with CRS manifest higher sinonasal symptom scores than patients with NSD alone, differentiating these 2 diagnoses on the basis of symptoms alone is difficult. These data suggest that as a disease process, CRS confers a significant disease burden with more significant negative symptom impact.
Pediatric Tracheotomies in an Asian Population: The Singapore Experience
Authors: Ang Annette H. C. , Chua Dennis Y. K. , Pang Kenny P. , Tan Henry K. K. 
Published: August 2005

Objective:Over the past 2 decades, tracheotomy in children and infants has evolved from a primarily emergent procedure for upper airway obstruction into a semielective procedure for airway access in assisted ventilation. We present a 12‐year retrospective review of tracheotomies performed in the pediatric population in Singapore.Study Design and Setting:We reviewed all tracheotomies performed in children below the age of 16 years in 2 tertiary pediatric medical centers in Singapore from January 1991 to December 2003. Indications for surgery are reviewed, and outcomes in terms of morbidity rate, mortality rate, postoperative rehabilitation, and duration of decannulation process were analyzed.Results:Tracheotomies were performed in 48 children during the study period. The mean age of patients was 3.24 years, with ages ranging from 16 days to 14 years. Sixty‐three percent of tracheotomies were done within the 1st year of life. The chief indication was airway access for assisted ventilation. The overall complication rate was 31%. There were 13 attempts at decannulation, with 9 successes. No tracheotomy‐related deaths occurred.Conclusion:Tracheotomy is a relatively safe procedure in children and infants. Lower decannulation rates and the evolving role of tracheotomy for early access in assisted ventilation permits earlier discharge with tracheotomy in situ.
Does Hydrogen Peroxide Mouthwash Improve the Outcome of Secondary Post‐Tonsillectomy Bleed? A 10‐year Review
Authors: Pai Irumee , Lo Stephen , Brown Satsuki , Toma Abbad G. 
Published: August 2005

Objective:To determine whether hydrogen peroxide (H2O2) mouthwash influences the outcome of secondary post‐tonsillectomy hemorrhage in children.Study Design:Ten‐year retrospective study of all children with secondary post‐tonsillectomy hemorrhage.Setting:Tertiary otolaryngology center.Results:Of the 156 patients, 59 received H2O2 and 97 did not. All patients received broad‐spectrum intravenous antibiotics. The average rehospitalization duration due to hemorrhage was 1.7 days (H2O2 group) and 1.6 days (control group). In the H2O2 group, 8.5% required surgery, compared with 10.3% in the control group. Further hemorrhage episodes requiring readmission occurred in 3.4% of the H2O2 group and 3.1% of controls. There was no difference between the 2 groups in rehospitalization duration (P = 0.49), rate of surgical intervention (P = 0.85), and rate of readmission with further hemorrhage (P = 0.92).Conclusion:Hydrogen peroxide mouthwash does not improve the outcome of secondary post‐tonsillectomy hemorrhage in pediatric patients.Significance:This study does not support the common practice of treating post‐tonsillectomy hemorrhage with H2O2.
Anatomic Analysis of the Genial Bone Advancement Trephine System's Effectiveness at Capturing the Genial Tubercle and its Muscular Attachments
Authors: Hennessee Jennifer , Miller Frank R. 
Published: August 2005

Objective:The Genial Bone Advancement Trephine (GBAT) System (Stryker Leibinger Inc, Kalamazoo, MI) is a 1‐step system that advances the genial tubercle for treatment of retrolingual obstruction in obstructive sleep apnea. The purpose of this project was to anatomically analyze the effectiveness of the GBAT System to capture the genial tubercle and its muscular attachments in the circular trephine.Methods:Eight cadaveric heads (ages 54‐89 years; 3 female and 5 male) were examined, and Panorex radiographs (Stryker Leibinger Inc, Kalamazoo, MI) were obtained. Seven specimens were selected on the basis of mandibular height and dentition to undergo the procedure. The procedure was performed using the GBAT system with the 14‐mm trephine according to the stepwise instructions. The mandibles were dissected, and analysis of the location of the osteotomy with respect to the genial tubercle, genioglossus muscles, geniohyoid muscles, and mandibular dentition was performed.Results:All 7 of the specimens had complete capture of the genial tubercle. The mean percentage of the genioglossus muscle captured in the circular trephine was 85% (50%‐100%). All specimens had preservation of the posterior muscle fibers. The mean percentage of the geniohyoid muscle captured was 78% (15%‐100%). No tooth roots were transected or contained in the bone plug.Conclusions:The GBAT System is an effective 1‐step system for capturing and advancing the genial tubercle and its muscular attachments in the treatment of OSA.
Standard Anesthetic Technique for Middle Ear Surgical Procedures: A Comparison of Desflurane and Sevoflurane
Authors: Jellish W. Scott , Owen Kevin , Edelstein Steven , Fluder Elaine , Leonetti John P. 
Published: August 2005

Objective:This study was designed to compare desflurane and sevoflurane anesthesia for middle ear microsurgery.Study Design:One hundred healthy adults undergoing middle ear surgery were assigned to receive either desflurane or sevoflurane as their anesthetic. Intraoperative hemodynamics and BIS numbers were recorded. Hemodynamics, pain, nausea/vomiting, discharge readiness, and other parameters were compared postoperatively and 24 hours later.Results:No intraoperative differences were noted except in BIS scores which trended lower with desflurane. PACU blood pressures were higher after desflurane but pain scores, nausea/vomiting, rescue anti‐emetics, recovery scores, and discharge times were similar. A significant difference was noted in anesthetic costs (desflurane > sevoflurane), and in patients with the lowest BIS scores associated with more nausea/vomiting.Conclusions:Both anesthetics may be used for ototic surgery but propofol anesthesia should still be considered in patients with a history of emetic sequelae.Significance:Short‐acting inhalational anesthetics produce excellent operating conditions and reduce costs for otologic surgery.
What is the Relationship Between Chronic Sinus Disease and Isolated Nasal Septal Deviation?
Authors: Yasan Hasan , Doĝru Harun , Baykal Bahattin , Döner Fehmi , Tüz Mustafa 
Published: August 2005

ObjectiveThe aim of this retrospective study is to examine the role of isolated nasal septal deviation (NSD) in the pathogenesis of chronic rhinosinusitis (CRS).Study Design and SettingThe interaction between isolated NSD and chronic sinus disease were retrospectively evaluated in 1452 patients. Out of 1452 patients, 152 patients were included in the study. Patients with anatomical variants other than NSD were excluded from the study. Patients with NSD were enrolled in the study group and patients without NSD were enrolled in the control group.ResultsThere was no statistically significant difference between NSD group and non‐NSD group with respect to the CRS.ConclusionsThe mild to moderate degree of NSD was not a risk factor for chronic sinus disease. Only gross deviation of the nasal septum itself is a risk factor for the development of CRS.SignificanceExcluding the subjects with ostiomeatal anatomic variations has differentiated this study from the previously reported researches (isolated NSD).
Radiofrequency Versus Injection Snoreplasty in Simple Snoring
Authors: Iseri Mete , Balcioğlu Okan 
Published: August 2005

Objective:To compare the efficacy and tolerance of controlled temperature radiofrequency (RF) and injection snoreplasty (IS) for the treatment of simple snoring.Study Design:The study was a nonrandomized, prospective study conducted on 70 simple snorers. Efficacy of the operations was subjectively evaluated by the bed partners and after 6 weeks of the last treatment. Tolerance was evaluated by the patient during first 10 postoperative days. Postoperative pain and discomfort level were assessed.Results:Satisfaction in terms of snoring severity was reported by 87.5% of the cases with RF and by 76.7% of the patients with IS. Discomfort levels also were similar for both groupsConclusions:Controlled‐temperature RF and IS were both effective on snoring and well tolerated by the patients. This allows retreatments if necessary.
Prevalence of Pus in Radiologically Diseased Sinuses in Patients Undergoing Surgery For Chronic Rhinosinusitis
Authors: Robinson Simon , Der‐Haroutian Vanik , Grove David , Rees Guy , Wormald Peter John 
Published: August 2005

OBJECTIVETo establish the prevalence of pus in radiologically diseased sinuses in patients undergoing sinus surgery and to correlate this with the bacterial load in the sinuses.Study Deign and SettingA prospective study performed on adult patients with the diagnosis of chronic sinusitis undergoing endoscopic sinus surgery at an Adelaide group of academic hospitals. In 45 consecutive and unselected patients, a radiologically diseased sinus was surgically opened, and a specially designed suction aspirator was placed into the sinus under endoscopic control. These aspirates were Gram stained and cultured to quantify the polymorphonuclear neutrophil count, bacterial flora, and bacterial colony count. The CT scans of all patients were graded by using the Lund‐Mackay scoring system.ResultsA variety of bacteria, most commonly staphylococci, were cultured from a radiologically diseased sinus in 88% of patients. There was no correlation between the bacterial colony count and presence of pus, and only 11% of patients had microscopic evidence of inflammation in sinus aspirates. There was no correlation between the Lund‐Mackay CT score and the presence of pus in the sinus.ConclusionsThe majority of patients undergoing surgery for chronic sinusitis did not have a purulent exudate, and there was no correlation with the bacterial load. The usefulness of antibiotics in the treatment of chronic rhinosinusitis, in the absence of macroscopic pus, is questionable.
Efficacy and Safety of a Novel, Single‐dose Azithromycin Microsphere Formulation Versus 10 Days of Levofloxacin for the Treatment of Acute Bacterial Sinusitis in Adults
Authors: Murray John J. , Emparanza Paz , Lesinskas Eugenijus , Tawadrous Margaret , Breen Jeanne D. 
Published: August 2005

ObjectiveTo compare the efficacy and safety of a single 2.0‐g dose of a novel azithromycin microsphere formulation with that of 10 days of levofloxacin, 500 mg/d, when used to treat adults with uncomplicated acute bacterial maxillary sinusitis (ABS).Study Design and SettingAn international, multicenter, randomized, double‐blind, double‐dummy trial. Eligible outpatients ≥18 years of age with clinical and radiographic evidence of ABS underwent maxillary sinus aspiration before randomization. Primary endpoint was clinical efficacy at the test‐of‐cure visit (day 17‐24).ResultsClinical success rates were 94.5% (242/256) in azithromycin‐microspheres‐treated patients and 92.8% (233/251) in the levofloxacin group. In patients with documented Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, clinical cure rates were 97.3% (36/37), 96.3% (26/27), and 100% (8/8), respectively, for the azithromycin group and 92.3% (36/39), 100% (30/30), and 90.9% (10/11), respectively, for the levofloxacin group.ConclusionsSingle‐dose azithromycin microspheres provided clinical and bacteriologic efficacy and safety comparable to 10 days of levofloxacin.SignificanceA novel microsphere formulation of azithromycin given as a single dose was safe and effective for the treatment of ABS.
Dexamethasone Inner Ear Perfusion by Intratympanic Injection in Unilateral Ménière's Disease: A Two‐year Prospective, Placebo‐Controlled, Double‐blind, Randomized Trial
Authors: Garduño‐Anaya Marco Antonio , De Toledo Heloísa Couthino , Hinojosa‐González Ramón , Pane‐Pianese Carlo , Ríos‐Castañeda Luis Camilo 
Published: August 2005

Objective:To investigate the efficacy of dexamethasone inner ear perfusion by intratympanic injection in hearing loss, tinnitus, aural fullness, and vertigo in the treatment of unilateral Ménière's disease and compare it with the control group.Study Design and Setting:A prospective, randomized, double‐blind study with 2‐year follow‐up comparing changes secondary to dexamethasone inner ear perfusion versus placebo consisting of saline solution.Patients:Twenty‐two patients having definite Ménière's disease as outlined by the 1995 American Academy of Otolaryngology‐Head and Neck Surgery Committee on Hearing and Equilibrium. All the patients were older than 18 years of age and were not receiving any other form of treatment with steroids for their Ménière's disease.Method:Five consecutive daily intratympanic injections of dexamethasone or placebo to the involved ear.Results:In the dexamethasone group at 2‐year follow‐up, complete control of vertigo (class A) was achieved in 9 of 11 patients (82%) and substantial control of vertigo (class B) in the remaining 2 patients (18%.) In the control group only 7 of 11 patients (64%) finished the 2‐year follow‐up because in the other 4 patients (36%) we had to give another treatment for the continuing vertigo and thus they were classified as failure (class F.) From the 7 patients who have finished the follow‐up of 2 years in the control group, 4 patients (57%) achieved class A, 2 patients (29%) achieved class C, and 1 patient (14%) class F.Conclusions:Dexamethasone (4 mg/mL) inner ear perfusion in a group of patients with unilateral Ménière's disease (Shea's stage III) showed 82% of complete control of vertigo over placebo (57%). There was also a subjective improvement in tinnitus (48%), hearing loss (35%), and aural fullness (48%) in the dexamethasone group compared with 20%, 10%, and 20% respectively in the control group.EBM Rating: A
Spectrum of Middle and Inner Ear Abnormalities in Infants With Congenital Heart Defects
Authors: Ulualp Seckin O. , Wright Charles G. , Roland Peter S. 
Published: August 2005

Objective:To evaluate temporal bone histopathology in infants with congenital heart defects (CHD).Study Design and Setting:A retrospective review of our temporal bone collection was conducted to identify temporal bones acquired from infants with CHD. Subjects were divided into nonsyndromic and syndromic CHD groups. The presence of temporal bone abnormalities and the incidence of abnormalities that may result in hearing impairment were determined.Results:Thirty‐eight temporal bones obtained from 16 infants with nonsyndromic CHD and 4 with syndromic CHD were evaluated. Nonsyndromic CHD cases had abnormalities such as a mesenchymal remnant, malformed stapes, persistent stapedial artery, shallow round window, dehiscent facial nerve canal, short cochlea, strial basophilic deposits, deformity of the spiral ligament, bulging Reissner's membrane, hypoplastic lateral semicircular canal, and cupular deposits. Syndromic CHD cases had abnormalities including narrow round window niche, facial canal dehiscence, strial basophilic deposits and cysts, and outer hair cell loss. Middle and inner ear abnormalities that may impair hearing were observed in 6 subjects with nonsyndromic CHD and in 1 subject with syndromic CHD.Conclusions:A wide variety of temporal bone defects were documented in infants with CHD. Congenital middle and inner ear abnormalities should be anticipated in the hearing assessment and otologic surgery of infants with CHD.
Intratympanic Steroid Injection for Treatment of Idiopathic Sudden Hearing Loss
Authors: Slattery William H. , Fisher Laurel M. , Iqbal Zarina , Friedman Rick A. , Liu Nancy 
Published: August 2005

Objective.To conduct a clinical trial of intratympanic steroid injection for idiopathic sudden sensorineural hearing loss in subjects who failed oral steroid therapy.Study Design and Setting.Open‐label methylprednisolone injection clinical trial in a tertiary neurotologic referral center. Twenty subjects (14 males; 6 females) received 4 injections within a 2‐week period (4 days apart). Hearing, dizziness/p, and tinnitus were evaluated before and after treatment.Results.There were no serious unexpected adverse events and 2 types of expected adverse events (tympanic membrane perforation, nausea after injection). No increases in dizziness or tinnitus lasting longer than 24 hours were observed after injections. One of 20 (5%) improved to near‐normal hearing. In addition, there was statistically significant improvement in 4‐frequency pure‐tone average and speech discrimination score at 1 month after treatment.Conclusion.Four intratympanic injections of methylprednisolone improved pure‐tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids.Significance.A clinical trial of intratympanic injections for idiopathic sudden hearing loss was successfully completed and promising results were found.