OtoRhinoLaryngology News: 05/26/16

Πέμπτη 26 Μαΐου 2016

Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea.

Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Emara TA, Hassan MH, Mohamad AS, Anany AM, Ebrahem AE

Abstract
OBJECTIVE: To investigate the efficacy of anterolateral advancement pharyngoplasty to enlarge pharyngeal airspace and to decrease palatal and lateral pharyngeal wall collapse in the treatment of obstructive sleep apnea (OSA).
STUDY DESIGN: Prospective study.
SETTING: University medical hospital.
SUBJECTS AND METHOD: Forty-one patients underwent an anterolateral advancement pharyngoplasty procedure according to the following criteria: body mass index <30 kg/m(2), Friedman stage II or III, type I Fujita, nocturnal polysomnography diagnostic of OSA, retropalatal and lateral pharyngeal collapse, and diagnosis with flexible nasoendoscopy during a Müller's maneuver based on a 5-point scale. Patients with retroglossal airway collapse were excluded from the study. The principle of this technique is to advance and fix the palatopharyngeus muscle with the superior pharyngeus constrictor muscle without transecting any of their fascicules anterolateral to the pterygomandibular raphe and anterosuperior to the levator veli palatine muscle.
RESULTS: Pre- and postoperative polysomnography findings (mean ± SD) showed significant statistical differences: apnea hypopnea index (AHI) decreased from 42.1 ± 16.34 to 16.3 ± 10.3 (P ≤ .001); percentage of time with oxyhemoglobin saturation <90% decreased from 18.5% ± 4.2% to 10.1% ± 1.3% (P ≤ .001); and lowest oxygen saturation level increased from 79.9% ± 14.8% to 89.3% ± 11.1% (P ≤ .05). The mean time for patients to return to a normal diet was 12.2 days. There was no postoperative bleeding, velopharyngeal insufficiency, speech alternations, or taste loss. Based on a threshold of a 50% reduction in AHI and AHI <20, surgical success was 86.8%.
CONCLUSION: Anterolateral advancement pharyngoplasty appears to be an effective technique with a high surgical success rate in the treatment of OSA patients with lateral pharyngeal wall collapse.

PMID: 27221568 [PubMed - as supplied by publisher]

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Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

http:--production.springer.de-OnlineReso

Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3311-6

Authors: Kim DK, Rhee CS, Yun PY, Kim JW

Abstract
No studies for the role of adenotonsillar hypertrophy in development of dentofacial abnormalities have been performed in Asian pediatric population. Thus, we aimed to investigate the relationship between adenotonsillar hypertrophy and dentofacial abnormalities in Korean children. The present study included consecutive children who visited a pediatric clinic for sleep-disordered breathing due to habitual mouth breathing, snoring or sleep apnea. Their palatine tonsils and adenoids were graded by oropharyngeal endoscopy and lateral cephalometry. Anterior open bite, posterior crossbite, and Angle's class malocclusions were evaluated for dentofacial abnormality. The receiver-operating characteristic curve analysis was used to identify age cutoffs to predict dentofacial abnormality. A total of 1,083 children were included. The presence of adenotonsillar hypertrophy was significantly correlated with the prevalence of dentofacial abnormality [adjusted odds ratio = 4.587, 95% CI (2.747-7.658)] after adjusting age, sex, body mass index, allergy, and Korean version of obstructive sleep apnea-18 score. The cutoff age associated with dentofacial abnormality was 5.5 years (sensitivity = 75.5%, specificity = 67%) in the children with adenotonsillar hypertrophy and 6.5 years (sensitivity = 70.6%, specificity = 57%) in those without adenotonsillar hypertrophy. In conclusion, adenotonsillar hypertrophy may be a risk factor for dentofacial abnormalities in Korean children and early surgical intervention could be considered with regards to dentofacial abnormality.

PMID: 25490975 [PubMed - indexed for MEDLINE]

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[Tumors of the lacrimal drainage system].

[Tumors of the lacrimal drainage system].

HNO. 2016 May 24;

Authors: von Goscinski C, Koch KR, Cursiefen C, Heindl LM

Abstract
BACKGROUND: The prevalence of tumors affecting the lacrimal drainage system is low, thus generating a risk of late diagnosis and treatment in clinical routine. However, these tumors can be potentially life-threatening, which emphasizes the relevance of early diagnosis and treatment.
OBJECTIVE: This review focuses on the symptoms, incidence, management, and prognosis of the different tumor entities affecting the lacrimal drainage system.
METHODS: The study provides a PubMed-based literature review and presents own clinical results.
RESULTS: Alongside detailed medical history taking and comprehensive clinical examination, precise inspection during external dacryocystography is important for diagnosis of tumors affecting the lacrimal drainage system. There is a wide spectrum of tumor entities located in the lacrimal drainage system. The tumors are classified into three groups: primary epithelial, primary nonepithelial, and inflammatory lesions. The most common primary epithelial tumors include papilloma, squamous cell carcinoma, and transitional cell carcinoma. The most common nonepithelial tumors include fibrous histiocytoma, malignant lymphoma, and malignant melanoma; while the most common inflammatory lesions comprise sarcoidosis, Wegener granulomatosis, and pyogenic granuloma. Treatment depends on the entity and stage of the tumor. In the case of malignancy, a multimodal and interdisciplinary approach is usually indicated.
CONCLUSION: Differential diagnostic signs in favor of a malignancy include a long medical history, predisposing conditions in the patient's history, a mass above the medial canthal ligament, teleangiectasis above the mass, and serosanguinous secretion.

PMID: 27222017 [PubMed - as supplied by publisher]

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[Efferent tear ducts in the focus of ophthalmic and otorhinolaryngologic surgeons].

[Efferent tear ducts in the focus of ophthalmic and otorhinolaryngologic surgeons].

HNO. 2016 May 24;

Authors: Struck HG, Heichel J

PMID: 27222016 [PubMed - as supplied by publisher]

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Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity-modulated radiotherapy.

Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity-modulated radiotherapy.

Head Neck. 2016 May 25;

Authors: Parahyba CJ, Ynoe Moraes F, Ramos PA, Haddad CM, da Silva JL, Fregnani ER

Abstract
BACKGROUND: The purpose of this study was to evaluate the distribution of the intensity-modulated radiotherapy (IMRT) dose delivered to the teeth, maxilla, and mandible.
METHODS: The mean dose (Dmean) and maximum dose (Dmax) of radiation for the maxilla, mandible, and teeth of 63 patients with oropharyngeal (n = 44) or nasopharyngeal (n = 19) tumors were retrospectively evaluated.
RESULTS: The posterior regions of the mandible received the highest doses, and the teeth received lower doses than the bones (maximum dose, p < .001; average dose, p < .001). The Dmax (p < .001) and Dmean (p < .001) depended on primary tumor location. The superior bones and teeth of patients with nasopharyngeal tumors received more radiation than those of patients with oropharyngeal tumors.
CONCLUSION: A dose distribution map was generated based on the estimated doses received, which could allow prediction of the areas most affected by radiation and facilitate further correlations with dental complications after radiotherapy. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27224929 [PubMed - as supplied by publisher]

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Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis.

Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis.

Head Neck. 2016 May 25;

Authors: Cannizzaro MA, Borzì L, Lo Bianco S, Okatyeva V, Cavallaro A, Buffone A

Abstract
BACKGROUND: The purpose of this review was to compare the efficacy and surgical outcomes of total thyroidectomy between the Focus Harmonic scalpel (Ethicon, Cincinnati, OH) and other hemostatic procedures.
METHODS: An extensive search was conducted using the PubMed and Cochrane databases from January 2008 to October 2014. Operating time, blood loss, pain, complications, and hospital stay were evaluated.
RESULTS: When compared with conventional techniques or LigaSure Precise Vessel Sealing System (Medtronic, Minneapolis, MN), the use of the Focus Harmonic scalpel reduced operative time by 22,428 minutes and blood loss by 13,914 mL. Length of hospital stay was significantly shorter in the Focus Harmonic scalpel group with a mean reduction of 0.410 days.
CONCLUSION: According to our meta-analysis, when comparing the Focus Harmonic scalpel versus conventional techniques, it seems evident that the use of this device in thyroid surgery is associated with a mean reduction in operating time, blood loss, and hospital stay, without any increase in pain and complications. There was no appreciable difference between the Focus Harmonic scalpel and the LigaSure Precise Vessel Sealing System. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27224745 [PubMed - as supplied by publisher]

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Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment.

Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment.

Head Neck. 2016 May 25;

Authors: Hoeben A, van de Winkel L, Hoebers F, Kross K, Driessen C, Slootweg P, Tjan-Heijnen VC, van Herpen C

Abstract
BACKGROUND: Sinonasal intestinal-type adenocarcinomas (ITACs) are epithelial tumors of the nasal cavity and the paranasal sinuses, often related to professional exposure to organic dust, mainly wood or leather. It is a rare cancer. If resectable, surgery is the treatment of choice. Postoperative radiotherapy is often indicated to increase local control. Systemic treatment (chemotherapy, targeted agents, or immunotherapy) of irresectable ITACs and/or metastasized disease is less standardized.
METHODS: Articles on ITAC histopathology, molecular profile, and current treatment options of this specific tumor were identified and reviewed, using the electronic databases Pubmed, Medline, Cochrane, and Web of Science.
RESULTS: This article reviews what is currently known on the histopathology, tumorigenesis, molecular characteristics, and standardized treatment options of ITAC.
CONCLUSION: More translational research is needed to identify druggable targets that may lead to a personalized treatment plan in order to improve long-term outcome in patients with locally advanced and/or metastasized ITAC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27224655 [PubMed - as supplied by publisher]

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Expression of the extracellular sulfatase SULF2 is associated with squamous cell carcinoma of the head and neck.

Expression of the extracellular sulfatase SULF2 is associated with squamous cell carcinoma of the head and neck.

Oncotarget. 2016 May 20;

Authors: Flowers SA, Zhou X, Wu J, Wang Y, Makambi K, Kallakury BV, Singer MS, Rosen SD, Davidson B, Goldman R

Abstract
Sulfatase 2 (SULF2), an extracellular sulfatase that alters sulfation on heparan sulfate proteoglycans, is involved in the tumorigenesis and progression of several carcinomas. SULF2 expression has not been evaluated in squamous cell carcinoma of the head and neck (HNSCC). Here we report results of IHC of SULF2 expression in HNSCC tissue. SULF2 was detected in 57% of tumors (n = 40) with a significant increase in intensity and number of stained cells compared to adjacent cancer-free tissue (p-value < 0.01), increasing with cancer stage when comparing stages 1 and 2 to stages 3 and 4 (p-value 0.01). SULF2 was not detected in epithelial cells of cancer-free controls, and expression was independent of patient demographics, tumor location and etiological factors, smoking and HPV infection by p16 IHC analysis. Sandwich ELISA was performed on serum of HNSCC patients (n = 28) and controls (n = 35), and although SULF2 was detectable, no change was observed in HNSCC. Saliva, collected by mouthwash, from HNSCC patients (n = 8) and controls (n = 8) was also tested by ELISA in a preliminary investigation and an increase in SULF2 was observed in HNSCC (p-value 0.041). Overall, this study shows that SULF2 is increased in HNSCC independent of tissue location (oral cavity, oropharynx, larynx and hypopharynx), patient demographics and etiology. Although no change in SULF2 was detected in HNSCC serum, its detection in saliva makes it worthy of further investigation as a potential HNSCC biomarker.

PMID: 27223083 [PubMed - as supplied by publisher]

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[Effective analysis of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal carcinoma].

[Effective analysis of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal carcinoma].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):372-7

Authors: Yan F, Zhang XX, Ma L, Liu MB, Chen NX, Wang JL, Wu WM, Huang DL

Abstract
OBJECTIVE: To evaluate the therapeutic effects, larynx preservation and adverse events of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal squamous cell carcinomas(SCCs).
METHODS: Forty-six patients with locally advanced laryngeal carcinoma (T2-4, N0-N3) were treated individually with non-surgical combined treatments for larynx preservation (LP). These treatments included concurrent chemoradiotherapy (CCRT)(±epidermal growth factor receptor (EGFR) inhibitor), induction chemotherapy (ICT) followed by CCRT(± EGFR inhibitor), or concurrent radiotherapy and EGFR inhibitor. Radiation therapy was given to a total dose of 60-70 Gy. The Kaplan-Meier method was used to determine the overall survival. Side-effects were evaluated with the established Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.
RESULTS: The average follow-up time was 31.8 months (range 6-95 months). All patients completed the planned radiotherapy without treatment breaks, and 45(97.8%) of 46 patients completed the planned chemotherapy.The 3-year and 5-year overall survival rates were 87.3%and 67.2%, respectively.The 5-year larynx preservation rate was 100.0%. The 3-year and 5-year progression free survival rates were 95.1% and 87.7%, respectively. The most common acute side effect in grade 3 was oropharyngeal mucositis. After treatment, tracheotomy was still required in 2 patients with glottis cancer for laryngeal edema or stenosis. No patient depended on a percutaneous gastrostomy and experienced speech impairment.
CONCLUSION: Patients with locally advanced laryngeal cancer can be offered non-surgical combined treatments for laryngeal preservation and the high quality of life, showing a higher laryngeal preservation survival rate with minimal toxicities.

PMID: 27220298 [PubMed - in process]

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Discussion.

http:--linkinghub.elsevier.com-ihub-imag

Discussion.

Surgery. 2016 Jan;159(1):63-4

Authors:

PMID: 26603843 [PubMed - indexed for MEDLINE]

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Editorial: Translaryngeal vocal cord ultrasound: Ready for prime time.

Editorial: Translaryngeal vocal cord ultrasound: Ready for prime time.

Surgery. 2016 Jan;159(1):67-9

Authors: Parangi S

PMID: 26522697 [PubMed - indexed for MEDLINE]

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Editorial: Laryngeal evaluation for thyroid surgery: Back to the basics.

Editorial: Laryngeal evaluation for thyroid surgery: Back to the basics.

Surgery. 2016 Jan;159(1):65-6

Authors: Shaha AR

PMID: 26453133 [PubMed - indexed for MEDLINE]

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Discussion.

Discussion.

Surgery. 2016 Jan;159(1):57

Authors:

PMID: 26422762 [PubMed - indexed for MEDLINE]

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Role of gradients in vocal fold elastic modulus on phonation.

Role of gradients in vocal fold elastic modulus on phonation.

J Biomech. 2015 Sep 18;48(12):3356-63

Authors: Bhattacharya P, Kelleher JE, Siegmund T

Abstract
New studies show that the elastic properties of the vocal folds (VFs) vary locally. In particular strong gradients exist in the distribution of elastic modulus along the length of the VF ligament, which is an important load-bearing constituent of the VF tissue. There is further evidence that changes in VF health are associated with alterations in modulus gradients. The role of VF modulus gradation on VF vibration and phonation remains unexplored. In this study the magnitude of the gradient in VF elastic modulus is varied, and sophisticated computational simulations are performed of the self-oscillation of three-dimensional VFs with realistic modeling of airflow physical properties. Results highlight that phonation frequency, characteristic modes of deformation and phase differences, glottal airflow rate, spectral-width of vocal output, and glottal jet dynamics are dependent on the magnitude of VF elastic modulus gradation. The results advance the understanding of how VF functional gradation can lead to perceptible changes in speech quality.

PMID: 26159059 [PubMed - indexed for MEDLINE]

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[Analysis of predictors of malignancy of nodular goiters: about 500 cases].

[Analysis of predictors of malignancy of nodular goiters: about 500 cases].

Pan Afr Med J. 2016;23:88

Authors: Bouaity B, Darouassi Y, Chihani M, Touati MM, Ammar H

Abstract
Thyroid nodules are very common and less than 10% of them are malignant. They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature. The study of some clinical and paraclinical factors for presumed malignancy makes it possible to codify appropriate therapeutic strategy. The aim of this study was to investigate predictors of malignancy in nodular goiters and to compare our results with those reported in the literature. This retrospective study consisted of 500 cases of nodular goiter operated in the Department of Otorhinolaryngology (ear, nose and throat or ENT) and Head and Neck Surgery at Avicenne military hospital in Marrakech between 2006 and 2012. The percentage of cancers was 6,8%. The average age of our patients was 46 years, with a sex-ratio of 5 (F/H). The hard nature of the nodule was present in 94,4% of the cases of cancer by palpation; irregular boundaries were present in 64.70% of the cases of cancer. Three nodules were fixed and malignant. Cervical lymphadenopathy were observed in 8 patients, 7 of which had cancer. Ultrasound examination showed hypoechoic appearance in 61,8% of the malignant nodules, with smooth-edges in 88,24% of the cases. Intranodular vascularization was found in 35,3% of the cases of cancers, with microcalcifications in 55,9% of the cases. Perinodular hypoechoic halo was incomplete in 73,5% of the cases of cancer. Our patients were euthyroid in 84,6% of the cases. Predictors of malignancy in nodular goiters were present in our first clinical study: patients over the age of 60 years, hard consistency of nodule, fixity, irregular and poorly defined character by palpation, as well as presence of cervical adenopathy on examination; and echographic features: hypoechoic character, smooth-edges, presence of microcalcifications and visualization of intranodular vascularization with or without peri-nodular vascularization. Although some of these factors are highly predictive of malignancy, only final histology provides certainty of diagnosis. Clinicians should base their clinical practice and patient management on a body of clinical arguments.

PMID: 27222685 [PubMed - in process]

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Personal music systems and hearing.

Personal music systems and hearing.

J Laryngol Otol. 2016 May 25;:1-13

Authors: Kumar UA, Deepashree SR

Abstract
OBJECTIVES: To measure the output sound pressure levels of personal music systems and evaluate their effect on hearing.
METHODS: Output sound pressure levels at preferred volume settings and listening environment were measured using a manikin. Effects of personal music system use on hearing were evaluated using pure tone audiometry (in conventional and extended high frequency ranges), transient evoked otoacoustic emissions, syllable identification in noise, intensity discrimination, frequency discrimination and temporal modulation transfer function.
RESULTS: Results showed, alarmingly, that large proportions of young adults are using personal music systems at levels higher than the safety limits set by regulatory bodies. Individuals who listened to personal music systems at levels higher than 80 dB LAeq exhibited poorer extended high frequency thresholds, reduced transient evoked otoacoustic emission amplitudes, poorer frequency discrimination, reduced modulation detection thresholds at 32 Hz modulation frequency, and reduced syllable identification in noise at -5 dB signal-to-noise ratio. Listening levels were significantly correlated with extended high frequency thresholds and transient evoked otoacoustic emission amplitudes.
CONCLUSION: These results suggest that listening to music through personal music systems at higher volume levels may be hazardous to hearing.

PMID: 27221308 [PubMed - as supplied by publisher]

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[Detection and management of the neurologic dysphagia].

[Detection and management of the neurologic dysphagia].

Rev Med Suisse. 2016 Mar 2;12(508):467-71

Authors: Leemann B, Sergi S, Sahinpasic L, Schnider A

Abstract
Neurologic dysphagia is frequent and has consequences which can be severe, such as, denutrition andpneumonia. In most cases, it can be detected with a clinical exam. The management includes some general measures, an adaptation of textures, specific rehabilitation, and nutritional assessment to judge whether complementary enteral nutrition is needed.

PMID: 27089605 [PubMed - indexed for MEDLINE]

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Does clinician continuity influence hearing aid outcomes?

Does clinician continuity influence hearing aid outcomes?

Int J Audiol. 2016 May 25;:1-8

Authors: Bennett RJ, Meyer C, Eikelboom RH

Abstract
OBJECTIVE: To evaluate whether clinician continuity is associated with successful hearing aid outcomes.
DESIGN: A prospective cohort study. Clinician continuity was defined as occurring when a patient was cared for by the same clinician for the hearing assessment, hearing aid selection process, hearing aid fitting and programming, and subsequent hearing aid fine tuning appointments. The hearing aid outcome measures included self-reported hearing aid use, benefit and satisfaction as well as self-reported handling skills and problems experienced with hearing aids.
STUDY SAMPLE: Four hundred and sixty-eight adult hearing aid users (mean age 73.9 years ±10.9) and 26 qualified audiologists (mean age 34 years ±6.34) recruited from a single hearing clinic in Perth, Western Australia.
RESULTS: There were no significant differences in hearing aid outcomes between participants who experienced clinician continuity and those who did not.
CONCLUSIONS: Within a controlled practice setting, hearing aid outcomes may not be adversely effected if services are provided by more than one clinician.

PMID: 27224042 [PubMed - as supplied by publisher]

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Book Review.

Book Review.

Int J Audiol. 2016 May 25;:1

Authors: Baguley DM, Fagelson M

PMID: 27223682 [PubMed - as supplied by publisher]

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Prognostic and Evolutive Factors of Tinnitus Triggered by Sudden Sensorineural Hearing Loss.

Prognostic and Evolutive Factors of Tinnitus Triggered by Sudden Sensorineural Hearing Loss.

Otol Neurotol. 2016 May 24;

Authors: Nogueira-Neto FB, Gallardo FP, Suzuki FA, Penido NO

Abstract
INTRODUCTION: The association between sudden sensorineural hearing loss (SSNHL) and tinnitus is frequent. Its correlation with the auditory prognosis remains controversial. The objective of the study is to evaluate tinnitus of which onset is concurrent with SSNHL and analyze it as a prognostic factor and its correlation with hearing recovery.
MATERIALS AND METHODS: A prospective cohort study was conducted with 30 patients with SSNHL. Serial audiometry was performed and the Tinnitus Handicap Inventory (THI) was applied at the initial consultation and after treatment.
RESULTS: Tinnitus had an incidence of 93.3%, with an initial mean THI of 63.6%. The mean decrease in THI was significant in all scale domains. However, there was no statistically significant difference between the degrees of tinnitus and hearing loss, as well as between hearing recovery percentage in relation to the degree of tinnitus. The correlation of THI gain with the hearing recovery rate was negative (the greater the decrease in the level of tinnitus discomfort, the greater the hearing recovery rate), being significant only in the emotional domain of THI, but showing a poor correlation.
DISCUSSION: There was a reduction in the level of tinnitus discomfort, as measured by THI, after treatment of SSNHL. There is a correlation between tinnitus and hearing improvement in patients with SSNHL only in the emotional domain of THI, but this correlation is considered poor. The degree of tinnitus severity as measured by THI was not proportional to the hearing loss and is not a prognostic factor for hearing improvement.

PMID: 27223675 [PubMed - as supplied by publisher]

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Association of Vogt Koyanagi Harada Syndrome and Seronegative Rheumatoid Arthritis.

Association of Vogt Koyanagi Harada Syndrome and Seronegative Rheumatoid Arthritis.

Ethiop J Health Sci. 2016 Mar;26(2):193-6

Authors: Aydin T, Taspinar O, Guneser M, Keskin Y

Abstract
BACKGROUND: Vogt Koyanagi Harada (VKH) Syndrome is a rarely-seen multi-systemic, autoimmune and inflammatory disease. It observed frequently with neurologic, auditory and skin manifestations and characterized with bilateral, chronic and diffused granulomatous panuveitis. It generally affects women in young-adult period.
CASE: A 57 year-old female patient applied to a special center one year ago with a complaint of decrease in the sight acuity of the right eye. The right eye was operated on with cataract diagnosis. Uveitis was developed firstly in the right eye and then in the left eye after the operation. Having complaints about uveitis, tinnitus and hear loss, the patient was diagnosed with VKH syndrome. The pains started to be felt in small hand joints and both of the two ankles. The pains were increasing especially in the mornings and during rest. The duration of morning stiffness was two hours in hand and foot joints. The patient had had lumbar pain with mechanic characteristic for five years.
CONCLUSION: Being diagnosed with seronegative rheumatoid arthritis (RA), our case is presented because VKH syndrome is rarely seen in Turkey, and the joint findings are at the forefront.

PMID: 27222633 [PubMed - in process]

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[The clinical experience of transnasal endoscopic approach for skull base osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma].

[The clinical experience of transnasal endoscopic approach for skull base osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):367-71

Authors: Lan GP, Huang B, Si YF, Qin YD, Deng ZX, Yang Y, Qin Y, Zhang BJ

Abstract
OBJECTIVE: To investigate the method of surgical treatment via trans-nasal endoscopic approach in osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma.
METHODS: Fifteen patients with osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma who underwent operation via trans-nasal endoscopic approach from 2008 to 2013 were retrospectively reviewed. The typical clinical manifestations included headache (NRS 6-9: 11 cases), foul odor (10 cases), epistaxis (4 cases), hearing loss (5 cases, 7 ears), tinnitus (4 cases, 5 ears). All patients underwent operation via trans-nasal endoscopic approach. During the operation, the diseased region was fully exposed, the necrotic tissue was resected, the necrotic bone was removed by high-speed electric drill, and the drainage was made unobstructed. The perioperative treatment and follow-up were carried out.
RESULTS: After operation, all patients were diagnosed pathologically as osteoradionecrosis and mucosal chroinic inflammation, 1 case combined with fungal sphenoid sinusitis. Headache (9 cases) and foul odor (9 cases) resolved after operation. The follow-up was lasted 18-82 months, 13 cases were survival, 1 case lost to follow-up, 1 case died of cerebral hemorrhage.
CONCLUSION: Surgical treatment via trans-nasal endoscopic approach is safe and effective in osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma, and is helping to improve the survival rate and survival quality.

PMID: 27220297 [PubMed - in process]

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Tympanic membrane perforation with squamous epithelial ingrowth.

Tympanic membrane perforation with squamous epithelial ingrowth.

Ear Nose Throat J. 2014 Aug;93(8):E31-2

Authors: Blake DM, Vazquez A, Tomovic S, Jyung RW

Abstract
The squamous epithelium of the tympanic membrane and external auditory canal exhibits an inherent migration pattern to facilitate the exfoliation of keratinizing squamous cells as part of a natural cleansing mechanism.

PMID: 25181673 [PubMed - indexed for MEDLINE]

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"Gan To Kagaku Ryoho"[jour]; +20 new citations

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Evaluation of type II thyroplasty on phonatory physiology in an excised canine larynx model.

Evaluation of type II thyroplasty on phonatory physiology in an excised canine larynx model.

Laryngoscope. 2016 May 25;

Authors: Devine EE, Hoffman MR, McCulloch TM, Jiang JJ

Abstract
OBJECTIVES/HYPOTHESIS: Type II thyroplasty is an alternative treatment for spasmodic dysphonia, addressing hyperadduction by incising and lateralizing the thyroid cartilage. We quantified the effect of lateralization width on phonatory physiology using excised canine larynges.
METHODS: Normal closure, hyperadduction, and type II thyroplasty (lateralized up to 5 mm at 1-mm increments with hyperadducted arytenoids) were simulated in excised larynges (N = 7). Aerodynamic, acoustic, and videokymographic data were recorded at three subglottal pressures relative to phonation threshold pressure (PTP). One-way repeated measures analysis of variance assessed effect of condition on aerodynamic parameters. Random intercepts linear mixed effects models assessed effects of condition and subglottal pressure on acoustic and videokymographic parameters.
RESULTS: PTP differed across conditions (P < .001). Condition affected percent shimmer (P < .005) but not percent jitter. Both pressure (P < .03) and condition (P < .001) affected fundamental frequency. Pressure affected vibratory amplitude (P < .05) and intrafold phase difference (P < .05). Condition affected phase difference between the vocal folds (P < .001).
CONCLUSIONS: Hyperadduction increased PTP and worsened perturbation compared to normal, with near normal physiology restored with 1-mm lateralization. Further lateralization deteriorated voice quality and increased PTP. Acoustic and videokymographic results indicate that normal physiologic relationships between subglottal pressure and vibration are preserved at optimal lateralization width, but then degrade with further lateralization. The 1-mm optimal width observed here is due to the small canine larynx size. Future human trials would likely demonstrate a greater optimal width, with patient-specific value potentially determined based on larynx size and symptom severity.
LEVEL OF EVIDENCE: NA Laryngoscope, 2016.

PMID: 27223665 [PubMed - as supplied by publisher]

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Virtual Screening Approaches in Identification of Bioactive Compounds Akin to Delphinidin as Potential HER2 Inhibitors for the Treatment of Breast Cancer.

Virtual Screening Approaches in Identification of Bioactive Compounds Akin to Delphinidin as Potential HER2 Inhibitors for the Treatment of Breast Cancer.

Asian Pac J Cancer Prev. 2016;17(4):2291-5

Authors: Patidar K, Deshmukh A, Bandaru S, Lakkaraju C, Girdhar A, Vr G, Banerjee T, Nayarisseri A, Singh SK

Abstract
Small molecule tyrosine kinase inhibitors targeting HER 2 receptors have emerged as an important therapeutic approach in inhibition of downstream proliferation and survival signals for the treatment of breast cancers. Recent drug discovery efforts have demonstrated that naturally occurring polyphenolic compounds like delphinidin have potential to inhibit proliferation and promote apoptosis of breast cancer cells by targeting HER2 receptors. While delphinidin may thus reduce tumour size, it is associated with serious side effects like dysphonia. Owing to the narrow therapeutic window of delphinidin, the present study aimed to identify high affinity compounds targeting HER2 with safer pharmacological profiles than delphinidin through virtual screening approaches. Delphinidin served as the query parent for identification of structurally similar compounds by Tanimoto-based similarity searching with a threshold of 95% against the PubChem database. The compounds retrieved were further subjected to Lipinski and Verber's filters to obtain drug like agents, then further filtered by diversity based screens with a cut off of 0.6. The compound with Pubchem ID: 91596862 was identified to have higher affinity than its parent. In addition it also proved to be non-toxic with a better ADMET profile and higher kinase activity. The compound identified in the study can be put to further in vitro drug testing to complement the present study.

PMID: 27221932 [PubMed - in process]

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Arytenoid cartilage chondroma.

Arytenoid cartilage chondroma.

Ear Nose Throat J. 2014 Aug;93(8):298

Authors: Portnoy JE, Sataloff JB, Hawkshaw MJ, Sataloff RT

PMID: 25181657 [PubMed - indexed for MEDLINE]

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Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Rizk HG, Hatch JL, Stevens SM, Lambert PR, Meyer TA

Abstract
OBJECTIVES: (1) To quantitatively assess the lateral skull base thickness in patients with superior semicircular canal dehiscense (SSCD) using a standardized and validated radiographic measure and to compare it with that of a population with spontaneous cerebrospinal fluid otorrhea (CSFO). (2) To analyze demographic and clinical factors associated with skull base thickness in the SSCD group.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary neurotologic referral center.
SUBJECTS AND METHODS: Based on computed tomography imaging of the tegmen, mean skull base thickness was calculated for 16 patients with radiographic and clinical SSCD. Similar measures were performed in 4 comparison groups consisting of adults with spontaneous CSFO (n = 33), as well as 3 control groups recruited from our adult cochlear implant database: 30 obese controls (body mass index [BMI] >30 kg/m(2)), 11 overweight controls (BMI, 25-30 kg/m(2)), and 20 normal weight controls (BMI <25 kg/m(2)).
RESULTS: The SSCD group had a significantly lower mean BMI (28.6 kg/m(2)) than the spontaneous CSFO group (37.7 kg/m(2); P = .0007). The mean skull base thickness of SSCD patients was 17% thinner than that of the CSFO group, 31% thinner vs obese controls, 49% thinner vs overweight controls, and 45% thinner vs normal weight controls. These differences were all statistically significant (P < .05).
CONCLUSION: Patients with SSCD have a marked thinning of the lateral skull base, more so than patients with spontaneous CSF otorrhea and control groups with different BMIs. Skull base attenuation in SSCD patients did not correlate with BMI.

PMID: 27221578 [PubMed - as supplied by publisher]

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Sphenoidal pneumosinus dilatans due to anterior skull base meningiomas - CT and MRI aspects: Report of two new cases and literature review.

Sphenoidal pneumosinus dilatans due to anterior skull base meningiomas - CT and MRI aspects: Report of two new cases and literature review.

Neuroradiol J. 2016 May 24;

Authors: Scuotto A, Saracino D, Rotondo M, Izzo A, Urraro F, Cappabianca S, Sampaolo S

Abstract
We report on two patients disclosing a pneumosinus dilatans (PSD) and an anterior skull base meningioma. Our findings, together with those from the pertinent literature, support the thought that this infrequent anomaly of paranasal sinuses is a useful clue to suspect a concomitant meningioma. Moreover, hypotheses concerning the pathophysiology of PSD are discussed.

PMID: 27220845 [PubMed - as supplied by publisher]

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[Verrucous carcinoma in the left lateral skull base: a case report].

[Verrucous carcinoma in the left lateral skull base: a case report].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):387-9

Authors: Cheng P, Tang SX, Qing J

PMID: 27220302 [PubMed - in process]

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[The clinical experience of transnasal endoscopic approach for skull base osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma].

[The clinical experience of transnasal endoscopic approach for skull base osteoradionecrosis after radiotherapy for nasopharyngeal carcinoma].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):367-71

Authors: Lan GP, Huang B, Si YF, Qin YD, Deng ZX, Yang Y, Qin Y, Zhang BJ

PMID: 27220297 [PubMed - in process]

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[Analyses of chronic otitis media with intact tympanic membrane concurrent with intracranial complication].

[Analyses of chronic otitis media with intact tympanic membrane concurrent with intracranial complication].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):343-7

Authors: Wang XQ, Wu PN, Huang HM, Fu M, Ge RM

Abstract
OBJECTIVE: To investigate the clinical and imaging characteristics of chronic otitis media with intact tympanic membrane.
METHOD: Ten patients were retrospective studied in the department of otorhinolaryngology of Guangdong general hospital from December 2006 to January 2015. The clinical characteristics of their manifestations, audiology and imaging examinations were analyzed.
RESULTS: All the cases could be divided into two groups: the intracranial complication group who was primarily diagnosed as intracranial complications, and the hearing loss group who primarily complained of hearing loss. Five cases belonged to the first group, which include 1 cerebellar abscess, 3 meningitis and 1 meningoencephalitis, 2 of them were profound hearing loss, 2 were mixed hearing loss, and 1 was normal hearing. The other 5 cases belonged to the hearing loss group, 3 were mixed deafness, 2 were conductive deafness. All the case showed positive high-resolution computed tomography (HRCT) features. In the first group, four cases showed the soft tissue shadow in tympanic antrum/superior tympanic pouch and 1 case showed a wide damage of skull base, in addition to intracranial complications. In the second group, five cases showed soft tissue imaging in tympanic antrum/superior tympanic pouch. Pathology showed that 2 cases were cholesterol granuloma(one was in the first group and the other was in the second group), 4 were intracranial inflammatory(the first group) and 4 were cholesteatoma(the seond group).
CONCLUSIONS: In chronic otitis media with intact tympanic membrane, intracranial complications may be the primarily diagnosis, which should be paid much attention by multidisciplinary team. HRCT and audiology were valuable for early diagnosis.

PMID: 27220293 [PubMed - in process]

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[Attaching importance to standardization of diagnosis and treatment in otitis media].

[Attaching importance to standardization of diagnosis and treatment in otitis media].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):321-3

Authors: Sun JJ, Chi FL

PMID: 27220288 [PubMed - in process]

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Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Rizk HG, Hatch JL, Stevens SM, Lambert PR, Meyer TA

PMID: 27221578 [PubMed - as supplied by publisher]

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Independent and joint exposure to passive smoking and cooking oil fumes on oral cancer in Chinese women: a hospital-based case-control study.

Independent and joint exposure to passive smoking and cooking oil fumes on oral cancer in Chinese women: a hospital-based case-control study.

Acta Otolaryngol. 2016 May 25;:1-5

Authors: He B, Chen F, Yan L, Huang J, Liu F, Qiu Y, Lin L, Zhang Z, Cai L

Abstract
CONCLUSIONS: Passive smoking and COF exposure are independent risk factors for oral cancer in Chinese women, with the multiplicative interactions from combined exposures. Avoiding exposure to environmental tobacco smoke and COF may contribute to the prevention of oral cancer in Chinese women.
OBJECTIVE: To evaluate the independent and joint effects of passive smoking and cooking oil fumes (COF) on oral cancer in Chinese women.
METHODS: A case-control study was performed including 238 female patients with pathologically confirmed oral cancer and 470 controls as age-matched controls. Face-to-face interviews were conducted based on a structured questionnaire. The effects of passive smoking and COF exposure were analyzed using non-conditional logistic regression models.
RESULTS: Passive smoking significantly increased the risk of oral cancer in Chinese women: adjusted ORs were 2.12 (95% CI = 1.11-4.07) for those only exposed before age 18, 1.52 (95% CI = 1.01-2.31) for those only exposed after age 18, and 2.38 (95% CI = 1.47-3.85) for those both exposed before and after age 18. In addition, COF exposure was significantly associated with a risk of oral cancer (adjusted ORs were 1.69 (95% CI = 1.03-2.78) for light exposure and 2.06 (95% CI = 1.21-3.50) for heavy exposure). Furthermore, there was a significantly multiplicative interaction between passive smoking and COF for oral cancer.

PMID: 27224835 [PubMed - as supplied by publisher]

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Video head impulse in comparison to caloric testing in unilateral vestibular schwannoma.

Video head impulse in comparison to caloric testing in unilateral vestibular schwannoma.

Acta Otolaryngol. 2016 May 25;:1-5

Authors: Tranter-Entwistle I, Dawes P, Darlington CL, Smith PF, Cutfield N

Abstract
CONCLUSIONS: Although there was a statistically significant relationship between the results of the vHIT and the caloric test, the limited strength of this relationship suggests that, for unilateral vestibular schwannoma (UVS), caloric testing and vHIT may provide complementary information on vestibular function.
OBJECTIVE: There is limited information that can be used to determine which of the video head impulse test (vHIT) and caloric test might be better used in the diagnosis and management of UVS. In this study, a group of participants with un-operated UVS was studied using both methods.
METHODS: The subjects' vestibular function was assessed using the vHIT and caloric testing. Tumour size was quantified using MRI and their balance disturbance assessed using the Jacobsen Dizziness Handicap Inventory (DHI).
RESULTS: Twenty of 30 subjects had an abnormal canal paresis according to the Jongkees' criterion (> 0.25); however, only 10/30 had an ipsilesional vHIT gain of <0.79. Canal paresis could be predicted from the ipsilesional and contralesional vHIT gains. Tumour size could also be predicted from the ipsilesional vHIT gain and canal paresis. However, DHI scores could not be predicted from the degree of canal paresis, vHIT gain, or the MRI measures.

PMID: 27224664 [PubMed - as supplied by publisher]

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Post-operative morbidity and 1-year outcomes in CO2-laser tonsillotomy versus dissection tonsillectomy.

Post-operative morbidity and 1-year outcomes in CO2-laser tonsillotomy versus dissection tonsillectomy.

Acta Otolaryngol. 2016 May 25;:1-8

Authors: Lourijsen ES, Wong Chung JE, Koopman JP, Blom HM

Abstract
OBJECTIVE: In this study a type of partial tonsil surgery, CO2-laser tonsillotomy, was compared to regular tonsillectomy. The effectiveness and post-operative recovery rate of both interventions in adult patients was assessed by using a questionnaire.
STUDY DESIGN: Prospective follow-up non-randomized cohort study.
METHOD: One hundred and seven adults were included; 46 tonsillectomies and 61 tonsillotomies were performed. Patients in the tonsillectomy group underwent general anaesthesia, while tonsillotomy was performed in an ambulatory setting with local anaesthesia. Post-operative questionnaires were administered by mail after 2 weeks, 6 months, and 1 year to assess recovery rate and symptom recurrence.
RESULTS: In total, 72.5% of patients were cured from their initial symptoms after tonsillotomy. Three patients (7.5%) required re-surgery for their initial complaints. After tonsillectomy, 97.2% of patients were cured. Both groups showed equally high satisfaction scores after treatment. Post-operative evaluation after 2 weeks showed a mean pain-intensity score of 5.4 (Visual Analogue Scale 0-10) after tonsillotomy and a mean pain-intensity score of 7.7 after tonsillectomy. The post-operative use of analgesics was twice as long in the tonsillectomy group compared to the tonsillotomy group and the tonsillectomy group required twice as many days for full recovery. After tonsillectomy a higher rate of major post-operative haemorrhage was seen.
CONCLUSION: CO2-laser tonsillotomy is associated with a shorter and less painful recovery period. Both surgical methods are equal in terms of long-term satisfaction, although tonsillotomy comes with a higher recurrence rate of mild symptoms. A strict pre-operative patient selection for CO2-laser tonsillotomy is necessary.

PMID: 27224472 [PubMed - as supplied by publisher]

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MBL, P2X7, and SLC11A1 gene polymorphisms in patients with oropharyngeal tularemia.

MBL, P2X7, and SLC11A1 gene polymorphisms in patients with oropharyngeal tularemia.

Acta Otolaryngol. 2016 May 25;:1-5

Authors: Somuk BT, Koc S, Ates O, Göktas G, Soyalic H, Uysal IO, Gurbuzler L, Sapmaz E, Sezer S, Eyibilen A

Abstract
CONCLUSION: A significant association was found of oropharyngeal tularemia with SLC11A1 allele polymorphism (INT4 G/C) and MBL2 C + 4T (P/Q). These results indicate C allele and Q allele might be a risk factor for the development of oropharyngeal tularemia.
AIM: This study aimed to investigate the relationship of SLC11A1, MBL, and P2X7 gene polymorphism with oropharyngeal tularemia.
METHODS: The study included totally 120 patients who were diagnosed with oropharyngeal tularemia. Frequencies of polymorphisms in the following genes were analyzed both in the patient and control groups in the study: SLC11A1 (5'(GT)n Allele 2/3, Int4 G/C, 3' UTR, D543N G/A), MBL (MBL2 C + 4T (P/Q), and P2X7 (-762 C/T and 1513 A/C).
RESULTS: Among all polymorphisms that were investigated in this study, SLC11A1 gene showed a significance in the distriburtion of polymorphism allelle frequency at the INT4 region. Frequency of C allele was 54 (28%) in patients with oropharyngeal tularemia, and 31 (13%) in the control group (p = 0.006 and OR = 1.96 (1.21-3.20)). An association was detected between MBL2 C + 4T (P/Q) gene polymorphism and oropharyngeal tularemia (p < 0.005 and OR = 0.30 (0.19-0.48)). No significant relation was found between P2X7 (-762 C/T and 1513 A/C) gene polymorphism and oropharyngeal tularemia in this study (p > 0.05).

PMID: 27223255 [PubMed - as supplied by publisher]

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A novel method for determining the relation between nasal polyposis and oxidative stress: the thiol/disulphide homeostasis.

A novel method for determining the relation between nasal polyposis and oxidative stress: the thiol/disulphide homeostasis.

Acta Otolaryngol. 2016 May 25;:1-4

Authors: Şimşek E, Erel O, Bicer CK, Çarlıoğlu A

Abstract
CONCLUSION: It is thought that oxidative stress may be the major cause of the increase in the oxide thiol form in the study group. The relationship between oxidative stress status and dynamic thiol/disulphide in nasal polyposis now needs to be investigated.
OBJECTIVES: The purpose of this study was to evaluate the relation between nasal polyposis and thiol/disulphide homeostasis, used as a marker of oxidative stress, by measuring that exchange using a novel technique.
MATERIALS AND METHODS: The study group consisted of 40 patients (mean age = 46.75 ± 13.92 years) with bilateral nasal polyposis patients admitted to the hospital. The control group consisted of 31 (mean age = 43.20 ± 5.68 years) age, sex, and body mass index matched healthy subjects. Thiol/disulphide homeostasis concentrations were measured using a newly-developed method (Erel & Neselioglu).
RESULTS: Native thiol and total thiol levels were lower in the study group compared to the control group (native thiol = 415.8 ± 69.1 μmol/L vs 448.7 ± 37.5 μmol/L, p < 0.05; total thiol = 449.02 ± 72.0 μmol/L vs 477.28 ± 44.5 μmol/L, p < 0.05, respectively). Disulphide level and the disulphide/native thiol and disulphide/total thiol ratios were higher in the study group compared to the control group (disulphide = 16.58 ± 5.04 μmol/L vs 14.28 ± 5.3 μmol/L, p < 0.05; disulphide/native thiol ratio = 4.07 ± 1.52% vs 3.14 ± 1.04%, p < 0.05, disulphide/total thiol ratio = 3.73 ± 1.23% vs 2.94 ± 0.92%, p < 0.05, respectively).

PMID: 27222940 [PubMed - as supplied by publisher]

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AAOM Clinical Practice Statement: Oral Cancer Examination and Screening.

AAOM Clinical Practice Statement: Subject: Oral Cancer Examination and Screening.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May 21;

Authors:

PMID: 27220604 [PubMed - as supplied by publisher]

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Are condylar morphologic changes associated with temporomandibular disorders in patients with orthognathia?

Are condylar morphologic changes associated with temporomandibular disorders in patients with orthognathia?

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Mar 15;

Authors: Catherine Z, Courvoisier DS, Scolozzi P

Abstract
OBJECTIVE: To determine the association between morphologic condylar changes and temporomandibular disorders (TMDs) in patients with orthognathia.
STUDY DESIGN: Data from 89 patients were analyzed. TMDs were classified according to the Research Diagnostic Criteria for TMDs. TMD severity was scored according to the Helkimo indices. Calculation of the condylar area, perimeter, and height was performed by using a specific computational method including panoramic radiography.
RESULTS: Sixty-five (73%) patients presented with morphologic condylar changes. Decreases in condylar perimeter and area were found to be predictors of postoperative TMDs (P = .009; odds ratio [OR] = 3.66) and disk displacement (P = .008; OR = 4.43), respectively. Condylar area and height decreases were associated with worsening of TMDs (P = .03 and 0.04).
CONCLUSIONS: This study demonstrated that in orthognathic patients, postoperative condylar changes are associated with postoperative TMDs as well as with the degree of TMD severity and that preoperative TMDs are associated with such condylar changes.

PMID: 27220603 [PubMed - as supplied by publisher]

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Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?

Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Ryan T, Specht J, Smith S, DelGaudio JM

Abstract
OBJECTIVES: Analyze the correlation between online-based review websites and the Press Ganey Patient Satisfaction Survey (PGPSS) in an academic otolaryngology department.
STUDY DESIGN: Retrospective cross sectional.
SETTING: Tertiary academic institution.
METHODS: All available data were collected for Vitals.com and Healthgrades.com, along with PGPSS data for 16 otolaryngology attending physicians from 2012 to 2014. A mean rating was calculated for each topic category for online websites and compared with 7 PGPSS content questions using zero-order correlations. A paired t test was used to analyze the difference between the PGPSS and online scores.
RESULTS: There were no statistically significant correlations between time spent with the patient (r = 0.391, P = .208) and overall provider scores (r = 0.193, P = .508) when compared between Vitals.com and the PGPSS. The correlations were not statistically significant when Healthgrades.com was compared with the PGPSS in the items "probability of recommending the provider" (r = -0.122, P = .666) and "trust in provider" (r = -0.025, P = .929). The most important factors in a patient recommending the provider were as follows, per resource: time spent with the patient for Vitals.com (r = 0.685, P = .014), listening for Healthgrades.com (r = 0.981, P ≤ .001), and trust in the provider for the PGPSS (r = 0.971, P ≤ .001).
CONCLUSION: This study suggests that online-based reviews do not have statistically significant correlations with the widely used PGPSS and may not be an accurate source of information for patients. Patients should have access to the most reliable and least biased surveys available to the public to allow for better-informed decisions regarding their health care.

PMID: 27221579 [PubMed - as supplied by publisher]

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Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Rizk HG, Hatch JL, Stevens SM, Lambert PR, Meyer TA

PMID: 27221578 [PubMed - as supplied by publisher]

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Systematic Review and Meta-analysis of Surgical Complications Following Cochlear Implantation in Canal Wall Down Mastoid Cavities.

Systematic Review and Meta-analysis of Surgical Complications Following Cochlear Implantation in Canal Wall Down Mastoid Cavities.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Hunter JB, O'Connell BP, Wanna GB

Abstract
OBJECTIVE: We sought to assess the complication rates following cochlear implantation in canal wall down mastoid cavities in adults and children.
DATA SOURCES: A systematic review of English articles from PubMed, Web of Science, EMBASE, and the Cochrane Library. Additional studies were identified by reviewing the reference lists of the originally identified studies.
REVIEW METHODS: Studies were included that reported on surgical outcomes following cochlear implantation in canal wall down mastoid cavities. Two authors, using predefined data fields, independently reviewed all articles while tabulating study quality indicators. A meta-analysis of proportions was conducted on select cohorts to determine weighted complication rates.
RESULTS: Forty-two articles were included that accounted for 424 patients and described surgical outcomes following cochlear implantation in canal wall down mastoid cavities. In a comparison of the postoperative complication rates, overclosing the external auditory meatus had significantly fewer global complications than did maintaining a canal wall down mastoid cavity (P = .027). In a comparison of the complication rates (1) between staging the cochlear implantation and performing external auditory meatus overclosure simultaneously with cochlear implantation and (2) between pediatric and adult cochlear implantation recipients with external auditory meatus overclosure, there were no significant differences (P = .085 and P = .92, respectively).
CONCLUSION: Overclosing the external auditory meatus at the same time of cochlear implantation leads to significantly fewer complications when compared with maintaining a canal wall down mastoid cavity with soft tissue coverage of the electrode array.

PMID: 27221577 [PubMed - as supplied by publisher]

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Sustained Inner Ear Steroid Delivery via Bioabsorbable Stent: A Tolerability and Feasibility Study on Guinea Pigs.

Sustained Inner Ear Steroid Delivery via Bioabsorbable Stent: A Tolerability and Feasibility Study on Guinea Pigs.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Lavigne P, Lavigne F, Saliba I

Abstract
OBJECTIVE: To determine the feasibility and tolerability of a steroid-eluting middle ear device on an animal model.
STUDY DESIGN: Prospective experimental.
SETTING: Experimental animal study.
SUBJECTS AND METHOD: Mometasone furoate (MF)-eluting miniature sticks were implanted through a myringotomy incision into the middle ear of 10 guinea pigs. Two additional ears of 2 animals served as controls. Fourteen days after implantation, perilymphatic fluid was collected through an endaural cochleostomy. MF concentrations were measured with high-performance liquid chromatography, and the middle ear mucosal inflammation was graded with hematoxylin and eosin colorations.
RESULTS: Fourteen days after implantation, all tympanic membranes had fully healed. An average of 165 ng/mL of MF was detected in the perilymphatic fluid of the experimental ears, and none was measured in control ears. Microscopic residues of the ministicks were found in 90% of the samples, confirming the bioabsorbable properties of this device. Histologic analysis of the middle ear mucosa found similar inflammation profiles in both groups, thereby suggesting middle ear tolerability.
CONCLUSION: MF-coated bioabsorbable miniature stick allows for prolonged delivery over 14 days without injuring the middle ear mucosa. Middle ear-sustained steroid delivery may prove to be beneficial in numerous neurotologic conditions.

PMID: 27221576 [PubMed - as supplied by publisher]

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Pathologic Findings of the Cochlea in Labyrinthitis Ossificans Associated with the Round Window Membrane.

Pathologic Findings of the Cochlea in Labyrinthitis Ossificans Associated with the Round Window Membrane.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Kaya S, Paparella MM, Cureoglu S

Abstract
OBJECTIVE: To quantitatively demonstrate and classify the histopathologic changes in the cochlea of the human temporal bones with labyrinthitis ossificans (LO).
STUDY DESIGN: Comparative human temporal bone study.
SETTING: Tertiary academic medical center.
SUBJECTS AND METHODS: We compared 23 temporal bone specimens from 19 deceased donors with LO associated with the round window membrane (RWM) and 27 age-matched specimens from 20 deceased donors without any otologic diseases. We focused on the location of LO in the inner ear, the intensity of endolymphatic hydrops, the number of spiral ganglion cells and cochlear hair cells, and the areas of the stria vascularis and spiral ligament. In addition, we created a new pathologic grading system for temporal bone specimens from deceased donors with LO associated with the RWM.
RESULTS: We most often observed LO in the scala tympani of the basal cochlear turn. In the LO group (as compared with the control group), the intensity of endolymphatic hydrops was significantly increased; the number of spiral ganglion cells was significantly decreased in all segments; the loss of outer and inner hair cells was significantly increased in all turns of the cochlea; the atrophy of the stria vascularis was significantly greater in all turns of the cochlea; and atrophy of the spiral ligament was significantly greater in the basal and middle cochlear turn.
CONCLUSION: LO was associated with significant cochlear damage (to the spiral ganglion cells, cochlear hair cells, stria vascularis, and spiral ligament) and with increased intensity of endolymphatic hydrops.

PMID: 27221575 [PubMed - as supplied by publisher]

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Incidence and Risk Factors for Prolonged Hospitalization and Readmission after Transsphenoidal Pituitary Surgery.

Incidence and Risk Factors for Prolonged Hospitalization and Readmission after Transsphenoidal Pituitary Surgery.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Bur AM, Brant JA, Newman JG, Hatten KM, Cannady SB, Fischer JP, Lee JY, Adappa ND

Abstract
OBJECTIVE: To evaluate the incidence and factors associated with 30-day readmission and to analyze risk factors for prolonged hospital length of stay following transsphenoidal pituitary surgery.
STUDY DESIGN: Retrospective longitudinal claims analysis.
SETTING: American College of Surgeons National Surgical Quality Improvement Program.
SUBJECTS AND METHODS: The database of the American College of Surgeons National Surgical Quality Improvement Program was queried for patients who underwent transsphenoidal pituitary surgery (Current Procedural Terminology code 61548 or 62165) between 2005 and 2014. Patient demographic information, indications for surgery, and incidence of hospital readmission and length of stay were reviewed. Risk factors for readmission and prolonged length of stay, defined as >75th percentile for the cohort, were identified through logistic regression modeling.
RESULTS: A total of 1006 patients were included for analysis. Mean hospital length of stay after surgery was 4.1 ± 0.2 days. Predictors of prolonged length of stay were operative time (P < .001, odds ratio [OR] = 1.7, 95% confidence interval [95% CI] = 1.5-2.0), bleeding disorder (P = .049, OR = 3.1, 95% CI = 1.0-9.5), insulin-dependent diabetes (P = .007, OR = 2.4, 95% CI = 1.3-4.4), and reoperation (P < .001, OR = 10.3, 95% CI = 4.7-23.9). In a subset analysis of 529 patients who had surgery between 2012 and 2014, 7.2% (n = 38) required hospital readmission. History of congestive heart failure (CHF) was a predictor of hospital readmission (P = 0.03, OR = 12.7, 95% CI = 1.1-144.0).
CONCLUSION: This review of a large validated surgical database demonstrates that CHF is an independent predictor of hospital readmission after transsphenoidal surgery. Although CHF is a known risk factor for postoperative complications, it poses unique challenges to patients with potential postoperative pituitary dysfunction.

PMID: 27221574 [PubMed - as supplied by publisher]

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Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival.

Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Imre A, Pinar E, Dincer E, Ozkul Y, Aslan H, Songu M, Tatar B, Onur I, Ozturkcan S, Aladag I

Abstract
OBJECTIVE: We investigated the value of lymph node density (LND) as a predictor of survival in patients with laryngeal squamous cell carcinoma (SCC) and positive neck node (pN+) after laryngectomy.
STUDY DESIGN: Case series with chart review.
SETTING: Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
SUBJECTS AND METHODS: We reviewed the records of 289 patients with newly diagnosed primary laryngeal carcinomas who underwent partial or total laryngectomy and combined neck dissection at a tertiary referral center between June 2006 and December 2014. Patients with pN+ laryngeal SCC (n = 101) were included in the study. Overall survival (OS) and disease-free survival (DFS) were used to evaluate the prognostic significance of LND.
RESULTS: In 101 patients with pN+ laryngeal SCC, LND ≥0.09 and number of metastatic lymph nodes >4 were significantly associated with OS and DFS but not the overall tumor, node, and metastasis stage. Forward stepwise Cox regression analysis revealed that LND ≥0.09 was the only independent predictor of both DFS and OS. Furthermore, the odds ratio of LND ≥0.09 was 10 times higher in patients with regional recurrence when compared patients without regional recurrence.
CONCLUSIONS: LND was the only independent prognostic predictor of OS and DFS in patients with pN+ laryngeal SCC. Moreover, patients with LND ≥0.09 were significantly associated with high risk of regional recurrence. Thus, patients with LND ≥0.09 are at high risk of regional recurrence and death and may be considered for adjuvant chemoradiation.

PMID: 27221573 [PubMed - as supplied by publisher]

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Retrosternal Goiter: 30-Day Morbidity and Mortality in the Transcervical and Transthoracic Approaches.

Retrosternal Goiter: 30-Day Morbidity and Mortality in the Transcervical and Transthoracic Approaches.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Khan MN, Goljo E, Owen R, Park RC, Yao M, Miles BA

Abstract
OBJECTIVE: Retrosternal goiters pose a significant challenge in determining the indications and appropriate approach for surgical removal while limiting postoperative morbidity and mortality. The objective of this study is to use the National Surgical Quality Improvement Program (NSQIP) database to compare outcomes of transcervical and transthoracic approaches for retrosternal goiter removal and to review the literature regarding the varying indications for the 2 surgical approaches.
STUDY DESIGN: Administrative database analysis.
SETTING: NSQIP database.
SUBJECTS AND METHODS: The NSQIP database was queried for all cases of retrosternal thyroid: 2716 patients were included, which represents one of the largest data reviews of patients with retrosternal thyroid pathology who underwent surgery. Data were analyzed to examine morbidity and mortality of the cervical and transthoracic approaches.
RESULTS: Patient demographics and preoperative comorbidities were similar between groups. Patients undergoing a transthoracic approach experienced increased rates of unplanned intubations and need for transfusion and length of stay postoperatively.
CONCLUSIONS: A transthoracic approach is associated with increased rates of several critical postoperative morbidities, and the data indicate the potential of increased overall mortality. Given equivalent retrosternal extension, a transcervical approach should be attempted whenever anatomically possible, regardless of pathology.

PMID: 27221572 [PubMed - as supplied by publisher]

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Mobile Endoscopy vs Video Tower: A Prospective Comparison of Video Quality and Diagnostic Accuracy.

Mobile Endoscopy vs Video Tower: A Prospective Comparison of Video Quality and Diagnostic Accuracy.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Liu H, Akiki S, Barrowman NJ, Bromwich M

Abstract
OBJECTIVE: To determine if any significant difference exists between endoscopic videos captured with a mobile adaptor and videos captured with a traditional tower.
STUDY DESIGN: Prospective controlled blinded comparison of mobile endoscopic videos captured through 2 methods.
METHODS: Thirty randomly selected patients underwent video endoscopy with both mobile and video tower recording methods. Sixty videos were edited into a series of 10-second clips. Thirteen otolaryngology staff and residents rated the video quality and provided a diagnosis for each video.
RESULTS: We found no significant difference in the video quality ratings between mobile and tower videos (mean difference, -0.07; P < .37). Similarly, we found no significant difference in the observers' diagnostic accuracy (mean difference, 1.54%; P < .686).
CONCLUSION: With adequate power, our study was unable to demonstrate a difference between mobile adapter videos and tower videos. Our findings suggest that mobile adapter videos may reasonably be used in lieu of tower videos in clinical practice.

PMID: 27221571 [PubMed - as supplied by publisher]

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MRI- and CT-Compatible Polymer Laryngoscope: A Step toward Image-Guided Transoral Surgery.

MRI- and CT-Compatible Polymer Laryngoscope: A Step toward Image-Guided Transoral Surgery.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Paydarfar JA, Wu X, Halter RJ

PMID: 27221570 [PubMed - as supplied by publisher]

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Reflections: Volunteering at Home.

Reflections: Volunteering at Home.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Hu A

Abstract
Many young people look forward to volunteering abroad and overlook the ample volunteer opportunities at home. There are several advantages to volunteering at home: you help people in your own community; you can make a long-term commitment; and you have continuity of care for your patients. There are >1200 free clinics in the United States whose main goal is to provide care to the indigent population. These free clinics are always looking for volunteers with specialized medical training. This article reviews the medically related and unrelated volunteer opportunities available in the United States. Volunteering at home is a worthwhile experience, and I encourage the otolaryngology community to explore these opportunities.

PMID: 27221569 [PubMed - as supplied by publisher]

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Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea.

Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Emara TA, Hassan MH, Mohamad AS, Anany AM, Ebrahem AE

PMID: 27221568 [PubMed - as supplied by publisher]

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Αρχειοθήκη ιστολογίου

Πέμπτη 26 Μαΐου 2016