Otolaryngology - Head and Neck Surgery via MedWorm.com

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Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:42 +0100

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Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:42 +0100

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Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:42 +0100

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Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:42 +0100

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Response to: The relationship between the air-bone gap and the size of superior semicircular canal dehiscence, from Dirk Beutner

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:42 +0100

We thank Dr. Beutner for his interest in our article examining the relationship between the air-bone gap (ABG) and size of dehiscence in superior semicircular canal dehiscence (SSCD). (Source: Otolaryngology - Head and Neck Surgery)

The relationship between the air-bone gap and the size of superior semicircular canal dehiscence

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:41 +0100

I read with great interest the article “The relationship between the air-bone gap and the size of superior semicircular canal dehiscence” by Yuen et al. They report that the size of the average air-bone gap (ABG) correlates with the size of the superior semicircular canal dehiscence (SSCD). (Source: Otolaryngology - Head and Neck Surgery)

Guillain-Barre syndrome presenting as epiglottitis in a child

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:41 +0100

A previously healthy five-year-old boy presented to the emergency department with respiratory distress and drooling. His medical history was unremarkable except for symptoms of an upper respiratory tract infection five days earlier. Upon arrival at the emergency room, the child was lethargic, leaning forward, and in severe distress. Stretch reflexes were absent in the upper and lower extremities. His temperature was normal. The child was immediately taken to the operating room for emergency intubation with a presumptive diagnosis of epiglottitis. Laryngoscopy and bronchoscopy revealed a large pool of secretions in the postcricoid area and pyriforms, bilateral vocal cord paralysis, and tracheobronchial aspiration. Postoperatively, an electromyography (EMG) showed no motor or sensory respons...

Mucoepidermoid carcinoma of the external auditory canal

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:41 +0100

A 29-year-old man was referred to our department with a mass in his right external auditory canal (EAC). No other symptoms or signs were reported. At 18 years, he had a pituitary macroadenoma removed through a transsphenoidal approach followed by radiation therapy. No other symptoms or signs were reported. (Source: Otolaryngology - Head and Neck Surgery)

Awake extracorporeal membrane oxygenation for management of critical distal tracheal obstruction

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:39 +0100

Pericarinal obstruction challenges traditional techniques for perioperative airway management. One etiology is spread of recurrent respiratory papillomatosis (RRP) to involve the distal trachea and bronchopulmonary airway. Herein, for carinal RRP, we report the first use of extracorporeal membrane oxygenation (ECMO) in the surgical management of near complete intrinsic airway obstruction. (Source: Otolaryngology - Head and Neck Surgery)

Acoustic recordings in human ear canals to sounds at different locations

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:38 +0100

Abstract: The head and pinna shape the sound reaching the tympanum. We explored this signal transformation in humans and a mini basketball for different sound locations in an anechoic chamber. For humans, we embedded microphones in ear molds that were custom fitted to the subject's ear canal. For the ball, the microphones were flush with the surface at ± 90 degrees azimuths on the equator. Sounds were generated with a custom point source. In the ball, the signal level was nearly flat across frequency, with no gains. In contrast, in the ears, signal level changed in a complex way across frequency, with considerable gains. For frequencies < 2 kHz, the interaural level difference (ILD) increased with decreasing distance similarly in the human ears and ball. For frequencies > 4 kHz, ILDs in t...

H1N1 influenza A presenting as bacterial tracheitis

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Abstract: Six cases of bacterial tracheitis (BT) occurring early in the 2009 flu season have been isolated in conjunction with the H1N1 strain of influenza A (H1N1). No previous H1N1 cases have presented as BT in the literature to date. We would like to discuss viral coinfection in BT patients and how this new strain may affect the rate and type of presentation encountered. The life-threatening potential of BT and the pandemic proportion of H1N1 highlight a possibly dangerous combination that should be recognized by the otolaryngology community. In hospitalized patients with presumed BT, consideration should be given to routine H1N1 testing and the addition of antiviral medication when indicated as this entity is further investigated. (Source: Otolaryngology - Head and Neck Surgery)

Bax, cytochrome c, and caspase-8 staining in parotid cancer patients: Markers of susceptibility in radiotherapy?

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: Bax, cytochrome c, and caspase-8 protein expression failed to independently predict survival in parotid cancer patients. However, patients with bax (−) or caspase-8 (−) tumors should be considered as candidates for adjuvant radiotherapy in order to achieve better local disease control. (Source: Otolaryngology - Head and Neck Surgery)

High-speed digital imaging of the neoglottis after supracricoid laryngectomy with cricohyoidoepiglottopexy

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: HSDI could be useful for evaluating the vocal kinetics of the neoglottis after SCL-CHEP. (Source: Otolaryngology - Head and Neck Surgery)

Neck restaging with sentinel node biopsy in T1-T2N0 oral and oropharyngeal cancer: Why and how?

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: The SN biopsy technique appeared to be the best staging method in cN0 patients and provided evidence that routinely undiagnosed lymph node invasion may have clinical significance. (Source: Otolaryngology - Head and Neck Surgery)

Disease relapse after segmental resection and free flap reconstruction for mandibular osteoradionecrosis

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: This present study confirms that microvascular free flaps are reliable for treatment of advanced mandibular ORN. Nevertheless, there remains a 55 percent incidence of wound-healing complications. The lack of objective clinical criteria to judge the appropriate amount of mandible resection in patients with ORN remains an unresolved issue that resulted in the development of recurrent ORN in 25 percent of patients. Further investigations are needed to better understand the pathophysiology of ORN to prevent postoperative wound complications and disease recurrence. (Source: Otolaryngology - Head and Neck Surgery)

Postoperative management following sphincter pharyngoplasty

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: Upper airway obstruction requiring overnight observation following SP is uncommon. In otherwise healthy patients, performing SP in an outpatient setting, given appropriate recovery room evaluation for airway concerns, oral intake, and pain control, should be considered. (Source: Otolaryngology - Head and Neck Surgery)

A novel surgical technique for management of tinnitus due to high dehiscent jugular bulb

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:37 +0100

Conclusion: The preliminary results suggest that surgical reconstruction of the middle ear floor under local anesthesia offers valuable treatment for patients with incapacitating tinnitus due to dehiscent middle ear floor. However, the risk of sigmoid sinus thrombosis should be considered. To our knowledge, this is the first trial of multilayer reconstruction of the middle ear floor dehiscence to manage high jugular bulb causing tinnitus. (Source: Otolaryngology - Head and Neck Surgery)

Intratympanic gentamicin treatment of patients with Ménière's disease with normal hearing

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:36 +0100

Conclusions: Patients with stage 1 Ménière's disease appear to have similar vertigo control with better hearing preservation than patients with advanced disease when treated with low-dose intratympanic gentamicin (10 mg/mL). (Source: Otolaryngology - Head and Neck Surgery)

Long-term prognosis of low-frequency hearing loss and predictive factors for the 10-year outcome

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:36 +0100

Conclusions: About half of the cases in our study developed high- or pan-frequency hearing loss within 10 years of onset of low-frequency hearing loss. The initial therapy results and fluctuation of hearing during the first year may indicate the long-term prognosis of patients presenting with low-frequency hearing loss. (Source: Otolaryngology - Head and Neck Surgery)

TriVerse versus molecular resonance–harvested grafts in single-stage Baha surgery

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:36 +0100

Conclusions: In our experience, the MR-harvested split-thickness skin graft is superior to the TV technique. (Source: Otolaryngology - Head and Neck Surgery)

The Baha system in patients with single-sided deafness and contralateral hearing loss

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:36 +0100

Conclusion: The Baha system is effective in the rehabilitation of patients with SSD and mild to moderate hearing loss in the only hearing ear. Results of the current study suggest that either the Divino or Intenso processor was successful in reestablishing hearing from the deafened side. (Source: Otolaryngology - Head and Neck Surgery)

Auto-crosslinked hyaluronan gel injections in phonosurgery

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:36 +0100

Conclusion: ACP-based gel seems to be a new tool in the challenging treatment of VF scarring, functioning as both an anti-adhesive product and an augmentation agent. Improvements in all glottal parameters and in both objective and subjective evaluation of voice performance were observed. (Source: Otolaryngology - Head and Neck Surgery)

Effects of type II thyroplasty on adductor spasmodic dysphonia

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:35 +0100

Conclusions: Treatment of AdSD with type II thyroplasty significantly improved aerodynamic and acoustic findings. The results of this study suggest that type II thyroplasty provides relief from voice strangulation in patients with AdSD. (Source: Otolaryngology - Head and Neck Surgery)

Gore-Tex medialization laryngoplasty for treatment of dysphagia

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:35 +0100

Conclusions: Gore-Tex medialization laryngoplasty is a well tolerated and well described treatment for the management of glottal incompetence. The procedure is an appropriate adjunct in dysphagia management for the appropriate patient population. (Source: Otolaryngology - Head and Neck Surgery)

Screening for obstructive sleep apnea/hypopnea syndrome: Subjective and objective factors

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:35 +0100

Conclusions: Neither the Berlin questionnaire nor the OSAHS score alone was both highly sensitive and specific for diagnosing OSAHS. By incorporating subjective and objective metrics into a single predictive equation, sensitivity and specificity were maximized, and 82.5 percent of diagnoses were accurately predicted. (Source: Otolaryngology - Head and Neck Surgery)

Reliability of airway obstruction analyses from Sleep MRI sequences

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:35 +0100

Conclusion: Intra-rater and inter-rater reliability coefficients are very high for determination of presence or absence of any obstruction, presence or absence of a retropalatal obstruction, presence or absence of a retroglossal obstruction, presence or absence of a swallow, and duration of obstruction from Sleep MRI sequences in OSAS patients. (Source: Otolaryngology - Head and Neck Surgery)

Measurements of adult lingual tonsil tissue in health and disease

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:35 +0100

Conclusion: CT images including the tongue base allow precise measurement of LTT thickness. LTT > 2.7 mm was not identified in patients without OSAHS or LPR. The mean LTT for patients with LPR and/or OSAHS was significantly greater than for patients without either disease. (Source: Otolaryngology - Head and Neck Surgery)

Palatine tonsil size in obese, overweight, and normal-weight children with sleep-disordered breathing

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:35 +0100

Conclusion: Obese children with SDB had larger palatine tonsils than did normal-weight children with SDB. This finding suggests that larger palatine tonsils may have a greater effect on upper airway obstruction in obese than in normal-weight children with SDB. (Source: Otolaryngology - Head and Neck Surgery)

Matrix metalloproteinase inhibition causes luminal narrowing and ring thickening in the cricoid cartilage

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:34 +0100

Conclusion: Matrix metalloproteinases likely play a significant role in growth of the cricoid cartilage such that their inhibition leads to marked changes in the shape of the ring. (Source: Otolaryngology - Head and Neck Surgery)

Effects of traditional Chinese acupuncture in post-viral olfactory dysfunction

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:34 +0100

Conclusion: TCA possibly offers a new therapeutic regimen for post-viral dysosmia. More research in a larger case series is needed before a clearer picture will emerge. (Source: Otolaryngology - Head and Neck Surgery)

Complications of esophagoscopy in an academic training program

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:34 +0100

Conclusion: The 2.6 percent esophageal perforation rate observed in this study is higher than that typically reported for rigid esophagoscopy. When performed as part of routine panendoscopy, no synchronous esophageal tumors were found, questioning the value of esophagoscopy in this setting. All perforations occurred in patients with a history of head and neck cancer and were associated with the level of the surgeon's experience in performing rigid endoscopy. (Source: Otolaryngology - Head and Neck Surgery)

Validation of a clinical practice ability instrument for surgical training

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:34 +0100

Conclusion: The CPI serves as a reliable, reproducible, and valid means to measure the progression of clinical practice ability in trainees as they transition from “novice” to “attending equivalent” surgeons. (Source: Otolaryngology - Head and Neck Surgery)

Mentoring in otolaryngology training programs

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:34 +0100

Conclusion: Residents perceive mentoring as important, and formal mentoring programs should be incorporated into otolaryngology training programs. (Source: Otolaryngology - Head and Neck Surgery)

How to review journal manuscripts

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:34 +0100

Abstract: Reviewing manuscripts is central to editorial peer review, which arose in the early 1900s in response to the editor's need for expert advice to help select quality articles from numerous submissions. Most reviewers learn by trial and error, often giving up along the way because the process is far from intuitive. This primer will help minimize errors and maximize enjoyment in reviewing. Topics covered include responding to a review invitation, crafting comments to editors and authors, offering a recommended disposition, dealing with revised manuscripts, and understanding roles and responsibilities. The target audience is primarily novice reviewers, but seasoned reviewers should also find useful pearls to assist their efforts. (Source: Otolaryngology - Head and Neck Surgery)

Extracts from The Cochrane Library: Scopolamine (hyoscine) for preventing and treating motion sickness

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:33 +0100

Abstract: The “Cochrane Corner” is a quarterly section in the Journal that highlights systematic reviews relevant to otolaryngology–head and neck surgery, with invited commentary to aid clinical decision making. This installment features a Cochrane Review entitled “Scopolamine (hyoscine) for preventing and treating motion sickness,” which concludes that scopolamine is more effective than placebo, but no conclusions can be made regarding comparative efficacy with other interventions or the ability of scopolamine to treat established symptoms. (Source: Otolaryngology - Head and Neck Surgery)

Cases

Otolaryngology - Head and Neck Surgery — Fri, 19 Mar 2010 15:22:30 +0100

Open an issue of this—or any other medical journal—and you are likely to find yourself immersed in a report of how a group of patients fared over time. If done properly, a case series can document natural history, enhance understanding of disease, and identify factors that influence outcomes. All doctors treat groups of patients, but few can report this experience in a manner worthy of publication. My response to the letter below might facilitate this goal. (Source: Otolaryngology - Head and Neck Surgery)

Information for Readers

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

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Society Page

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

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Editorial Board

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

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Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

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Propranolol may become first-line treatment in obstructive subglottic infantile hemangiomas

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

The spectacular effect of propranolol therapy on cutaneous hemangiomas of infancy was described for the first time in 2008 by Léauté-Labrèze et al. They successfully treated 11 cases and observed a change in the coloration of the hemangioma in all the children as early as 24 hours after initiation of treatment. Recently, we reported on two cases of obstructive subglottic hemangiomas, associated with PHACES (posterior fossa brain malformations, hemangiomas, arterial anomalies, cardiac anomalies/coarctation of the aorta, eye abnormalities, and sternal clefting/supraumbilical raphe) syndrome (first case) and multiple head and neck cutaneous hemangiomas (second case). Propranolol at 2 mg/kg/d in three divided doses had a rapid, intense effect on subglottic hemangioma and allowed both childr...

Treatment of head and neck cancer at academic centers

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

“Importance of treatment institution in head and neck cancer radiotherapy” is an important study and answers relevant and practical questions facing those of us treating head and neck cancer. In these days of organ preservation, otolaryngologists are frequently referring their patients for radiotherapy and chemoradiotherapy. It is commonly thought that one must make a decision between convenient location and better outcomes. Kubicek et al have alleviated our concerns with this but left important questions unanswered. I ask the authors to please consider adding complication rates to the outcome measures for a follow-up article. As an otolaryngologist in private practice, I continue to refer my patients to the academic center for radiotherapy and chemoradiotherapy and strongly encourage ...

Response to: Minimally invasive radioguided parathyroidectomy performed for primary hyperparathyroidism, from Russell B. Smith

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

The authors thank Dr. Smith for his comments on our article “Minimally invasive radioguided parathyroidectomy performed for primary hyperparathyroidism.” In our series, termination of the procedure was based upon rapid parathyroid hormone (PTH), although preoperative and postoperative radiation counts were measured and correlated. Although cost containment is important, these considerations have limited meaning if the patient's operation is unsuccessful. A number of authors have suggested that ex vivo confirmation of hyperfunctioning glands (20% rule) should indeed be confirmed using intraoperative rapid PTH. Some have gone as far as suggesting that the gamma probe was the least essential component for successful operative management, and therefore we felt that it was important to con...

Minimally invasive radioguided parathyroidectomy performed for primary hyperparathyroidism

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:32 +0100

Adil et al reported exemplary outcome in patients with primary hyperparathyroidism who underwent minimally invasive radioguided parathyroidectomy (MIRP). This degree of success is envied by all who perform parathyroid surgery. There exist varied opinions regarding this technique, especially with respect to the role of radioguidance during the procedure. Most likely, the application of the “20% rule,” as described by Murphy and Norman, has a much greater impact than intraoperative guidance to the adenoma in the vast majority of cases. (Source: Otolaryngology - Head and Neck Surgery)

Multiple head and neck tuberculosis granulomas in a patient with thymoma and immunodeficiency (Good's syndrome)

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:31 +0100

A 28-year-old man presented with a two-month history of odynophagia, cough, and neck mass. At our clinic, the pharyngeal examination showed multiple ulcerations on the bilateral tonsil fossa and pharyngeal wall. A chest x-ray revealed diffuse centrilobular opacities over the bilateral lungs with a huge tumor in the anterior mediastinum, which was later confirmed as a thymoma. Meanwhile, Mycobacterium tuberculosis (TB) was identified by sputum culture. After thymectomy and initial anti-TB chemotherapy, the patient developed nosocomial pneumonia with a positive sputum polymerase chain reaction (PCR) for Pneumocystis jiroveci and positive Toxoplasma gondii serology. Low peripheral blood B-cell and CD4 T-cell count with a reverse CD4:CD8 T-cell ratio confirmed the diagnosis of thymoma with imm...

A convenient, practical adapter for bronchotracheoscopy through a tracheostomy tube in a ventilator-dependent patient

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:30 +0100

Pediatric intensivists caring for patients with tracheostomies will frequently request an otolaryngology evaluation for any patient with new-onset bleeding from the tracheostomy site. Fiberoptic visualization of the bronchotracheal tree to assess for a source of bleeding is a required aspect of this evaluation. However, in the pediatric intensive care unit (PICU) setting, many patients have poor pulmonary function, often because of extreme prematurity and consequent bronchopulmonary dysplasia, and require high ventilator settings to maintain adequate oxygenation. These patients cannot tolerate more than a few moments without ventilatory support. (Source: Otolaryngology - Head and Neck Surgery)

Porcine dermal collagen graft for tracheoesophageal fistula repair

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:30 +0100

Tracheoesophageal puncture with voice prosthesis insertion is a well-established, proven method for restoring speech post laryngectomy. The formation of the puncture and the use of speech valves revolutionized voice rehabilitation for the laryngectomy patient. Surgical fistula formation, either primary or secondary, is relatively straightforward but established fistulas are not without potential complications. The most significant problem is leakage through a widened puncture site with subsequent aspiration of saliva, food, water, or gastric reflux contents. Widening of the puncture site usually occurs secondary to repeated trauma during valve change and is often associated with thinning of the tracheoesophageal wall, but may be caused by tumour recurrence at the site itself. (Source: Otol...

The -509 C/T genotype of TGFβ1 might contribute to the pathogenesis of benign airway stenosis

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:30 +0100

Abstract: Benign airway stenosis (BAS) is one of the most severe complications of endotracheal intubation. The aim of this pilot study was to compare the frequencies of four polymorphisms of the transforming growth factor (TGF) β1 gene in patients with BAS due to endotracheal intubation (n = 36) and a control group of intensive care patients who had also undergone endotracheal intubation but did not present BAS (n = 30). One of the studied polymorphisms, the -509 C/T, demonstrated a differential genotype distribution between the affected and the control population: the ratio of heterozygous mutants was significantly (P = 0.0116) higher among the control patients. These data suggest a protective function of the frequent heterozygous C/T genotype against BAS; alternatively, the C/C genotype...

Functional testing of a tissue-engineered vocal fold cover replacement

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:30 +0100

Conclusion: Bilayered tissue-engineered constructs were produced that exhibited indentation modulus, microstructure, and vibration similar to that exhibited by human vocal fold covers. (Source: Otolaryngology - Head and Neck Surgery)

Pediatric otogenic intracranial abscesses

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:29 +0100

Conclusion: Patients with intracranial abscesses, in selected cases, can be managed with intravenous antibiotics without mastoidectomy. The use of canal wall up mastoidectomy is an acceptable alternative to radical mastoidectomy when surgical intervention is necessary. (Source: Otolaryngology - Head and Neck Surgery)

Assessment of self-selection bias in a pediatric unilateral hearing loss study

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:29 +0100

Conclusion: Self-selection bias may jeopardize both internal and external validity of study results and should be evaluated whenever possible. Methods to minimize self-selection bias should be considered and implemented during the planning stages of clinical studies. (Source: Otolaryngology - Head and Neck Surgery)

Percutaneous cochlear implant drilling via customized frames: An in vitro study

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:27 +0100

Conclusion: In a cadaveric model, PCI drilling is safe and effective. (Source: Otolaryngology - Head and Neck Surgery)

Preoperative predictors of incudal necrosis in chronic suppurative otitis media

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:27 +0100

Conclusion: Incus necrosis is best predicted by the presence of middle ear granulations and moderate to moderately severe hearing loss (41-70 dB HL). Knowledge of this information preoperatively can influence surgical decision making and preparedness regarding ossiculoplasty and patient consent. (Source: Otolaryngology - Head and Neck Surgery)

Comparative outcomes of using fibrin glue in septoplasty and its effect on mucociliary activity

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:26 +0100

Conclusion: In our series of patients, we have seen no gross complications from fibrin glue usage. Fibrin glue can be readily used in septoplasty; it requires no special treatment, has an adequate hemostatic effect, and appears to promote the regeneration of mucociliary activity of the injured mucosa postoperatively. (Source: Otolaryngology - Head and Neck Surgery)

Experience with endoscopic dacryocystorhinostomy using four methods

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:26 +0100

Conclusion: The best EDCR results are achieved by stenting or removal of the medial wall of the LS. In our experience, excision of the medial wall of the LS was as successful as insertion of silastic lacrimal intubation stents, without the disadvantage of causing corneal opacities. (Source: Otolaryngology - Head and Neck Surgery)

Pulsating aerosols for drug delivery to the sinuses in healthy volunteers

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:26 +0100

Conclusion: Our data support the hypothesis that topical drug delivery in relevant quantities to the nose and osteomeatal areas, including the paranasal sinuses, is possible using pulsating airflows. Furthermore, the frequency of drug applications may be reduced due to a delayed clearance and longer residence time. (Source: Otolaryngology - Head and Neck Surgery)

Impact of pretreatment nasal symptoms on treatment outcome in allergic rhinitis

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:26 +0100

Conclusion: A worse treatment outcome despite more clinical improvements during the treatment period in a higher severity score suggests the therapeutic predictive value of pretreatment nasal symptom scoring and the need for more dosing and continuing medication in higher scores, especially in blocked nose. (Source: Otolaryngology - Head and Neck Surgery)

Role of nasal muscles in nasal valve collapse

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:25 +0100

Conclusion: Determination of agents involved in pathologies of the nasal valve region is necessary for planning appropriate treatment. The role of nasal muscles in dynamic nasal valve pathologies, which has not been previously recognized, should be considered. A more effective and adequate solution for the nasal sidewalls than static pathologies should be considered in these patients by taking into account the muscular activity disorders detected by EMG at the stage of surgical treatment. (Source: Otolaryngology - Head and Neck Surgery)

When to address level I lymph nodes in neck dissections?

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:25 +0100

Conclusion: Although the submandibular content is resected as part of radical and modified radical neck dissections, level I–sparing selective neck dissections could be a safe and effective surgical neck management strategy in appropriately selected patients with OP, Lx, and HP carcinoma. (Source: Otolaryngology - Head and Neck Surgery)

Computed tomographic angiography with three-dimensional reconstruction for transoral laser microsurgery

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:25 +0100

Conclusion: Three-dimensional CT angiography was useful in identifying the anatomical orientation of major arteries and the planning of transoral laser microsurgery to treat tumors involving the pharynx. (Source: Otolaryngology - Head and Neck Surgery)

Outcomes of laser thermal therapy for recurrent head and neck cancer

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:25 +0100

Conclusion: In this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. The highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT. (Source: Otolaryngology - Head and Neck Surgery)

Stereotactic body radiotherapy for refractory cervical lymph node recurrence of nonanaplastic thyroid cancer

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:25 +0100

Conclusion: In select patients, stereotactic body radiotherapy may be a feasible option for treating refractory nodal recurrence from nonanaplastic thyroid cancer. Further studies are necessary to define the role of stereotactic body radiotherapy in the management of thyroid cancer. (Source: Otolaryngology - Head and Neck Surgery)

Janus flap: Bilateral nasoseptal flaps for anterior skull base reconstruction

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:24 +0100

Conclusion: Bilateral nasoseptal flaps are a viable option for large dural defects of the anterior and ventral skull base when one nasoseptal flap may not completely seal the entire defect. (Source: Otolaryngology - Head and Neck Surgery)

Endoscopic management of sphenoclival neoplasms: Anatomical correlates and patient outcomes

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:24 +0100

Conclusion: The sphenoclival region poses a significant surgical challenge given its central location at the skull base and proximity to critical structures. This study demonstrates that transnasal endoscopic access to the sphenoclival region is technically feasible and allows successful surgical extirpation of tumors with a low complication rate and acceptable patient outcomes. (Source: Otolaryngology - Head and Neck Surgery)

Primary care approach to dysphonia

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:24 +0100

Conclusion: Primary care physicians face limitations with respect to evaluating patients for voice problems. Otolaryngologists must continue outreach efforts and collaboration with primary care colleagues in order to enhance the screening for voice problems. (Source: Otolaryngology - Head and Neck Surgery)

Diagnostic efficacy of surgeon-performed ultrasound-guided fine needle aspiration: A randomized controlled trial

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:23 +0100

Conclusion: Office-based surgeon-performed ultrasound-guided FNA of palpable lesions in the head and neck yields a statistically significant higher diagnostic rate compared to standard palpation technique. Our institutional experience supports the utility of surgeon-performed ultrasound as a core competency in clinical practice. (Source: Otolaryngology - Head and Neck Surgery)

The future of otolaryngology training threatened: The negative impact of residency training reforms

Otolaryngology - Head and Neck Surgery — Sat, 20 Feb 2010 14:20:23 +0100

Abstract: Resident training regulations developed by the Accreditation Council for Graduate Medical Education (ACGME) in 2003 have limited resident work hours and autonomy. Proposed to improve patient safety and resident education, these regulations have not had their intended effects. They have acted to dilute otolaryngology residents' experiences, thereby weakening their training. The ACGME is currently considering tightening these regulations. By advocating for residency guidelines that are more conducive to the needs of otolaryngology education, otolaryngologists can guarantee continued superlative training for future residents. (Source: Otolaryngology - Head and Neck Surgery)

Seal it and reveal it: Postoperative otoplasty care using a silicone-based occlusive dressing

Otolaryngology - Head and Neck Surgery — Wed, 17 Feb 2010 00:00:00 +0100

Prominent ears are one of the most common congenital anomalies of the head and neck, affecting about five percent of the general population. The normal external ear makes a 20 to 30 degree angle with the temporal surface of the head. A more obtuse angle makes ears appear more prominent. When measured from the most lateral edge of the ear to the mastoid, the ear usually protrudes 2 to 2.5 cm. The three basic deformities in ear structure that are responsible for prominent-appearing ears are valgus of the concha with a cranioauricular angle greater than 40 degrees, underdevelopment of the antihelix, and excessive growth of the concha. (Source: Otolaryngology - Head and Neck Surgery)

Retained tracheotomy suture: Nine years of morbidity

Otolaryngology - Head and Neck Surgery — Wed, 10 Feb 2010 00:00:00 +0100

A32-year-old male presented complaining of throat irritation, cough, and dysphonia since a motor vehicle accident nine years previously. At that time, the patient experienced a traumatic brain injury (TBI) and required long-term ventilation. After 1.5 weeks of orotracheal intubation, a tracheotomy was performed. When we examined the patient, in-office transnasal laryngoscopy revealed a normal larynx with a firm white strand emanating from the trachea and extending through the glottis. (Source: Otolaryngology - Head and Neck Surgery)

Endoscopic resection of supraglottic (T1-T2-T3) and glottic (T2-T3) carcinomas using microdissection electrodes

Otolaryngology - Head and Neck Surgery — Fri, 22 Jan 2010 00:00:00 +0100

Endoscopic electrosurgical resection of vocal cord carcinomas of stage T1 using microelectrodes (MEs) is a reliable surgical procedure; we have applied that experience to more advanced tumor stages in the glottis and the supraglottis. The present study describes the new electrode shape and the surgical technique. (Source: Otolaryngology - Head and Neck Surgery)

Audiological and transient evoked otoacoustic emission findings in patients with vitiligo

Otolaryngology - Head and Neck Surgery — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion: Hearing thresholds at pure-tone and high-frequency audiometry were higher in patients with vitiligo. Also, significantly lower high-frequency amplitudes were recorded during transient evoked otoacoustic emission testing in the disease group. (Source: Otolaryngology - Head and Neck Surgery)

Effect of oral tolerance in a mouse model of allergic rhinitis

Otolaryngology - Head and Neck Surgery — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion: These results suggest that OT may effectively reduce allergic inflammation as well as airway remodeling in a mouse model of AR. (Source: Otolaryngology - Head and Neck Surgery)

Transfusion criteria in free flap surgery

Otolaryngology - Head and Neck Surgery — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion: For patients undergoing free flap surgery, a postoperative transfusion trigger of hematocrit < 25 percent decreases blood transfusion rates without increasing rates of flap-related complications. (Source: Otolaryngology - Head and Neck Surgery)

Maxillary removal and reinsertion: A favorable approach for extensive anterior cranial base tumors

Otolaryngology - Head and Neck Surgery — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion: MRRI is a favorable surgical technique for the treatment of anterior cranial base (ACB) tumors in adults and even in children. It improves operative morbidity by preserving both function and form of the maxillary region and gives excellent exposure to ACB. (Source: Otolaryngology - Head and Neck Surgery)

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Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:54 +0100

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Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:54 +0100

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Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:54 +0100

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Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:54 +0100

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Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:54 +0100

This is the second book on structural fat injection by Dr. Sydney Coleman. Dr. Coleman has established his secure stature as one of the leading experts in fat transfer technique and understanding. He has dedicated several decades of clinical practice, research, and teaching to the topic. He has developed principles of fat grafting that serve as the fundamentals of the practice for many surgeons. He may be the most influential proponent of structural fat grafting for the rejuvenation of the aging face; many surgeons ascribe to his techniques and approach to the practice. This second volume, Fat Injection: From Filling to Regeneration, is co-edited by Dr. Riccardo F. Mazzola and serves as a valuable sequel to Dr. Coleman's first book on the subject. (Source: Otolaryngology - Head and Neck Su...

Lingual tonsillectomy for the management of persistent obstructive sleep apnea after adenotonsillectomy in children

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:53 +0100

Tonsillectomy and adenoidectomy (T&A) is the first-line surgical treatment for the management of pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS). However, contrary to the initial reports, recent studies demonstrated higher rates of persistence of OSAHS after T&A. It was emphasized that T&A for pediatric OSAHS patients with smaller tonsils, narrower epipharyngeal airspace, and more poorly developed maxillary and mandibular protrusion had poorer response. Therefore, different and advanced surgical approaches, such as uvulopalatopharyngoplasty and orthognatic surgeries (maxillomandibular expansion, distraction osteogenesis, etc.), were offered. (Source: Otolaryngology - Head and Neck Surgery)

Response to: A more skeptical review of homeopathy, from Michael Hopfenspirger

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:53 +0100

Dr. Hopfenspirger takes Dr. Couch and me to task for two statements in our comments on the Cochrane review of homeopathic medicines for adverse effects of cancer treatment. I can only respond for myself. On re-reading what I wrote in the original commentary, I find it hard to imagine that anyone would think I was a supporter of, or even a “believer” in, homeopathic medicine. (Source: Otolaryngology - Head and Neck Surgery)

A more skeptical review of homeopathy

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:53 +0100

Burton et al discussed the Cochrane review on homeopathic medicines. Comments such as homeopathic medicine is “a promising area of research” (Dr. Couch) and the “benefit of doubt has now shifted” (Dr. Burton) left me bewildered. (Source: Otolaryngology - Head and Neck Surgery)

Lobular capillary hemangioma of the nasal cavity in a five-year-old boy

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:49 +0100

A five-year-old male was referred to the pediatric otolaryngology clinic with recurrent right anterior epistaxis and unilateral nasal obstruction. There was no history of systemic disease, neurologic changes, trauma, or foreign body insertion. He had no significant medical or surgical history. Upon examination, he was noted to have an obstructing friable right intranasal mass (). Anterior rhinoscopy was normal on the opposite side. The remainder of his head and neck examination was normal. Imaging studies revealed a lobular heterogeneous nasal mass causing mass effect on the septum and lateral nasal wall. There was no erosion or remodeling of bone, and no extension outside of the nasal cavity. No prominent feeding vessels were identified. The mass was excised endoscopically using image gui...

Postauricular epidermal cyst

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:49 +0100

A 57-year-old male presented to our clinic with an eight-year history of a slowly growing mass behind his right ear. There was no trauma or surgical intervention in his history. Physical examination revealed a 4 cm × 3 cm, nonfluctuant, mobile mass behind the right auricle (). The overlying skin was blue-purple in color. CT scans revealed a mass with a dense content and no contrast enhancement. There was no invasion to the temporal bone or auricular cartilage. The mass was excised under local anesthesia, including the overlying skin. Pathological diagnosis was reported as epidermoid cyst. (Source: Otolaryngology - Head and Neck Surgery)

Upper lip elongation in Möbius syndrome

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:49 +0100

Möbius syndrome is a rare congenital disorder characterized by complete or partial facial paralysis, with or without paralysis of other cranial nerves, and occasional limb and/or orofacial malformations. It occurs in one of every 50,000 live births, and affects boys and girls equally. Many patients have a foreshortened upper lip with exposed incisors, and experience oral incompetence, poor articulation, and exposure dental caries from bilateral facial paralysis. Facial reanimation surgery performed using gracilis muscle transfer has been shown to improve drooling, speech, and facial animation. Despite successful facial animation, many patients still experience speech difficulties related to the foreshortened upper lip. (Source: Otolaryngology - Head and Neck Surgery)

Unsedated office-based tracheoesophageal puncture using a novel guidewire technique

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:48 +0100

Tracheoesophageal puncture (TEP) is an effective and preferred means by which alaryngeal patients can achieve post-laryngectomy speech. While TEP has traditionally been performed in the operating room (OR) with the patient under general anesthesia, the availability of the transnasal esophagoscope has allowed TEP to be performed as an unsedated, office-based procedure. Additional advantages include a reduction in surgery time and procedure-related cost, and improved collaboration between the otolaryngologist and the speech pathologist to achieve improved clinical outcomes. (Source: Otolaryngology - Head and Neck Surgery)

Intraoperative radiation exposure with the use of 18F-FDG–guided thyroid cancer surgery

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:48 +0100

Abstract: Radio-guided surgery is an established means for surgeons to identify a target of interest for biopsy or excision. This technique is used for a variety of malignancies as well as minimally invasive parathyroid surgery. The primary radionuclide used for these procedures is technetium-99m (Tc-99m), but others have been used. Use of 18fluorine-fluorodeoxyglucose (18F-FDG) in oncology has proliferated. This has created the opportunity to use 18F-FDG as a potential radio tracer in the operating room. A pilot study of three patients with non-iodine avid thyroid cancers undergoing 18F-FDG–guided revision thyroid cancer surgery is reported. Radiation exposure to operating room personnel was measured. Radiation exposure to the surgeon and staff members of an operating room is well below...

Conservative management of advanced external auditory canal cholesteatoma

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:48 +0100

Conclusions: EACC is associated with adjacent bony erosion, most often involving the inferior EAC. Despite the potentially destructive nature of these lesions, most cases can be successfully managed with serial debridement. (Source: Otolaryngology - Head and Neck Surgery)

Hearing impairment and poverty: The epidemiology of ear disease in Peruvian schoolchildren

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:48 +0100

Abstract: Objectives: 1) To measure prevalence of hearing impairment (HI) in schoolchildren living in poverty in Peru. 2) To identify risk factors for HI and assess its impact on academic performance.Study Design: Cross-sectional.Setting: Elementary schools in an asentimiento humano (shantytown) near Lima, Peru, October 2008 to March 2009.Subjects: Schoolchildren (n = 335), ages six to 19 years.Methods: Audiological health was assessed with pure-tone audiometry, tympanometry, and otoscopy. The primary outcome was HI, defined as average threshold >25 dB HL for 0.5, 1, 2, and 4 kHz, in one or both ears (per World Health Organization/International Organization for Standardization). A questionnaire on health history was administered to parents. Statistical analysis included univariate analysis...

Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:46 +0100

Conclusion: IMP through a microcatheter is a promising treatment for refractory SSNHL. The data suggest that the treatment may be more effective when administered at the earlier stages of SSNHL when the conventional treatment has failed. (Source: Otolaryngology - Head and Neck Surgery)

Magnetic resonance imaging of guinea pig cochlea after vasopressin-induced or surgically induced endolymphatic hydrops

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:45 +0100

Conclusions: In vivo postcontrast MRI of the inner ear demonstrated cochlear changes associated with chronic systemic administration of vasopressin and surgical ablation of the endolymphatic sac. Understanding the MRI appearance of endolymphatic hydrops induced by various methods contributes to the future use of MRI as a possible tool in the diagnosis and treatment of Ménière's disease. (Source: Otolaryngology - Head and Neck Surgery)

Time of cochlear implant surgery in academic settings

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:45 +0100

Conclusions: We report the time required to perform CI in academic settings—data that are vital for cost-benefit analyses and assessing new CI techniques. (Source: Otolaryngology - Head and Neck Surgery)

The children speak: An examination of the quality of life of pediatric cochlear implant users

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:45 +0100

Conclusion: Children with CIs experience quality of life similar to that of normal-hearing peers. Parents are reliable reporters on the status of their child's overall quality of life. (Source: Otolaryngology - Head and Neck Surgery)

Air quality improvement and the prevalence of frequent ear infections in children

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:45 +0100

Abstract: Objective: To determine whether air quality influences the prevalence of pediatric frequent ear infections and respiratory allergy.Study Design: Case-control study.Setting: Academic medical center.Subjects and Methods: The National Health Interview Survey child sample for the calendar years 1997 through 2006 was analyzed, extracting 12-month prevalence data for the following three disease conditions: frequent (≥3 within 12 months) ear infections, respiratory allergy, and seizures (nonrespiratory control condition). Based on information from the Environmental Protection Agency, yearly historical data for the air quality criteria pollutants carbon monoxide, nitrous dioxide, sulfur dioxide, and particulate matter were tabulated. Graphical and linear regression analyses were conduc...

Clinical assessment of adenoidal obstruction based on the nasal obstruction index is no longer useful in children

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:43 +0100

Conclusion: Clinical assessment based on the NOI is incapable of accurately predicting the degree of adenoidal obstruction. In children with clinical nasal obstruction not explainable by adenoidal size, the clinician should consider, among causes of more anterior obstruction, nasal allergy. (Source: Otolaryngology - Head and Neck Surgery)

A prospective study of vitamin intake and the risk of hearing loss in men

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:43 +0100

Conclusions: Higher intake of vitamin C, E, beta carotene, or B12 does not reduce the risk of hearing loss in adult males. Men aged ≥60 years may benefit from higher folate intake to reduce the risk of developing hearing loss. (Source: Otolaryngology - Head and Neck Surgery)

Do abstracts in otolaryngology journals report study findings accurately?

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:43 +0100

Conclusions: Readers of otolaryngology journals may form biased or inappropriate conclusions if they read only the abstract of a study, particularly with regard to study limitations, adverse events, and subject dropouts or losses. These results highlight the perils of using the abstract as a sole source of information. (Source: Otolaryngology - Head and Neck Surgery)

Propofol-induced sleep: Polysomnographic evaluation of patients with obstructive sleep apnea and controls

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:43 +0100

Conclusions: These preliminary results allow us to infer that sedation with propofol changes sleep architecture but permits respiratory evaluation, because the main respiratory parameters evaluated in OSA are maintained. These preliminary results support the view that nasoendoscopy under propofol sedation is a promising examination for management of this disease. (Source: Otolaryngology - Head and Neck Surgery)

Influence of head rotation on upper esophageal sphincter pressure evaluated by high-resolution manometry system

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:42 +0100

Conclusion: The present study provided us with physiological information regarding normal UES pressure in relation to head rotation. This data will be of aid to future clinical and investigative swallowing studies. Additionally, the current study provides evidence of the safety and usefulness of the head rotation maneuver for dysphagic patients. (Source: Otolaryngology - Head and Neck Surgery)

Prevalence of penetration and aspiration on videofluoroscopy in normal individuals without dysphagia

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:42 +0100

Conclusion: Aspiration on VFSS is not a normal finding. Penetration is present in 11.4 percent of normal adults and is more common with a liquid bolus. (Source: Otolaryngology - Head and Neck Surgery)

From virtual reality to the operating room: The endoscopic sinus surgery simulator experiment

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:42 +0100

Conclusion: The validity of the ES3 as an effective surgical trainer was verified in multiple instances, including those not depending on subjective rater evaluations. The ES3 is one of the few virtual reality simulators with a comprehensive validation record. Advanced simulation technologies need more rapid implementation in otolaryngology training, as they present noteworthy potential for high-quality surgical education while meeting the necessity of patient safety. (Source: Otolaryngology - Head and Neck Surgery)

Failures in endoscopic surgery of the maxillary sinus

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:42 +0100

Conclusion: Intraoperative bleeding may be a risk factor for failure in endoscopic surgery of maxillary rhinosinusitis, but there is substantial uncertainty and future research is needed. (Source: Otolaryngology - Head and Neck Surgery)

Lumen formation in three-dimensional cultures of salivary acinar cells

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:42 +0100

Conclusion: A novel system supporting acini-like assembly in a 3D culture system was established. Presence of biomarkers and secretion of salivary enzymes confirms functionality in vitro. Future experiments will test the 3D system in an animal model. (Source: Otolaryngology - Head and Neck Surgery)

Clinical course of arteriovenous malformations of the head and neck: A case series

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:41 +0100

Conclusion: The natural course of AVMs is progressive, invasive, and destructive. Vigilant observation, early treatment, and radical therapy are necessary for AVMs of the head and neck. (Source: Otolaryngology - Head and Neck Surgery)

Keratocystic odontogenic tumor associated with nevoid basal cell carcinoma syndrome: Similar behavior to sporadic type?

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:41 +0100

Conclusion: On the basis of the analysis of the expression of PCNA, Ki-67, and p53, there appears to be no evidence to indicate higher aggressiveness in growth and infiltrative behavior in syndromic KCOT compared with the sporadic type. Therefore, surgical treatment may be approached in the same manner in KCOT sporadic and syndromic with the goal of minimizing recurrence. (Source: Otolaryngology - Head and Neck Surgery)

A randomized, prospective, controlled study of forearm donor site healing when using a vacuum dressing

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:41 +0100

Conclusions: Although an attractive option for wound care, the NPD does not appear to offer a significant improvement over an SPD in healing of the RFFF donor site. (Source: Otolaryngology - Head and Neck Surgery)

Vasopressor use in free tissue transfer surgery

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:41 +0100

Conclusion: Intraoperative vasopressors are used more frequently than previously realized but do not appear to increase overall flap failure and the incidence of complications. Intraoperative vasopressor use in free flap surgery may not be as harmful as previously feared. (Source: Otolaryngology - Head and Neck Surgery)

Assessment of the chin in patients undergoing rhinoplasty: What proportion may benefit from chin augmentation?

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:41 +0100

Conclusion: Surgeons who practice rhinoplasty should consider making an objective assessment of the need for possible chin augmentation. Our study shows that as many as 81 percent of patients may benefit, although this figure varies with the method of assessment. In this study, the necessity for further analysis with a view to chin augmentation was more likely in women. (Source: Otolaryngology - Head and Neck Surgery)

Practitioners need corporate compliance education: AAO–HNS survey results

Otolaryngology - Head and Neck Surgery — Sat, 16 Jan 2010 14:12:41 +0100

Abstract: The environment in which otolaryngologists coexist with device and drug development has become increasingly complex. There are broad implications for both the academic and the private practitioner, with neither group being more or less insulated than the other. From the medical, ethical, and resource-oriented standpoints, otolaryngologists must consider this evolving area very carefully. A survey of the American Association of Otolaryngology–Head and Neck Surgery membership identified areas of education to improve the awareness and knowledge base of these complex considerations. In particular, knowledge of legal proceedings, Food and Drug Administration processes, relevant hospital resources, and conflict of interest considerations were areas in which the membership would benef...

Life-threatening tension subcutaneous emphysema as a complication of open tracheostomy

Otolaryngology - Head and Neck Surgery — Thu, 07 Jan 2010 00:00:00 +0100

We report on a patient who developed acute, life-threatening subcutaneous emphysema after an open tracheostomy and who was successfully treated with emergent subcutaneous decompression. The University of Missouri Health Sciences institutional review board approved this project. (Source: Otolaryngology - Head and Neck Surgery)

Pituitary adenoma manifests as blood-tinged sputum

Otolaryngology - Head and Neck Surgery — Thu, 07 Jan 2010 00:00:00 +0100

A 57-year-old woman had visited our hospital four times complaining of intermittent blood-tinged sputum between the years 2000 to 2001. No bloody sputum or epistaxis was found in those visits. Workup for minor hemoptysis at the chest and otolaryngology departments revealed nothing except an occasional cough. (Source: Otolaryngology - Head and Neck Surgery)

Safety and efficacy of carbomethylcellulose foam in guinea pig middle ear surgery

Otolaryngology - Head and Neck Surgery — Thu, 07 Jan 2010 00:00:00 +0100

Conclusion: CMC was associated with hearing loss and may be ototoxic. Therefore, CMC should not be used in human middle ears given the presence of several nontoxic alternative materials. (Source: Otolaryngology - Head and Neck Surgery)

Acoustic tumor observation and failure to follow-up

Otolaryngology - Head and Neck Surgery — Thu, 07 Jan 2010 00:00:00 +0100

Conclusion: Failure to follow-up is a serious problem with acoustic tumor observation protocols. It is difficult to detect which patients are at risk for noncompliance. Patient noncompliance with observation protocols should be considered when determining the most appropriate treatment for each acoustic tumor patient. (Source: Otolaryngology - Head and Neck Surgery)

Expression of cell-cycle regulators (cyclin D1, cyclin E, p27kip1, p57kip2) in papillary thyroid carcinoma

Otolaryngology - Head and Neck Surgery — Thu, 07 Jan 2010 00:00:00 +0100

Conclusion: Our results suggest that immunohistochemistry of certain cell-cycle regulators may be helpful in the diagnosis of papillary thyroid carcinoma, and that cyclin D1 in particular may be a useful marker for evaluating lymph node metastasis. (Source: Otolaryngology - Head and Neck Surgery)

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