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Publisher: Elsevier   (Total: 3042 journals)

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Showing 1 - 200 of 3042 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 19, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 81, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 326, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 203, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 22, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 3)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 124, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 44, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 20, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 24)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 34, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 21, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 58)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 339, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 15)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 311, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 398, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 38, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 50, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 46, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 45, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 30, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 44, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 182, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 54, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 23, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 33, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 4)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 161, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 153, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of Otolaryngology
  [SJR: 0.59]   [H-I: 45]   [23 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0196-0709
   Published by Elsevier Homepage  [3042 journals]
  • Surgical timing for facial paralysis after temporal bone trauma
    • Authors: Peng Xu; Aiyan Jin; Baoqiang Dai; Ruijie Li; Yefeng Li
      Pages: 269 - 271
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Peng Xu, Aiyan Jin, Baoqiang Dai, Ruijie Li, Yefeng Li
      Objectives To explore surgical timing of facial paralysis after temporal bone trauma. Methods The clinical data of the patients with facial paralysis after temporal bone trauma who underwent subtotal facial nerve decompression were retrospectively collected, and 80 cases followed-up for one year were enrolled in the study. They were divided into different subgroups according to the age, onset, and interval between facial paralysis and surgery, and the outcomes of facial nerve between different subgroups were compared. Results The number of patients who achieved good recovery of HB Grade I or II was 52 of 80 (65.0%). 43 of 66 cases (65.2%) in the younger group had good recovery of facial nerve in contrast to 9 of 14 cases (64.3%) in the elderly group, without significant difference (p >0.05). 9 of 13 cases (69.2%) in the delayed onset group had good recovery, while 43 of 67 cases (64.2%) in the immediate onset group had good recovery, without significant difference (p >0.05). The good recovery rate of the <1month group was statistically higher compared to the 3–6months group or the >6months group (P <0.05), while the good recovery rate of the <1month group was not statistically higher than that of the 1–2months group or the 2–3months group (P >0.05). Conclusion This study demonstrated that the good recovery rate of facial paralysis after temporal bone trauma was uncorrelated with age and onset. It was better to perform surgical decompression within 3months after facial paralysis.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.002
       
  • Adenoid cystic carcinoma of the base of tongue: A population-based study
    • Authors: Diana N. Kirke; Chandala Chitguppi; Samuel J. Rubin; Minh T. Truong; Scharukh Jalisi
      Pages: 279 - 284
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Diana N. Kirke, Chandala Chitguppi, Samuel J. Rubin, Minh T. Truong, Scharukh Jalisi
      Background The objective was to assess demographic and survival patterns in patients with adenoid cystic carcinoma of the base of tongue. Methods Patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1973 through 2012 and were categorized by age, gender, race, historical stage A, and treatment. Incidence and survival were compared with Kaplan Meier curves and mortality hazard ratios. Results A total of 216 patients were included. After adjusting for age, gender, race and tumor-directed treatment, patients over the age of 70years had a significantly increased mortality [HR=2.847, 95% CI (1.499, 5.404) p =0.0014]. Furthermore mortality among patients with distant disease was significantly increased [HR=2.474 95% CI (1.459, 4.195) p =0.00008]. Conclusion By examining the largest collection of patients we have demonstrated that there is a significant difference in mortality based on both the age at diagnosis and in the setting of distant disease.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.010
       
  • Free dermal fat graft reconstruction of the head and neck: An alternate
           reconstructive option
    • Authors: Adam Honeybrook; Sanjay M. Athavale; Sanjeet V. Rangarajan; Sarah L. Rohde; James L. Netterville
      Pages: 291 - 296
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Adam Honeybrook, Sanjay M. Athavale, Sanjeet V. Rangarajan, Sarah L. Rohde, James L. Netterville
      Objectives Ablative procedures of the head and neck often result in significant facial and cervical irregularities and cosmetic asymmetry. The deformity resulting from ablative procedures of the head and neck is a significant source of cosmetic morbidity and postoperative dissatisfaction. Reconstruction of post-ablative defects in the head and neck can employ a broad range of techniques, ranging from primary closure to free tissue transfer. The free dermal fat graft (FDFG) is one such option and has been used to repair volume defects of varying sizes after common head and neck procedures such as parotidectomy. However, its use is largely undocumented in the literature. We seek to further illustrate the FDFG as an alternate method of reconstruction of head and neck defects. Study design Non-randomized retrospective analysis. Methods The medical records of all patients who underwent primary autologous abdominal FDFG reconstruction of head and neck defects by a single surgeon at Vanderbilt University Medical Center from January 1997 to August 2010 were reviewed. All patients were called in order to assess their post-operative cosmetic satisfaction. Results Sixty-two patients were analyzed. Only three patients were found to have post-operative complications directly related to the FDFG. No complications were found at the donor site. Based on a telephone survey, the majority of patients were satisfied post-operatively with their cosmetic outcomes in the primary site and donor site. Conclusions From our experience the FDFG is a cosmetically and functionally advantageous option for reconstruction of ablative procedures of the head and neck.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.026
       
  • Nasopharyngeal adenocarcinoma: A population-based analysis
    • Authors: Edward C. Kuan; Jose E. Alonso; Armin Arshi; Maie A. St. John
      Pages: 297 - 300
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Edward C. Kuan, Jose E. Alonso, Armin Arshi, Maie A. St. John
      Objectives/hypothesis To describe the incidence and determinants of survival of patients with nasopharyngeal adenocarcinoma between the years of 1973 to 2012 using the Surveillance, Epidemiology, and End Result (SEER) database. Study design Retrospective cohort study using a national database. Methods The SEER registry was utilized to calculate survival trends for patients with nasopharyngeal adenocarcinoma between 1973 and 2012. Patient data was then analyzed with respect to histopathology, age, sex, race, stage, grade, and treatment modalities (surgery and radiation therapy). Overall (OS) and disease-specific survival (DSS) were calculated. Results A total of 148 cases of nasopharyngeal adenocarcinoma were identified. The cohort was composed of 54.7% males. The mean age at diagnosis was 59.0years. The median OS was 60.6months. 59.4% of cases were treated with surgery, while 64.1% received radiation therapy. OS at 2, 5, and 10years was 63%, 49%, and 36%, respectively. There was no significant difference in OS and DSS between adenocarcinoma of the nasopharynx versus the sinonasal tract (p >0.05). On univariate analysis, younger age, surgery, surgery and radiation, and lower tumor grade were associated with improved OS and DSS, while papillary subtype, lower stage, and no distant metastasis were associated with improved OS alone (all p <0.05). Conclusions Nasopharyngeal adenocarcinoma is an extremely rare malignancy with poor prognosis, with the exception of the papillary subtype. Age, grade, and surgical therapy are predictors of survival.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.028
       
  • Effect of nebulized budesonide on decreasing the recurrence of allergic
           fungal rhinosinusitis
    • Authors: Qi Dai; Chen Duan; Quan Liu; Hongmeng Yu
      Pages: 321 - 324
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Qi Dai, Chen Duan, Quan Liu, Hongmeng Yu
      Objective The aim of this study was to evaluate the clinical efficacy and the effects on decreasing the recurrence of AFRS (allergic fungal rhinosinusitis) of a budesonide inhalation suspension delivered via transnasal nebulization to patients following endoscopic sinus surgery. Subjects and methods Thirty-five patients were recruited into this study. Final diagnoses were reached using Bent and Kuhn's criteria. The eligible patients were randomly divided into two groups: the budesonide transnasal nebulization group (group A) and the topical nasal steroids group (group B). Nasal symptoms, Lund-Mackay scores, and Kupferberg grades were evaluated before surgery, after surgery and during the follow-up to assess the effects of these two approaches. Results A total of 30 patients with AFRS who were eligible were included in the study. Four of the 15 patients in group B (26.67%) developed recurrent disease, whereas no patients in group A developed recurrent disease. This difference was statistically significant (p =0.032). Conclusion Nebulized budesonide is an effective and safe treatment for patients with AFRS following endoscopic sinus surgery, as evidenced by the reduced recurrence rate observed in the budesonide transnasal nebulization group relative to the topical nasal steroids group.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.034
       
  • Effect of vitamin D deficiency on the laryngo-pharyngeal tract
    • Authors: Abdul-Latif Hamdan; Ghina Fakhri; Ghassan Haddad; Gabriel Dunya; Doja Sarieddine; Bilal Turfe; Georges Tabet; Sami Azar
      Pages: 333 - 336
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Abdul-Latif Hamdan, Ghina Fakhri, Ghassan Haddad, Gabriel Dunya, Doja Sarieddine, Bilal Turfe, Georges Tabet, Sami Azar
      Objective To investigate the effect of vitamin D deficiency on the laryngopharyngeal tract. Study design Prospective cohort study. Setting Tertiary care center. Subjects and methods A total of 38 human subjects were prospectively recruited, equally divided into two groups. The Vitamin D deficiency group defined as 25-OH<25ng/dl and the control subjects with normal vitamin D level defined as 25-OH>25ng/dl. The presence and severity of vocal tract symptoms was assessed using the Vocal Tract Discomfort score. Results There was no significant difference in vocal tract discomfort score for frequency and severity between patients with Vitamin D deficiency and patients with no vitamin D deficiency (p value 0.272). However there was a significant difference in the mean frequency of burning, aching, soreness and lump sensation (p value<0.05) in patients with vitamin D deficiency compared to those with no vitamin D deficiency. There was also a significant difference in the means of vocal tract severity symptoms, namely for burning and aching between patients with vitamin D deficiency compared to patients with no vitamin D deficiency (p value<0.05). Conclusion Subjects with vitamin D deficiency do not have a higher vocal tract discomfort score than subjects with no vitamin D deficiency. However the frequency and severity of certain vocal tract discomfort symptoms was higher and can be based hypothetically on the similarity in structure between the laryngopharyngeal complex and the musculoskeletal system.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.02.001
       
  • Reconstruction of midface defect from idiopathic destructive process using
           Medpor implant
    • Authors: Joel Franco; Michael S. Harris; Dominic Vernon; Taha Z. Shipchandler
      Pages: 351 - 353
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Joel Franco, Michael S. Harris, Dominic Vernon, Taha Z. Shipchandler
      Importance Reconstruction of the midface remains a challenging task for even the most experienced surgeon, with a host of reconstructive options including free tissue transfer, allografts, or prosthetic implants. Presented here is a case of idiopathic bony destruction of the right midface in a 19year old female, creating a unique defect requiring repair. Objective Demonstrate a unique case of severe maxillary degeneration and discuss the associated reconstructive challenges and final repair with a prosthetic implant. Design Case report. Results The patient presented with a 7month history of an idiopathic progressive deformity of the right cheek. Computed tomography of the paranasal sinuses revealed extensive bone loss of the right midface and orbit. The patient underwent facial reconstruction using a customized Medpor (Stryker Corp, Kalamazoo, MI) implant. At 6month follow-up the patient and physician were both pleased with the patient's overall appearance. The patient did have some residual lower lid retraction present as well as some lateral pull at the lateral canthus outward from the orbit itself. Conclusions Preoperative planning for midface reconstruction requires a deep understanding of the aesthetic, functional, and supportive roles this structure holds. Computer assistance allows the creation of custom made implants, providing the reconstructive surgeon with innovative options for reconstruction with minimal morbidity to the patient. As the technology around the design and creation of the custom implants continues to improve, the role of computer assistance in reconstruction will become more prominent.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.007
       
  • Nasal septal perforation secondary to systemic bevacizumab
    • Authors: Mathew Geltzeiler; Toby O. Steele
      Pages: 354 - 355
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Mathew Geltzeiler, Toby O. Steele
      Importance A case of nasal septal perforation secondary to systemic bevacizumab therapy for ovarian cancer is reported. Bevacizumab is a vascular endothelial growth factor A (VEGF-A) inhibitor that is becoming more widely utilized in the oncologic community. There is only one prior report of septal perforation secondary to bevacizumab in the Otolaryngology specific literature. The purpose of this report is: 1) to raise awareness and discuss the literature surrounding the sinonasal complications of bevacizumab and 2) provide workup and treatment recommendations based on the sum of the available literature. Observations We review the clinical record of a 59year old patient who presented with an anterior septal perforation while taking bevacizumab therapy for ovarian cancer. She had mild symptoms. Her oncologist held bevacizumab and topical moisture therapy was started. After several weeks, the perforation remained stable and bevacizumab was restarted for her ovarian cancer. Conclusion and relevance Bevacizumab is associated with both septal perforation and more widespread sinonasal toxicity. These lesions tend to produce only mild symptoms and can usually be managed conservatively. The decision to hold bevacizumab therapy should be made in conjunction with the patient and medical oncologist. Otolaryngologists should be aware of the toxicity from this increasingly common oncologic therapy.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.018
       
  • Cochlear implantation in an NPC patient post-irradiation presenting with
           electrode array extrusion through the posterior canal wall
    • Authors: Celeste Ann Chua; David Low; Tiong-Yong Tan; Heng-Wai Yuen
      Pages: 356 - 357
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Celeste Ann Chua, David Low, Tiong-Yong Tan, Heng-Wai Yuen


      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.021
       
  • Facial nerve sacrifice during parotidectomy: A cautionary tale in
           pathologic diagnosis
    • Authors: Nicholas B. Abt; Adeeb Derakhshan; Matthew R. Naunheim; Heather A. Osborn; Daniel G. Deschler
      Pages: 358 - 359
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Nicholas B. Abt, Adeeb Derakhshan, Matthew R. Naunheim, Heather A. Osborn, Daniel G. Deschler


      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.022
       
  • Bilateral sinonasal extramedulary plasmacytoma treated with radiotherapy
           and a medial maxillectomy with a Denker's procedure
    • Authors: Samuel N. Helman; Peter Filip; Codrin Iacob; Patrick Colley
      Pages: 360 - 362
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Samuel N. Helman, Peter Filip, Codrin Iacob, Patrick Colley


      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.02.003
       
  • Lobular capillary hemangiomas: Case report and review of literature of
           vascular lesions of the nasal cavity
    • Authors: Akina Tamaki; Eric Babajanian; Brian D'Anza; Kenneth Rodriguez
      Pages: 363 - 366
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Akina Tamaki, Eric Babajanian, Brian D'Anza, Kenneth Rodriguez
      Vascular tumors of the nasal cavity can represent a variety of pathologies. In this case report, we discuss two patients presenting with a large vascular lesion occupying the nasal cavity. Significant bleeding was encountered during the initial attempts for endoscopic surgical resection. One lesion was successfully excised following preoperative embolization while a second following sphenopalatine artery vascular ligation. In both cases, final pathology showed lobular capillary hemangioma (LCH). We present a literature review and discussion of LCH and other vascular tumors that present in the nasal cavity. In addition, we discuss the utility of pre-resection vascular control of these tumors.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.02.004
       
  • Hearing loss in Meniere's disease
    • Authors: Hossein Ghazavi; Leila Asadpour
      First page: 367
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Hossein Ghazavi, Leila Asadpour


      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.025
       
  • Is histopathological diagnosis useful in choosing treatments for tumors of
           the temporal bone?
    • Authors: Jerzy Kuczkowski; Wojciech Brzoznowski; Jolanta Szade
      Pages: 367 - 368
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Jerzy Kuczkowski, Wojciech Brzoznowski, Jolanta Szade


      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.02.002
       
  • Corrigendum to “Combined medial canthopexy and lateral tarsal strip for
           floppy eyelid syndrome” [Am J Otolaryngol 37 (2016) 240–244]
    • Authors: Christopher J. Compton; Andrew T. Melson; Jeremy D. Clark; Taha Z. Shipchandler; William R. Nunery; H.B. Harold Lee
      First page: 370
      Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3
      Author(s): Christopher J. Compton, Andrew T. Melson, Jeremy D. Clark, Taha Z. Shipchandler, William R. Nunery, H.B. Harold Lee


      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.01.029
       
  • Comparison of the effects of esomeprazole plus mosapride citrate and
           botulinum toxin A on vocal process granuloma
    • Authors: Lei Lei; Hui Yang; Xinsheng Zhang; Jia Ren
      Abstract: Publication date: Available online 21 June 2017
      Source:American Journal of Otolaryngology
      Author(s): LeiLei Master, Hui Yang, Xingsheng Zhang, Jia Ren
      Objectives Vocal process granulomas have a high tendency for persistence despite many treatment alternatives. Anti-reflux medications or botulinum toxin A injections are the main current therapies. There are no studies that compare the effects on vocal process granuloma of proton pump inhibitors plus prokinetic agents with botulinum toxin A injections. Study design Prospective cohort study. Methods Adult patients reporting to our outpatient department complaining of trachyphonia and/or abnormal pharyngeal sensations who were found to have contact granulomas. Patients were divided into two groups according to the treatment: esomeprazole with mosapride citrate (n =26) or botulinum toxin A injection (n =20). The reflux symptom index and reflux finding score determined by electronic fibrolaryngoscopy were utilized to assess efficacy. Results Forty-six patients were recruited (43 male; 3 female). The mean age (range) was 48.3years (38–69) and the body mass index was 23.51kg/m2 (19.13–27.89). Laryngopharyngeal reflux disease diagnosed by RSI or RFS was found in 18 and 27 patients, respectively, and 18 diagnosed without laryngopharyneal reflux disease. Twenty patients (95%) were cured in the esomeprazole with mosapride citrate group and nine (45%) in the botulinum toxin A group. Eleven (55%) patients had recurrence after botulinum toxin A injection, with an average interval of 3.1months (range 1–6). The recorded symptoms after therapy resolved within 6months with a statistically significant improvement in the esomeprazole with mosapride citrate group. Conclusions Combined proton pump inhibitor plus prokinetic drug therapy plays a significant role in the treatment of vocal process granulomas or after surgery.

      PubDate: 2017-06-23T23:30:43Z
      DOI: 10.1016/j.amjoto.2017.01.039
       
  • Parathyroidectomy for tertiary hyperparathyroidism: A systematic review
    • Authors: Jessica A. Tang; Jacob Friedman; Michelle S. Hwang; Anna M. Salapatas; Lauren B. Bonzelaar; Michael Friedman
      Abstract: Publication date: Available online 21 June 2017
      Source:American Journal of Otolaryngology
      Author(s): Jessica A. Tang, Jacob Friedman, Michelle S. Hwang, Anna M. Salapatas, Lauren B. Bonzelaar, Michael Friedman
      Objective Analyze the efficacy and indications for parathyroidectomy as an intervention for tertiary hyperparathyroidism. Data sources PubMed, MEDLINE, and Cochrane Library databases. Review methods A systematic literature search was performed using the. Original research articles in English were retrieved using the search terms (“tertiary hyperparathyroidism” OR “3HPT”) AND “parathyroidectomy”. Articles were analyzed in regards to their surgical indications, operative endpoints, comparison between different surgical interventions, characterization of disease recurrence rates, and evaluation of alternative medical management. Results Thirty studies met the criteria for inclusion. Among the studies that report indications for parathyroidectomy, persistent hypercalcemia as well as clinical manifestations of hypercalcemia despite medical therapy predicted which patients would eventually need surgical intervention. The majority of studies comparing the extent of parathyroidectomy recommended a more focused approach to parathyroidectomy when warranted. All studies found that parathyroidectomy was an effective treatment for 3HPT. Three studies discussed alternative conservative approaches. Conclusion Interestingly, hyperparathyroidism alone is not an indication for surgery without other findings; rather, symptomatic hypercalcemia appears to be the main indication. Most studies recommend limited or subtotal parathyroidectomy for 3HPT. The operative endpoint of surgery is not necessarily a return of PTH to normal, but a >50% drop in PTH level even if PTH remains above normal. Additionally, “success” or “cure” is defined as normal calcium levels regardless of whether or not PTH is elevated. It appears the goal of surgery for 3HPT is not a normal PTH value, but a normal calcium level at least six months postoperatively.

      PubDate: 2017-06-23T23:30:43Z
      DOI: 10.1016/j.amjoto.2017.06.009
       
  • Utilization of sinus stents as a novel approach for benign cystic lesions
           of the sella
    • Authors: Akina Tamaki; Berje Shammassian; Abhishek Ray; Warren R. Selman; Kenneth Rodriguez
      Abstract: Publication date: Available online 21 June 2017
      Source:American Journal of Otolaryngology
      Author(s): Akina Tamaki, Berje Shammassian, Abhishek Ray, Warren R. Selman, Kenneth Rodriguez
      Steroid-releasing sinus stents have emerged as a safe and effective tool in endoscopic sinus surgery. In this case report, we present two patients with recurrent cystic sellar masses. Transsphenoidal approach was used to access the sella. Following resection and drainage of the cystic pathology, a Propel (Menlo Park, CA) stent was placed through the corridor of the resection site to stent the cavity open. This is the first report where a steroid-releasing sinus stent was used in the treatment of a sellar lesion. It supports that this technology is safe and effective for use in skull base surgery.

      PubDate: 2017-06-23T23:30:43Z
      DOI: 10.1016/j.amjoto.2017.06.008
       
  • Long-term outcomes of central neck dissection for cN0 papillary thyroid
           carcinoma
    • Authors: Davide Giordano; Andrea Frasoldati; Enrico Gabrielli; Carmine Pernice; Michele Zini; Andrea Castellucci; Simonetta Piana; Alessia Ciarrocchi; Silvio Cavuto; Verter Barbieri
      Abstract: Publication date: Available online 14 June 2017
      Source:American Journal of Otolaryngology
      Author(s): Davide Giordano, Andrea Frasoldati, Enrico Gabrielli, Carmine Pernice, Michele Zini, Andrea Castellucci, Simonetta Piana, Alessia Ciarrocchi, Silvio Cavuto, Verter Barbieri
      Objective. The risk-benefit ratio of central neck dissection (CND) in patients affected by papillary thyroid carcinoma (PTC) without clinical or ultrasonographic (US) evidence of neck lymph node metastasis (cN0) is currently debated. The aim of this study was to evaluate long-term outcome of CND on locoregional recurrence, distant metastasis, survival, and postoperative complications in a large series of patients with cN0-PTC. Study Design. Observational retrospective controlled study. Methods Clinical records of patients (n =610) surgically treated for cN0-PTC at the Otolaryngology Unit of the Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy, from January 1984 to December 2008, were retrospectively reviewed. Study population was divided into three groups according to surgical treatment: Group A, total thyroidectomy (n =205); Group B, total thyroidectomy and elective ipsilateral CND (n =281); Group C, total thyroidectomy and bilateral CND (n =124). Results Of a total of 610 patients, 305 (50%) were classified as low-risk, 278 (45.57%) as intermediate-risk, and 27 (4.43%) as high-risk. Response to initial therapy was excellent in 567 patients (92.95%), acceptable in 21 (3.44%), and incomplete in 22 (3.61%), with no significant differences among groups. Locoregional recurrence was detected in 32 (5.2%) out of 610 patients. Distant metastasis was found in 15 patients (2.5%). Statistical analysis showed no significant differences in the rates of locoregional recurrence (p =0.890) or distant metastasis (p =0.538) among groups. Disease-specific mortality and overall survival did not significantly differ among groups (p =0.248 and 0.223, respectively). Rate of permanent hypoparathyroidism was significantly higher in Group C patients compared to those in Groups A and B. Conclusion CND does not confer any clear advantage in the treatment of low-risk patients, regardless of surgical procedure. Instead, bilateral CND may be effective in limiting disease relapse and/or progression in patients at higher prognostic risk. Our data indicate that elective CND does not confer any clear advantage in terms of locoregional recurrence and long-term survival, as demonstrated by outcomes of the study Groups, regardless of their different prognostic risk. Elective CND allows a more accurate pathologic staging of central neck lymph nodes, despite its increasing the risk of permanent hypoparathyroidism. Intraoperative pathologic staging is a valuable tool to assess the risk of controlateral lymph node metastasis in the central neck compartment and to limit more aggressive surgery only to cases, otherwise understaged, with lymph node metastasis.

      PubDate: 2017-06-18T23:26:38Z
      DOI: 10.1016/j.amjoto.2017.06.004
       
  • The effects of fibroblast growth factor-2 delivered via a Gelfoam patch on
           the regeneration of myringosclerotic traumatic eardrum perforations lying
           close to the malleus
    • Authors: Zhong-hai Jin; Yi-Han Dong; Zi-Han Lou
      Abstract: Publication date: Available online 14 June 2017
      Source:American Journal of Otolaryngology
      Author(s): Zhong-hai Jin, Yi-Han Dong, Zi-Han Lou
      Objective We evaluated the effects of fibroblast growth factor-2 (FGF-2) delivered via a Gelfoam patch on the regeneration of myringosclerotic traumatic tympanic membrane perforations (TMPs) lying close to the malleus. Study design A prospective, randomized, controlled clinical study. Setting A university-affiliated teaching hospital. Subjects and methods We prospectively analyzed, in a randomized manner, the outcomes of treatment for traumatic TMPs constituting >25% of the tympanic membrane. The closure rates, closure times, and otorrhea rates were compared among patients treated via FGF-2-containing Gelfoam patches, Gelfoam patches alone, and observation only. Results We analyzed data from 138 patients. The perforation closure rates in the FGF-2 plus Gelfoam patch, Gelfoam patch, and observation alone groups were 97.9, 89.8, and 70.7%, respectively. Both the FGF-2 plus Gelfoam and Gelfoam alone groups exhibited significantly higher closure rates than the observational group (both p<0.05).The mean closure times were 15.7±5.1, 24.8±4.9, and 35.7±9.2days in the FGF-2 plus Gelfoam patch, Gelfoam patch alone, and observation alone groups, respectively. The FGF-2 plus Gelfoam patch group exhibited a significantly shorter closure time than the Gelfoam patch alone and observation alone groups (p<0.05). The incidences of purulent otorrhea were 14.6, 6.1, and 4.9% in the FGF-2 plus Gelfoam patch, Gelfoam patch alone, and observation alone groups, respectively. Surprisingly, 7 of 7 (100.0%) perforations associated with purulent otorrhea completely closed in the FGF-2 plus Gelfoam patch group; however, no such perforation healed in either the Gelfoam alone or observation alone group. Conclusions FGF-2 plus Gelfoam patching significantly shortened the closure time compared to observation and Gelfoam patching alone, and it significantly improved the closure rate (compared to observation alone) of myringosclerotic perforations lying close the malleus. FGF-2 plus Gelfoam patching is a valuable, minimally invasive alternative treatment that may be readily applied to outpatient settings.

      PubDate: 2017-06-18T23:26:38Z
      DOI: 10.1016/j.amjoto.2017.06.005
       
  • Analysis of archived newborn dried blood spots (DBS) identifies congenital
           cytomegalovirus as a major cause of unexplained pediatric sensorineural
           hearing loss
    • Authors: Lucy Meyer; Bazak Sharon; Tina C. Huang; Abby C. Meyer; Kristin E. Gravel; Lisa A. Schimmenti; Elizabeth C. Swanson; Hannah E. Herd; Nelmary Hernandez-Alvarado; Kirsten R. Coverstone; Mark McCann; Mark R. Schleiss
      Abstract: Publication date: Available online 7 June 2017
      Source:American Journal of Otolaryngology
      Author(s): Lucy Meyer, Bazak Sharon, Tina C. Huang, Abby C. Meyer, Kristin E. Gravel, Lisa A. Schimmenti, Elizabeth C. Swanson, Hannah E. Herd, Nelmary Hernandez-Alvarado, Kirsten R. Coverstone, Mark McCann, Mark R. Schleiss
      Purpose Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL). However, accurate diagnosis of cCMV as the etiology of SNHL is problematic beyond the neonatal period. This study therefore examined whether cCMV infection could be identified retrospectively in children presenting with unexplained SNHL to a multidisciplinary diagnostic outpatient otolaryngology clinic at an academic medical center in Minnesota. Methods Over a 4-year period, 57 patients age 3months to 10years of age with unexplained SNHL were recruited to participate in this study. Informed consent was obtained to test the archived dried blood spots (DBS) of these patients for cCMV infection by real-time PCR, targeting a highly conserved region of the CMV UL83 gene. Results were normalized to recovery of an NRAS gene control. Chart review was conducted to identify subjects who underwent genetic testing and/or neurodiagnostic imaging to investigate possible genetic, syndromic, or anatomical causes of SNHL. Results In total, 15 of the 57 children with unexplained SNHL tested positive for CMV DNA in their DBS (26%). A mean viral load of 8.3×104 (±4.1×104) [range, 1×103–6×105] copies/μg DNA was observed in subjects retrospectively diagnosed with cCMV. No statistically significant correlation was found between viral load and SNHL severity. Conclusions A retrospective DBS analysis demonstrated 26% of patients presenting with unexplained SNHL in childhood had cCMV. DBS testing is useful in the retrospective diagnosis of cCMV, and may provide definitive diagnostic information about the etiology of SNHL.

      PubDate: 2017-06-08T23:19:07Z
      DOI: 10.1016/j.amjoto.2017.06.002
       
  • Various combinations of velopharyngeal and hypopharyngeal surgical
           procedures for treatment of obstructive sleep apnea: Single-stage,
           multilevel surgery
    • Authors: Murat Binar; Omer Karakoc; Timur Akcam; Burak Asik; Mustafa Gerek
      Abstract: Publication date: Available online 6 June 2017
      Source:American Journal of Otolaryngology
      Author(s): Murat Binar, Omer Karakoc, Timur Akcam, Burak Asik, Mustafa Gerek
      Objective The aim of this study was to investigate the safety and outcomes of velopharyngeal surgeries combined with hypopharyngeal surgeries as single-stage interventions for treatment of obstructive sleep apnea (OSA). Methods Retrospective analysis of operated patients. The velopharyngeal surgical interventions were uvulopalatal flap, anterior palatoplasty, expansion sphincter pharyngoplasty, transpalatal advancement pharyngoplasty, Cahali lateral pharyngoplasty, Z-palatoplasty, and modified uvulopalatopharyngoplasty. The hypopharyngeal surgical interventions were tongue base suspension, mucosal sparing partial glossectomy, genioglossus advancement, mandibulohyoid suspension, thyrohyoid suspension, and epiglottoplasty. Results Forty-one patients were enrolled after inclusion and exclusion criteria. The evaluation of symptoms and polysomnographic findings were performed preoperatively and at a minimum of 3months postoperatively. The mean age was 42.17±9.50years and the mean follow-up time was 6.8±6.0months. After single-stage multilevel surgery, the mean apnea hypopnea index (AHI) improved from 29.13±15.87events/h to 14.28±16.14events/h (p<0.001). According to the classical definition of success criteria (>50% reduction in AHI and postoperative AHI<20events/h), the surgical success rate was 56%, with cure of OSA (AHI<5events/h) in 41% of study population. The combined surgeries also improved Epworth scores, snoring scores, and respiratory parameters significantly (in all p<0.05). The major complications were bleeding requiring re-admission in surgery room and severe tongue base edema which regressed by steroid administration. The minor complications were pain, difficulty in swallowing, velopharyngeal insufficiency, regurgitation, minor bleeding, and occlusion disorder. The mean postoperative period to beginning of normal feeding was 1.81±1.01days. The percentage of pain, the number of patients with major bleeding, and the need for patient-controlled analgesia were higher in patients undergoing tissue resection/ablative hypopharyngeal procedures. The mean postoperative period to beginning of normal feeding was shorter in patients undergoing suture/repositioning hypopharyngeal procedures. Conclusion According to outcomes of this study, OSA patients with multilevel obstructions can benefit from combined surgeries for velopharyngeal and hypopharyngeal regions at the same operation stage, without experiencing persistent complaints. It is promising that, despite multiple levels of obstruction was operated at single-stage, airway safety was preserved in all patients.

      PubDate: 2017-06-08T23:19:07Z
      DOI: 10.1016/j.amjoto.2017.06.003
       
  • Malignant external otitis: The shifting treatment paradigm
    • Authors: Daniel A. Carlton; Enrique E. Perez; Eric E. Smouha
      Abstract: Publication date: Available online 25 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Daniel A. Carlton, Enrique E. Perez, Eric E. Smouha
      Importance Malignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat. Objective Determine if there has been a shift in the microbiology and outcomes of MEO. Design A retrospective case series at a tertiary care institution. Setting Inpatient and outpatient tertiary care hospital. Participants 12 cases of recent MEO were reviewed. Main Outcomes and measures The primary outcome was progression of disease. Secondary outcomes were drug resistance and complications of MEO. Results Only 4 patients were cured of MEO. Four patients expired during the study period and at least one of these deaths was a direct result of the MEO. 7 patients developed Cranial nerve palsies, and 3 patients developed abscesses. Conclusions Select cases of MEO now require multi-drug and long-term parenteral antibiotic therapy with extended hospital stays.

      PubDate: 2017-05-29T23:11:55Z
      DOI: 10.1016/j.amjoto.2017.05.010
       
  • Prognostic value of lymph node density in buccal squamous cell carcinoma
    • Authors: Tam-Lin Chow; Wilson W.Y. Kwan; Siu-Chung Fung; Lai-In Ho
      Abstract: Publication date: Available online 20 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Tam-Lin Chow, Wilson W.Y. Kwan, Siu-Chung Fung, Lai-In Ho
      Purpose Lymph node density(LND) has been shown to be a better prognosticator than conventional nodal classification to predict prognosis for squamous cell carcinoma(SCC) of the oral cavity. However, studies focusing on subsites of oral cancer are meager. The role of LND for buccal SCC was evaluated in this study. Methods A total of 39 patients with buccal SCC primarily treated surgically with neck dissection were identified. LND was defined as the number of positive nodes over the number of nodal yield. The cut-off of LND was ≤0.07 or >0.07. Patient demographic data and clincopathologic parameters were described. Survival was expressed by Kaplan-Meier method and correlation with survival is analyzed with log-rank test. IBM SPSS Statistics version 22 was used for data computation. Results The median follow-up was 79.0months and median nodes removed was 23 (range 8–93). Positive nodal involvement was found in 19(48.7%) patients. The 5-year and 10-year OS were 67.4% and 42.5% whilst for DSS were 69.2% and 65.5%, respectively. When pT-, pN-, LND-classification and AJCC stage were analyzed for the whole series, only pN- (p =0.006) and LND-classification (p =0.002) were significant factors for OS, while pT-, pN-, LND-classification and AJCC stage were all significant factors for DSS. When only cases with positive nodal spread were considered, the pN-classification (pN1 vs pN2) was not a significant risk factor for either OS (p =0.075, HR 3.10(CI 0.89–10.76)) and DSS (p =0.074, HR 3.58(CI 0.88–14.56)). By contrast, LND-classification (≤0.07 vs >0.07) remained a significant predictor for OS (p =0.03, HR 3.95(CI 1.15–13.63)), but not for the DSS (p =0.112, HR 2.92(CI 0.78–10.99)). Conclusion The prognostic value of LND on buccal SCC is supported in this study. The results also suggest that LND is better than the conventional pN-classification to predict OS. Further studies on LND with big sample size for buccal SCC or other subsites of OSCC are worthwhile.

      PubDate: 2017-05-24T23:07:55Z
      DOI: 10.1016/j.amjoto.2017.05.001
       
  • Cochlear implantation in patients with otosclerosis of the otic capsule
    • Authors: Jay Burmeister; Susan Rathgeb; Jacques Herzog
      Abstract: Publication date: Available online 19 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Jay Burmeister, Susan Rathgeb, Jacques Herzog
      Objective To evaluate outcomes of cochlear implantation of patients with otosclerosis of the otic capsule. Study design A retrospective case series of 6 patients (7 ears). Patients 6 patients (7 ears), 5 patients with severe to profound sensorineural hearing loss; 1 patient with mild to profound sensorineural hearing loss, with radiologic evidence of otosclerosis. All patients were adult males, with or without history of stapes surgery. Intervention Cochlear implantation of 7 ears. 5 patients with severe to profound sensorineural hearing loss received the Nucleus Contour Advance peri-modiolar electrode array with binaural implantation performed in one patient. One patient with mild to profound sensorineural hearing loss received a Cochlear® Nucleus Hybrid L24 device. Methods Preoperative temporal bone CT, audiometric and speech perception testing scores were reviewed, confirming presence of otosclerosis of the cochlea as well as cochlear implant candidacy. Speech perception testing included CNC words, HINT sentences and AZ Bio scores to measure hearing outcomes post implantation. Results All recipients of the contour advance device had a significant improvement in hearing at both 3 and 6month follow up. The hybrid device recipient experienced loss of residual hearing in the implanted ear without improvement at 3months and mild improvement at 6months. Conclusion Cochlear implantation has proven to be effective in the treatment of patients with sensorineural hearing loss, including those with otosclerosis of the cochlea. Hybrid candidacy in the setting of otosclerosis of the cochlea may require consideration of alternative electrode devices, most likely a peri-modiolar device.

      PubDate: 2017-05-19T23:03:09Z
      DOI: 10.1016/j.amjoto.2017.05.011
       
  • Guidelines for Contributing Authors
    • Abstract: Publication date: May–June 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 3


      PubDate: 2017-05-19T23:03:09Z
       
  • Utility of a multidisciplinary approach to pediatric hearing loss
    • Authors: Karen Hawley; Donald Goldberg; Samantha Anne
      Abstract: Publication date: Available online 12 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Karen Hawley, Donald Goldberg, Samantha Anne
      Introduction Because management of hearing loss (HL) often requires multiple specialists, a multidisciplinary clinic, Pediatric Hearing Management Clinic, (PHMC) was established to coordinate care for children with newly diagnosed HL. Methods Retrospective review of patients seen in PHMC from February 2009 to April 2010. Results Clinic information was available for 40/41 of the patients and was included in the study. 37/41 had confirmed HL. HL was categorized into bilateral/symmetric [15], bilateral/asymmetric [12] and unilateral [10]. Sixteen patients subsequently received hearing amplification after PHMC visit. Follow up was successfully established with otolaryngology in 23/32 (72%) patients, audiology in 29/40 (73%) patients, speech pathology in 11/12 (92%) patients, and ophthalmology in 15/30 (50%) patients. Twenty-nine patients completed evaluations of PHMC. The mean score in six total categories was 3.8/4.0 (4.0 as the highest satisfaction). Conclusion A multidisciplinary clinic approach provides a convenient and effective way to coordinate care for children with HL.

      PubDate: 2017-05-14T22:58:38Z
      DOI: 10.1016/j.amjoto.2017.05.008
       
  • Fungal granulomatous disease of the nasal cavity: A case report of a rare
           entity
    • Authors: Samuel N. Helman; Peter Filip; Ameet Kamat
      Abstract: Publication date: Available online 8 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Samuel N. Helman, Peter Filip, Ameet Kamat


      PubDate: 2017-05-09T22:54:28Z
      DOI: 10.1016/j.amjoto.2017.05.005
       
  • Decreased clinic visits for acute respiratory infections following an
           adult tonsillectomy: A population-based study
    • Authors: Shiu-Dong Chung; Shih-Han Hung; Herng-Ching Lin; Kuan-Chen Chen
      Abstract: Publication date: Available online 5 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Shiu-Dong Chung, Shih-Han Hung, Herng-Ching Lin, Kuan-Chen Chen
      Purpose This study attempted to investigate the effects of a tonsillectomy on utilization of medical resources for acute respiratory infections by comparing numbers and costs of clinic visits within 1year before and after a tonsillectomy. Materials and methods Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. The study includes 481 patients aged 18–80years who underwent a tonsillectomy and 481 comparison patients. A multivariate regression model employing difference-in-difference was carried out to assess the independent association between a tonsillectomy and the number and costs of clinic visits. Results We found that for patients who underwent a tonsillectomy, the mean number of clinic visits for acute respiratory care 1year before and after the index date significantly decreased from 7.3 to 4.2 (p <0.001). However, for the comparison group, there was no significant difference in the number (p =0.540) or costs (p =0.221) of clinic visits for acute respiratory care 1year before and after the index date. A multivariate regression model revealed that a tonsillectomy was associated with a reduction of 3.38 in the mean number of clinic visits for acute respiratory care (p <0.001). In other words, a tonsillectomy reduced by 46.3% (3.38/7.3) the number of clinic visits for acute respiratory care after adjusting for sociodemographic characteristics and medical comorbidities compared to comparison patients. Conclusions This study demonstrated that a tonsillectomy was of substantial benefit to adult patients in that it provides decreased healthcare utilization for acute respiratory infections.

      PubDate: 2017-05-09T22:54:28Z
      DOI: 10.1016/j.amjoto.2017.05.004
       
  • A sustained increase of plasma fibrinogen in sudden sensorineural hearing
           loss predicts worse outcome independently
    • Authors: Yoon Ah. Park; Tae Hoon Kong; Young Joon Seo
      Abstract: Publication date: Available online 5 May 2017
      Source:American Journal of Otolaryngology
      Author(s): Yoon Ah. Park, Tae Hoon Kong, Young Joon Seo
      Objectives A number of etiologies of idiopathic sudden sensorineural hearing loss (
      ISSN HL) have been proposed. Vascular disturbance is one cause of
      ISSN HL and has been reported to be associated with fibrinogen. We aimed to determine whether hyperfibrinogenemia is associated with poor outcome and whether a serial change in fibrinogen level is associated with outcome. Methods Twenty-two patients with
      ISSN HL were enrolled. We compared the levels of fibrinogen in
      ISSN HL groups classified as improved and non-improved according to improvement of hearing. Blood samples were also collected from patients who visited the emergency room with coronary heart disease (CHD) as the control group. Results Initial fibrinogen level was significantly different between the non-improved and improved
      ISSN HL group (350.63±87.20 vs. 310.71±81.06. The improved
      ISSN HL group showed a “surge phenomenon”, in which fibrinogen started to decrease at day 5 and increased at day 26. In the non-improved group, fibrinogen remained elevated throughout the course of therapy. Conclusion It is important to measure not only the initial fibrinogen level but also to monitor its change throughout the course of therapy in order to predict the outcome of
      ISSN HL.

      PubDate: 2017-05-09T22:54:28Z
      DOI: 10.1016/j.amjoto.2017.05.002
       
  • Corrigendum to “malignant transformation of keratocystic odontogenic
           tumor: Two case reports” [American journal of otolaryngology 34 (2013)
           357–361]
    • Authors: Bernard Tan; Sok Yan Tay; Lee Shermin; Kwa Chong Teck; Poon Choy Yoke; Christopher Goh; Abhilash Balakrishnan
      Abstract: Publication date: Available online 21 March 2017
      Source:American Journal of Otolaryngology
      Author(s): Bernard Tan, Sok Yan Tay, Lee Shermin, Kwa Chong Teck, Poon Choy Yoke, Christopher Goh, Abhilash Balakrishnan


      PubDate: 2017-03-23T19:02:29Z
      DOI: 10.1016/j.amjoto.2017.03.002
       
 
 
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