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Publisher: Elsevier   (Total: 3049 journals)

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Showing 1 - 200 of 3089 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 7)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 25, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 86, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, 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: 363, 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   (Followers: 1)
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: 229, 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: 10, 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: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 24, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
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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: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
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: 6)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 133, 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: 17, 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: 26, 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)
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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)
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Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
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: 27, 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: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, 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 Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 7)
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: 45, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 26, 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: 43, 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: 51, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
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: 11)
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: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
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: 36, 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: 6)
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: 6, 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: 8, 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 Organ Biology     Full-text available via subscription   (Followers: 2)
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: 24, 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: 8, 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: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
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 Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 361, 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: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
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: 44, 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: 331, 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: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 417, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 40, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 55, 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: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
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   (Followers: 1)
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: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, 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: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 48, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 40, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, 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: 46, 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: 199, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 59, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
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: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 25, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 35, 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: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 58, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 12)
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: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, 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: 12)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  

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Journal Cover American Journal of Otolaryngology
  [SJR: 0.59]   [H-I: 45]   [25 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0196-0709
   Published by Elsevier Homepage  [3049 journals]
  • Comparison of radiation doses imparted during 128-, 256-, 384-multislice
           CT-scanners and cone beam computed tomography for intra- and perioperative
           cochlear implant assessment
    • Authors: N. Guberina; U. Dietrich; D. Arweiler-Harbeck; M. Forsting; A. Ringelstein
      Pages: 649 - 653
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): N. Guberina, U. Dietrich, D. Arweiler-Harbeck, M. Forsting, A. Ringelstein
      Purpose To examine radiation-doses imparted during multislice (MSCT) and cone-beam computed-tomography (CBCT) for perioperative examination of cochlear-implant insertion. Methods Radiation-doses were assessed during standardized petrous-bone CT-protocols at different MSCT ((I) single-source CT-scanner Somatom-Definition-AS+, (II) 2nd generation of dual-source CT-scanner Somatom-Definition-Flash, (III) 3rd generation of dual-source CT-scanner Somatom-Force and at the CBCT Ziehm-Vision-RFD3D ((IV) (a) RFD-3D (Standard-modifier), (b) RFD-3D (Low-dose-modifier)). Image quality was examined by two radiologists appraising electrode-array placement, quality-control of cochlear-implant surgery and complications based on real patients' examinations (n=78). Results In MSCT-setting following radiation-doses were assessed (CTDIw; DLP): (I) 21.5mGy; 216mGycm; (II) 19.7mGy; 195mGycm; (III) 12.7mGy; 127mGycm; in the CBCT setting radiation doses were distributed as follows: (IV) (a) 1.9mGy; 19.4mGycm; (b) 1.2mGy; 12.9mGycm. Overall, image quality was evaluated as good for both, MSCT- and CBCT-examinations, with a good interrater reliability (r=0.81). Conclusion CBCT bears considerable dose-saving potential for the perioperative examination of cochlear-implant insertion while maintaining adequate image quality.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.09.005
       
  • Marital status as a predictor of survival in patients with human papilloma
           virus-positive oropharyngeal cancer
    • Authors: Samuel J. Rubin; Diana N. Kirke; Waleed H. Ezzat; Minh T. Truong; Andrew R. Salama; Scharukh Jalisi
      Pages: 654 - 659
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Samuel J. Rubin, Diana N. Kirke, Waleed H. Ezzat, Minh T. Truong, Andrew R. Salama, Scharukh Jalisi
      Purpose Determine whether marital status is a significant predictor of survival in human papillomavirus-positive oropharyngeal cancer. Materials and methods A single center retrospective study included patients diagnosed with human papilloma virus-positive oropharyngeal cancer at Boston Medical Center between January 1, 2010 and December 30, 2015, and initiated treatment with curative intent at Boston Medical Center. Demographic data and tumor-related variables were recorded. Univariate analysis was performed using a two-sample t-test, chi-squared test, Fisher's exact test, and Kaplan Meier curves with a log rank test. Multivariate survival analysis was performed using a Cox regression model. Results A total of 65 patients were included in the study with 24 patients described as married and 41 patients described as single. There was no significant difference in most demographic variables or tumor related variables between the two study groups, except single patients were significantly more likely to have government insurance (p =0.0431). Furthermore, there was no significant difference in 3-year overall survival between married patients and single patients (married=91.67% vs single=87.80%; p =0.6532) or 3-year progression free survival (married=79.17% vs single=85.37%; p =0.8136). After adjusting for confounders including age, sex, race, insurance type, smoking status, treatment, and AJCC combined pathologic stage, marital status was not a significant predictor of survival [HR=0.903; 95% CI (0.126,6.489); p =0.9192]. Conclusions Although previous literature has demonstrated that married patients with head and neck cancer have a survival benefit compared to single patients with head and neck cancer, we were unable to demonstrate the same survival benefit in a cohort of patients with human papilloma virus-positive oropharyngeal cancer.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.09.003
       
  • Adjuvant radiation and survival following surgical resection of sinonasal
           melanoma
    • Authors: Gaurav S. Ajmani; Erik Liederbach; Alex Kyrillos; Chi-Hsiung Wang; Jayant M. Pinto; Mihir K. Bhayani
      Pages: 663 - 667
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Gaurav S. Ajmani, Erik Liederbach, Alex Kyrillos, Chi-Hsiung Wang, Jayant M. Pinto, Mihir K. Bhayani
      Background Surgery remains the mainstay of treatment for sinonasal melanoma, but it is often difficult to obtain clear, negative margins. Therefore, patients often receive adjuvant radiation therapy (RT), however its impact on overall survival (OS) is not well understood. Methods Patients with surgically resected sinonasal melanoma were identified from the National Cancer Data Base (NCDB, n =696). Kaplan-Meier curves and parametric survival regression were used to analyze the impact of adjuvant RT on OS from surgery. Adjusted time ratios (aTRs) were computed, with values >1 corresponding to improved survival. Results 399 (57.3%) patients received adjuvant RT. Those receiving RT tended to be younger but with more advanced disease and greater likelihood of positive margins, compared to those receiving no adjuvant therapy. Median survival was 25.0months for those treated with surgery alone, compared to 28.3months for those receiving adjuvant RT (log-rank P =0.408). When adjusting for potential confounders, there was a trend towards greater survival with adjuvant RT (aTR 1.16, 95%CI 0.98–1.37). RT appeared beneficial in those with stage IVB disease (aTR 2.58, 95%CI 1.40–4.75) but not stage IVA (aTR 1.19, 95%CI 0.88–1.61) or III (aTR 0.85, 95%CI 0.65–1.13) disease. In contrast, there were no differences in impact of RT according to margin status (aTR 1.16 for both positive and negative margins). Conclusions Adjuvant therapy does not appear to provide a significant survival benefit in resected sinonasal melanomas regardless of margin status, except those with stage IVB disease. Practitioners should carefully consider the added benefit of adjuvant therapy in these patients.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.010
       
  • Effects of surgical treatment of hypertrophic turbinates on the nasal
           obstruction and the quality of life
    • Authors: Katharina Stölzel; Marie Bandelier; Agnieszka J. Szczepek; Heidi Olze; Steffen Dommerich
      Pages: 668 - 672
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Katharina Stölzel, Marie Bandelier, Agnieszka J. Szczepek, Heidi Olze, Steffen Dommerich
      Purpose Chronic hyperplasia of the inferior nasal concha is accompanied by a nasal obstruction; however, there is no standardised surgical treatment for this condition. Here, we compared the outcome of three surgical techniques frequently used to treat the hyperplasia of inferior turbinates: turbinectomy with lateralization, submucosal electrocautery and laser cautery additional to septoplasty. Materials and methods One hundred and nine patients participated in this prospective randomized study upon signing written consent. The subjects were randomly assigned to one of three intervention groups: 1) submucosal turbinectomy with lateralization, 2) submucosal electrocautery or 3) laser cautery. All groups were followed-up for up to 6months after surgical intervention. During the four follow-up appointments, the outcomes were measured with the modified German version of Sino-Nasal Outcome Test 20 questionnaire. In addition, the nasal breathing and the absolute nasal flow rates and respective mucosal component were determined by the anterior rhinomanometry. Results Following surgery, the subjective and objective nasal obstruction decreased significantly in all three groups. Moreover, the subjective symptoms measured by modified Sino-Nasal Outcome Test 20 improved significantly, although there were some temporal differences between groups regarding subjective nasal obstruction, ear pressure, nasal discomfort, daytime fatigue, cough and dry mouth. The mucosal component of nasal congestion decreased significantly after surgery. Conclusions All surgical techniques used to reduce the conchae mucosa led to a significant improvement in the objective and subjective nasal breathing and the quality of life. Septoplastic reduction proved to be of additional benefit.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.009
       
  • Survival trends in patients with tracheal carcinoma from 1973 to 2011
    • Authors: Surbhi Agrawal; Christopher Jackson; Karel-Bart Celie; Chetan Dodhia; Daphne Monie; Jose Monzon; Theodor Kaufman; Nicholas J. Hellenthal
      Pages: 673 - 677
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Surbhi Agrawal, Christopher Jackson, Karel-Bart Celie, Chetan Dodhia, Daphne Monie, Jose Monzon, Theodor Kaufman, Nicholas J. Hellenthal
      Purpose The prognosis for primary tracheal cancer is dismal. We investigated whether there has been improvement in survival in tracheal cancer patients and how treatment modality affected overall and cancer-specific survival. Materials and methods Using the Surveillance, Epidemiology, and End Results database, 1144 patients with tracheal cancer were identified between 1973 and 2011. Patients were stratified by age group, gender, race, tumor histology, and treatment modality. Radical surgery and survival rates based upon these stratifications were determined. Longitudinal analyses of survival and the percentage of patients undergoing surgery and radiation were conducted. Results In the final cohort, 327 tracheal cancer patients (34%) underwent radical surgery. Patients of younger age, female gender, and who presented with non-squamous cell tumors were statistically more likely to undergo surgery. Over time, utilization of radiation has declined while use of radical surgery has increased. Concomitantly, 5-year survival has increased from approximately 25% in 1973 to 30% by 2006. Those who did not have surgery were 2.50 times more likely to die of tracheal cancer (95% Confidence Interval 2.00–3.11, p<0.001) than those who did have surgery. Additionally, patients who underwent radical surgery alone (without adjuvant radiation therapy) were 50% or 19% less likely to die of tracheal cancer than those who underwent no treatment or combination therapy, respectively (both p<0.001). Conclusions Survival in patients with tracheal cancer is improving over time. The utilization of radical surgery is increasing and confers the highest survival advantage to patients who are candidates.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.005
       
  • Conchal contractility after inferior turbinate hypertrophy treatment:A
           prospective, randomized clinical trial
    • Authors: Remzi Dogan; Erol Senturk; Orhan Ozturan; Yavuz Selim Yildirim; Selahattin Tugrul; Aysenur Meric Hafiz
      Pages: 678 - 682
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Remzi Dogan, Erol Senturk, Orhan Ozturan, Yavuz Selim Yildirim, Selahattin Tugrul, Aysenur Meric Hafiz
      Objective The aim of this study is to evaluate the effects of these two methods (Nasal corticosteroids (NCS) and radiofrequency (RF) application) on conchal contractility utilizing objective rhinologic measurement parameters. Methods 82 patients were presented with the complaint of nasal obstruction and diagnosed with inferior turbinate hypertrophy and were included in the study. Patients in Group 1 received NCS for 12weeks. Patients in Group 2 were administered RF to their inferior turbinates. Acoustic rhinometry and rhinomanometry tests with and without decongestant were performed. Results In the evaluation of the contractility difference of rhinometry parameters, there was not a significant difference among pre and postoperative acoustic rhinometric parameters in Group 1. Whereas in Group 2, postoperative contractility difference was significantly decreased compared to preoperative values. In the evaluation of the contractility difference of rhinomanometric parameters, no significant difference was found between pre and postoperative values in Group 1. However, postoperative contractility difference was significantly decreased compared to preoperative values in Group 2 in terms. Conclusion Because the RF procedure produces fibrosis in the vascular tissues, inferior turbinates do not have a shrinking response to decongestant administration. Administration of NCS administration maintains the contractility function compared to RF application.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.002
       
  • Randomized double blind trial of amitriptyline versus placebo in treatment
           of chronic laryngopharyngeal neuropathy
    • Authors: Minyoung Jang; Samuel J. Rubin; Daniel J. Stein; Jacob Pieter Noordzij
      Pages: 683 - 687
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Minyoung Jang, Samuel J. Rubin, Daniel J. Stein, Jacob Pieter Noordzij
      Objective A neuropathic etiology has been suggested for patients with chronic laryngopharyngitis symptoms without visible structural pathology. Prior studies have shown that treatment with neuro-modulating medications is beneficial, but it is unknown if this was due to placebo effect. Our objective was to compare the efficacy of amitriptyline versus placebo in treating chronic laryngopharyngeal neuropathy. Study design Prospective, randomized placebo-controlled trial. Methods Patients were randomized to receive placebo or amitriptyline for 8weeks. Primary outcome was change in modified Reflux Symptom Index (mRSI) score. Secondary outcomes were change in Voice Handicap Index-10 (VHI) scores, rates of adverse effects, and overall symptom severity. Results Eighteen patients completed the study. The average difference in mRSI and VHI-10 scores after treatment were not significantly different between study arms. However, more subjects taking amitriptyline felt their symptoms had subjectively improved (6 out of 9, 67%), while the remainder noted no change. In the placebo group, only 4 out of 9 subjects (44%) felt their symptoms were better and 2 felt worse. Subjects took an average of 25mg of amitriptyline or placebo daily by the end of the 8-week treatment period. No serious adverse effects were noted. Conclusion Although there was a trend toward greater subjective improvement in overall symptoms with amitriptyline, interpretation is limited due to the small sample size. Larger randomized controlled trials to determine the efficacy of neuro-modulating agents in the treatment of chronic laryngopharyngeal neuropathy, as well as better metrics to characterize this disorder, are warranted.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.07.006
       
  • Surgical management of temporal bone osteoradionecrosis: Single surgeon
           experience of 47 cases
    • Authors: Sameep Kadakia; Arvind Badhey; Jared Inman; Moustafa Mourad; Yadranko Ducic
      Pages: 688 - 691
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Sameep Kadakia, Arvind Badhey, Jared Inman, Moustafa Mourad, Yadranko Ducic
      Purpose To report the outcomes of 47 patients with temporal bone osteoradionecrosis treated primarily with surgical resection in order to analyze whether flap type and hyperbaric oxygen use affect wound breakdown. Materials and methods Between January 1998 and January 2016, 47 patients were treated for temporal bone osteoradionecrosis with surgery. Some patients were also treated with hyperbaric oxygen. Resection of grossly necrotic temporal bone was followed by immediate reconstruction with local, regional, or free flaps. Minimum follow-up was 6months. If patients had breakdown of their initial reconstructions, secondary reconstruction was performed with either a regional or free flap. During the post-operative period, wound breakdown, flap complications, and patient survival were noted. Results 30 patients developed ORN from primary radiotherapy while 17 had post-operative radiation. It was found that wound breakdown was significantly associated with type of flap reconstruction (p=0.02) with local flap reconstruction portending a poorer prognosis. Hyperbaric oxygen was not associated with decreased wound breakdown (p=0.5). Conclusions Surgical treatment can be an effective treatment for temporal bone osteoradionecrosis, without hyperbaric oxygen providing any additional benefit. Reconstruction with regional or free flaps may be a more reliable method to resurface defects compared to local flaps.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.07.005
       
  • Hearing loss in enlarged vestibular aqueduct and incomplete partition type
           II
    • Authors: Emily Ahadizadeh; Mustafa Ascha; Nauman Manzoor; Amit Gupta; Maroun Semaan; Cliff Megerian; Todd Otteson
      Pages: 692 - 697
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Emily Ahadizadeh, Mustafa Ascha, Nauman Manzoor, Amit Gupta, Maroun Semaan, Cliff Megerian, Todd Otteson
      Purpose The purpose of this work is to identify the role of incomplete partition type II on hearing loss among patients with enlarged vestibular aqueduct (EVA). Background EVA is a common congenital inner ear malformation among children with hearing loss, where vestibular aqueduct morphology in this population has been shown to correlate to hearing loss. However, the impact of incomplete partition between cochlear turns on hearing loss has not been, despite meaningful implications for EVA pathophysiology. Methods A retrospective review of radiology reports for patients who had computed tomography (CT) scans with diagnoses of hearing loss at a tertiary medical center between January 2000 and June 2016 were screened for EVA. CT scans of the internal auditory canal (IAC) for those patients with EVA were examined for evidence of incomplete partition type II (IP-II), measurements of midpoint width and operculum width a second time, and patients meeting Cincinnati criteria for EVA selected for analysis. Statistical analysis including chi-square, Wilcoxon rank-sum, and t-tests were used to identify differences in outcomes and clinical predictors, as appropriate for the distribution of the data. Linear mixed models of hearing test results for all available tests were constructed, both univariable and adjusting for vestibular aqueduct morphometric features, with ear-specific intercepts and slopes over time. Results There were no statistically significant differences in any hearing test results or vestibular aqueduct midpoint and operculum widths. Linear mixed models, both univariable and those adjusting for midpoint and operculum widths, did not indicate a statistically significant effect of incomplete partition type II on hearing test results. Conclusions Hearing loss due to enlarged vestibular aqueduct does not appear to be affected by the presence of incomplete partition type II. Our results suggest that the pathophysiological processes underlying hearing loss in enlarged vestibular aqueduct may not be a result of cochlear malformation, and instead are more likely to involve vestibular aqueduct or cellular and molecular-level mechanisms of hearing loss.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.06.010
       
  • Temporal bone computed tomography findings associated with feasibility of
           endoscopic ear surgery
    • Authors: Dunia Abdul-Aziz; Elliott D. Kozin; Brian M. Lin; Kevin Wong; Parth V. Shah; Aaron K. Remenschneider; Lukas D. Landegger; Amy F. Juliano; Michael S. Cohen; Daniel J. Lee
      Pages: 698 - 703
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Dunia Abdul-Aziz, Elliott D. Kozin, Brian M. Lin, Kevin Wong, Parth V. Shah, Aaron K. Remenschneider, Lukas D. Landegger, Amy F. Juliano, Michael S. Cohen, Daniel J. Lee
      Purpose There are no formal radiologic criteria to stratify patients for transcanal (TEES) or transmastoid endoscopic ear surgery for resection of cholesteatoma. We aim to determine 1) whether standard preoperative computed tomography (CT) findings are associated with the need for conversion to a transmastoid approach and 2) the amount of time added for conversion from TEES to transmastoid techniques. Materials and methods Retrospective chart review of consecutive pediatric and adult cases of TEES for primary cholesteatoma from 2013 through 2015 (n=52). TEES cases were defined as endoscope-only procedures that did not require a transmastoid approach (n=33). Conversion cases were defined as procedures that began as TEES however, required conversion to a transmastoid approach due to the inability to complete cholesteatoma removal (n=19). Preoperative CT findings and total operating room (OR) times of TEES and conversion cases were compared. Results Preoperative CT scan characteristics that were associated with conversion included tegmen erosion (p=0.026), malleus erosion (p<0.001), incus erosion (p=0.009), mastoid opacification (p=0.009), soft tissue opacification extending into the aditus ad antrum (p=0.009) and into antrum (p=0.006). Total OR time for TEES cases was significantly shorter than conversion cases (median 143min versus 217min, p<0.001). Conclusions Preoperative CT findings, notably extension of soft tissue in the aditus ad antrum, antrum and mastoid, are associated with need for conversion to transmastoid technique to achieve removal of cholesteatoma. Endoscope-only cases were significantly faster than cases that required conversion to a transmastoid approach.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.06.007
       
  • Innovative application of intraoperative laser-assisted fluorescence
           angiography in resection of an angiosarcoma of the scalp
    • Authors: Clara M. Olcott; Daniel W. Karakla
      Pages: 710 - 712
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Clara M. Olcott, Daniel W. Karakla


      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.006
       
  • Transtympanic pseudoaneurysm of the internal carotid artery complicating a
           myringotomy in a four-year old child: Case report and literature review
    • Authors: Damien Bonnard; Erwan de Monès; Thomas Sagardoy; Valérie Franco-Vidal; Vincent Darrouzet; Sylvestre Fierens
      Pages: 713 - 717
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Damien Bonnard, Erwan de Monès, Thomas Sagardoy, Valérie Franco-Vidal, Vincent Darrouzet, Sylvestre Fierens
      We report the first case of a transtympanic iatrogenic internal carotid artery (ICA) pseudoaneurysm diagnosed in a 4-year-old child following a myringotomy. An endovascular treatment with a covered-stent was decided; spontaneous thrombosis was found during the therapeutic arteriography, and the procedure was aborted. Otoscopy and computed tomography (CT) scan monitoring showed a prolonged thrombosis and the disappearance of the pseudoaneurysm 18months after the diagnostic arteriography. Based on literature review, endovascular techniques seem to be preferred to the surgical approach for treatment of intrapetrous ICA pseudoaneurysm, however clinical and CT scan monitoring may also be a valid option.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.003
       
  • Retropharyngeal abscess as a result of hyaluronic acid injection
           pharyngoplasty: A first of its kind
    • Authors: Joseph Capo; Samuel N. Helman; Lianne M. de Serres
      Pages: 718 - 719
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Joseph Capo, Samuel N. Helman, Lianne M. de Serres


      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.07.008
       
  • Metastatic squamous cell carcinoma to the superior cervical ganglion
           mimicking a retropharyngeal lymph node
    • Authors: Sami P. Moubayed; Rosalie Machado; Marcela Osorio; Azita Khorsandi; Juan Hernandez-Prera; Mark L. Urken
      Pages: 720 - 723
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Sami P. Moubayed, Rosalie Machado, Marcela Osorio, Azita Khorsandi, Juan Hernandez-Prera, Mark L. Urken
      Background Metastasis of squamous cell carcinoma (SCC) to the superior cervical ganglion (SCG) has never been reported. Its anatomic location may easily be mistaken for a retropharyngeal lymph node. We present the first case of SCC metastasis to the SCG. Methods We report a case of a 69year-old never smoking male, who presented with right retropharyngeal PETCT-avid disease following chemoradiation for squamous cell carcinoma of the tonsil. He was brought to the operating room for resection, intraoperative radiation and reconstruction. Results Intraoperatively, visualization and frozen section confirmed squamous cell carcinoma located in the superior cervical ganglion. The ganglion was resected, intraoperative radiation was given and the patient was reconstructed with a radial forearm free flap. Postoperatively, the patient displayed features of a Horner's syndrome. Conclusions The superior cervical ganglion may be mistaken for a retropharyngeal lymph node. Although extremely rare, these entities may be differentiated on the basis of radiological studies.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.07.001
       
  • Oral foregut duplication cysts: A rare and fascinating congenital lesion.
           Case report and review of the literature
    • Authors: Kurt J. Knowles; Juraj Berkovic; Anil Gungor; Majd Al Shaarani; Valerie Lockhart; Firas Al-Delphi; Elba A. Turbat-Herrera
      Pages: 724 - 725
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Kurt J. Knowles, Juraj Berkovic, Anil Gungor, Majd Al Shaarani, Valerie Lockhart, Firas Al-Delphi, Elba A. Turbat-Herrera
      Oral foregut duplication cysts are extremely rare lesions with approximately 57 cases reported. They are congenital cysts, located in the anterior or ventral tongue, and occur predominantly in males. They are lined by one or more types of epithelia which is limited to gastric, intestinal or respiratory epithelium. The differential diagnosis includes lymphangioma, hemangioma, ranula, epidermoid cyst, teratoma and less likely a malignant process.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2016.11.008
       
  • Comment on: “The outcomes of overlay myringoplasty: Endoscopic versus
           microscopic approach”
    • Authors: Zhengcai Lou
      First page: 728
      Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6
      Author(s): Zhengcai Lou


      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.08.007
       
  • Is an endoscopic or a microscopic approach optimal for management of attic
           cholesteatoma'
    • Authors: Zhengcai-Lou; Zihan-Lou; Zhenqi-Gong
      Abstract: Publication date: Available online 8 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Zhengcai-LouZihan-LouZhenqi-Gong


      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.12.004
       
  • In response to Letter to the Editor entitled ‘Is an endoscopic or a
           microscopic approach optimal for management of attic cholesteatoma'’
           
    • Authors: Giuseppe Magliulo; Giannicola Iannella
      Abstract: Publication date: Available online 8 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Giuseppe Magliulo, Giannicola Iannella


      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.12.005
       
  • Comparison of transcanal endoscopic tympanoplasty with sterile acellular
           dermal allograft to conventional endaural microscopic tympanoplasty with
           tragal perichondrium
    • Authors: Jia Min; Se-Hyung Kim
      Abstract: Publication date: Available online 7 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Jia Min, Se-Hyung Kim
      Objectives This study aimed to compare the outcome of endoscopic tympanoplasty with sterile acellular dermal allograft (ADA) and conventional endaural microscopic tympanoplasty with tragal perichondrium. Methods This was a retrospective comparative study of 53 patients (25 males and 28 females) with tympanic membrane perforation who underwent type I tympanoplasty in the department of otorhinolaryngology at a tertiary medical center from March 2011 to April 2017. The subjects were classified into two groups; transcanal endoscopic tympanoplasty with ADA (TET, n=26), conventional endaural microscopic tympanoplasty with autologous tragal perichondrium (EMT, n=27). Demographic data, perforation size of tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3months postoperatively, operation time, sequential postoperative pain scale, and postoperative graft failure rate were evaluated. Results The perforation size of the tympanic membrane in TET and EMT group was 22.3±10.9% and 23.5±9.7%, respectively (P =0.143). Mean operation time of EMT (92.3±16.5min) was longer than that of the TET (65.3±20.5min) with a statistical significance (P =0.004). Graft success rate in the TET and EMT group were 92.3% and 96.3%, respectively; the values were not significantly different (P =0.610). Pre- and postoperative audiometric results including bone and air conduction thresholds and air-bone gap were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Pain in the immediate postoperative and day 1 after surgery were significantly less in the TET group. Conclusion With human cadaveric ADA, minimal invasive endoscopic tympanoplasty can be achieved with similar postoperative results and less pain.

      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.11.014
       
  • Symptomatic unilateral vocal fold paralysis following cardiothoracic
           surgery
    • Authors: Cassandra Puccinelli; Mara C. Modzeski; Diana Orbelo; Dale C. Ekbom
      Abstract: Publication date: Available online 6 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Cassandra Puccinelli, Mara C. Modzeski, Diana Orbelo, Dale C. Ekbom
      Purpose Unilateral vocal fold paralysis (UVFP) is a complication associated with cardiothoracic procedures that presents clinically as dysphonia and/or dysphagia with or without aspiration. The literature lacks both data on recovery of mobility and consensus on best management. Herein, our goals are to 1) Identify cardiothoracic procedures associated with symptomatic UVFP at our institution; 2) Review timing and nature of laryngology diagnosis and management; 3) Report spontaneous recovery rate of vocal fold mobility. Materials and methods Retrospective case series at single tertiary referral center between 2002 and 2015. 141 patients were included who underwent laryngology interventions (micronized acellular dermis injection laryngoplasty and/or type 1 thyroplasty) to treat symptomatic UVFP diagnosed subsequent to cardiothoracic surgery. Results Pulmonary procedures were most often associated with UVFP (n=50/141; 35.5%). 87.2% had left-sided paralysis (n=123/141). Median time to diagnosis was 42days ( x ¯ =114±348). Over time, UVFP was diagnosed progressively earlier after cardiothoracic surgery. 63.4% of patients (n=95/141) underwent injection laryngoplasty as their initial intervention with median time from diagnosis to injection of 11days ( x ¯ =29.6±54). 41.1% (n=58/141) ultimately underwent type 1 thyroplasty at a median of 232.5days ( x ¯ =367±510.2) after cardiothoracic surgery. 10.2% (n=9/88) of those with adequate follow-up recovered full vocal fold mobility. Conclusions Many cardiothoracic procedures are associated with symptomatic UVFP, predominantly left-sided. Our data showed poor recovery of vocal fold mobility relative to other studies. Early diagnosis and potential surgical medialization is important in the care of these patients.

      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.11.011
       
  • Reliability of temporal bone high-resolution CT in patients with facial
           paralysis in temporal bone fracture
    • Authors: Yaofeng Chen; Kai Zhang; Yanfeng Xu; Yanxu Che; Linna Guan; Yefeng Li
      Abstract: Publication date: Available online 5 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Yaofeng Chen, Kai Zhang, Yanfeng Xu, Yanxu Che, Linna Guan, Yefeng Li
      Objective This study aimed to investigate the reliability of temporal bone high-resolution CT (HRCT) in patients with traumatic facial paralysis. Methods HRCT with cross-sectional scanning and multi-planar reformation (MPR) was performed on 26 cases with traumatic facial paralysis, and the preoperative imaging manifestations were compared with surgical findings. Results Preoperative HRCT revealed fallopian canal damage at the posterior genu in 1 case, geniculate ganglion in 22 cases, labyrinthine segment in 4 cases, tympanic segment in 13 cases and mastoid segment in 0 case, while surgical findings confirmed fallopian canal damage at the posterior genu in 7 cases, geniculate ganglion in 23 cases, labyrinthine segment in 4 cases, tympanic segment in 17 cases and mastoid segment in 7 cases. The accuracy of temporal bone HRCT in revealing damage at those segments of fallopian canal was 14.3%, 95.7%, 100%, 76.5, and 0%, respectively. Conclusion Temporal bone HRCT can generally estimate the extent of damage and provide important information for traumatic facial paralysis before surgery. However, it is unreliable in revealing the damage of fallopian canal at the posterior genu and mastoid segment.

      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.12.003
       
  • Intestinal permeability and Ménière's disease
    • Authors: F. Di Berardino; E. Ciusani; C. Caccia; V. Leoni; U. De Grazia; E. Filipponi; D. Zanetti; L. Elli
      Abstract: Publication date: Available online 5 December 2017
      Source:American Journal of Otolaryngology
      Author(s): F. Di Berardino, E. Ciusani, C. Caccia, V. Leoni, U. De Grazia, E. Filipponi, D. Zanetti, L. Elli
      Purpose Ménière disease (MD) is a multifactorial chronic disabling condition characterized by episodic vertigo, ear fullness, and hearing loss. MD patients often complain of aspecific gastrointestinal symptoms associated with autonomic dysregulation, frequently outweighed by the otological manifestations. Dietary modifications have been reported to improve the typical MD symptoms in some cases. Our purpose was to test the urinary levels of lactulose and mannitol (double sugar test) and the fecal calprotectin, both markers of altered intestinal permeability, in subjects with definite MD in an active and inactive stage. Materials and methods Twenty-six with definite unilateral MD were studied: 14 patients were symptomatic for at least 3months with moderate to severe vertigo spells and a functional level ≥4; 12 patients had been asymptomatic (no vertigo spells) for at least 3months and had a functional level=1 at the time of testing. Twenty healthy volunteers were recruited as “control group”. Results Lactulose and mannitol absorption was significantly increased in the symptomatic M patients compared to the asymptomatic group (p<0.02 and p<0.004, respectively) and to the controls. FC were also higher than normal only in the symptomatic group. (p<0.01). Conclusions An altered intestinal permeability, according to the two assays, was found only in symptomatic MD patients. The rationale for a possible relationship between MD and intestinal permeability is forwarded. The double-sugar test and FC quantification might be implemented in the MD diagnostic workup.

      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.12.002
       
  • Commentary to letter to the editor to manuscript “Effects of surgical
           treatment of hypertrophic turbinates on the nasal obstruction and the
           quality of life”
    • Authors: Katharina Stölzel
      Abstract: Publication date: Available online 2 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Katharina Stölzel


      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.11.010
       
  • Mycology of chronic suppurative otitis media-cholesteatoma disease: An
           evaluative study
    • Authors: Gautam Bir Singh; Medozhanuo Solo; Ravinder Kaur; Rubeena Arora; Sunil Kumar
      Abstract: Publication date: Available online 2 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Gautam Bir Singh, Medozhanuo Solo, Ravinder Kaur, Rubeena Arora, Sunil Kumar
      Aims & objectives To detect the prevalence of fungus in chronic suppurative otitis media-cholesteatoma disease and to evaluate its clinical significance. Study design Prospective observational study conducted in a sample size of 46 patients at a tertiary care university teaching hospital. Materials & methods Forty six patients suffering from chronic suppurative otitis media-cholesteatoma disease were recruited in this prospective study. Data was duly recorded. Cholesteatoma sample was procured at the time of mastoid surgery and microbiologically analysed for fungal infestation. Clinical correlation to fungus infestation of cholesteatoma was statistically analysed. Results Out of the recruited 46 patients, post-operatively cholesteatoma was seen in 40 cases only. Seventeen i.e. 42.5% of these cases had fungal colonization of cholesteatoma. Further a statistically significant correlation between persistent otorrhoea and fungal infestation of cholesteatoma was observed. Three cases of fungal otomastoiditis were also recorded in this study, but a statistically significant correlation between complications and fungus infestation of cholesteatoma could not be clearly established. Conclusions There is fungal colonization of cholesteatoma which is pathogenic and can cause persistent otorrhoea.

      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.12.001
       
  • Retrograde parotidectomy and facial nerve outcomes: A case series of 44
           patients (Letter to Editor)
    • Authors: Tam-Lin Chow
      Abstract: Publication date: Available online 1 December 2017
      Source:American Journal of Otolaryngology
      Author(s): Tam-Lin Chow


      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.11.013
       
  • The extent of surgery for benign parotid pathology and its influence on
           complications: A prospective cohort analysis
    • Authors: Wai Keat Wong; Subhaschandra Shetty
      Abstract: Publication date: Available online 29 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Wai Keat Wong, Subhaschandra Shetty
      Background The surgical management of benign parotid tumors is aimed at complete extirpation of the mass with preservation of facial nerve function. There is a relative paucity of literature pertaining to complications after benign parotid surgery and related risk factors. We aim to critically review the outcomes following treatment of benign parotid pathology when surgery entailed either complete superficial parotidectomy (CSP), partial superficial parotidectomy (PSP) or extracapsular dissection (ECD). Material and methods This is a review of prospectively collected data of all parotidectomies performed between June 2006 to June 2016 for histologically-proven benign pathology of the parotid. Median follow-up time was 31.6weeks. Results A total of 101 parotidectomies were carried out on 97 patients (40 CSP, 56 PSP and 5 ECD). Pleomorphic adenoma (48.4%) and Warthin tumors (32.7%) were the most common pathologies. Temporary facial weakness occurred after 7 operations (6.9%). Facial weakness was permanent in 4 cases (3.9%). The rates of sialocele and salivary fistula were 4.9% and 0.9%, respectively. Only one patient (0.9%) developed Frey Syndrome postoperatively. No significant associations between extent of parotid surgery and postoperative facial nerve dysfunction (p=0.674) or wound complications (p=0.433) were observed. Univariate analyses for potential contributing factors such as advanced age, smoking status, tumor location or histology did not demonstrate any increased risk with developing postoperative complications. Conclusion Partial superficial parotidectomy was associated with low rates of morbidity to the facial nerve and surgical wound. The results were comparable to complete superficial parotidectomy. We recommend offering patient partial superficial parotidectomy where appropriate and this is in line with the current trend of minimising surgical dissection, thereby potentially decreasing the risk of short-term and long-term complications.

      PubDate: 2017-12-10T04:29:23Z
      DOI: 10.1016/j.amjoto.2017.11.015
       
  • Letter to the editor
    • Authors: Satvinder Singh Bakshi
      Abstract: Publication date: Available online 28 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Satvinder Singh Bakshi


      PubDate: 2017-11-29T03:08:38Z
      DOI: 10.1016/j.amjoto.2017.11.009
       
  • Image analysis of interarytenoid area to detect cases of Laryngopharyngeal
           Reflux: An objective method
    • Authors: Anindya Nayak; Sunil Kumar; Rubeena Arora; Gautam Bir Singh
      Abstract: Publication date: Available online 28 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Anindya Nayak, Sunil Kumar, Rubeena Arora, Gautam Bir Singh
      Purpose To diagnose Laryngopharyngeal Reflux by observing colour (Red, Green, Blue) at the interarytenoid area during 70° laryngeal endoscopy. Materials and methods Endoscopic images from 50 normal controls and 50 patients of LPR were obtained in this observational study. LPR patients were selected on the basis of RSI and RFS. Images were analysed using ImageJ, a free image analysis software, developed by the National Institute of Health (NIH). Colour changes in the form of RGB (red, green, blue) values were calculated and analysed at the interarytenoid area. The values in the normal and patient group were compared and correlated with RSI and RFS. Results RGB values of the LPR group and the normal group were statistically different (P value<0.01). Strong correlation was also found between R and G values and both RFS and RSI. However, no correlation was seen with B values. Conclusion Image analysis is an easy, economical and objective method to diagnose LPR.

      PubDate: 2017-11-29T03:08:38Z
      DOI: 10.1016/j.amjoto.2017.11.012
       
  • Response Regarding Surgical Techniques for Retrograde Parotidectomy
    • Authors: Maxwell Kligerman; Uchechukwu Megwalu; Davud Sirjani
      Abstract: Publication date: Available online 22 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Maxwell Kligerman, Uchechukwu Megwalu, Davud Sirjani


      PubDate: 2017-11-29T03:08:38Z
      DOI: 10.1016/j.amjoto.2017.11.008
       
  • Development and face validation of a Virtual Reality Epley Maneuver System
           (VREMS) for home Epley treatment of benign paroxysmal positional vertigo:
           A randomized, controlled trial
    • Authors: Reza Tabanfar; Harley H.L. Chan; Vincent Lin; T. Le; Jonathan C. Irish
      Abstract: Publication date: Available online 14 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Reza Tabanfar, Harley H.L. Chan, Vincent Lin, T. Le, Jonathan C. Irish
      Purpose To develop and validate a smartphone based Virtual Reality Epley Maneuver System (VREMS) for home use. Methods A smartphone application was designed to produce stereoscopic views of a Virtual Reality (VR) environment, which when viewed after placing a smartphone in a virtual reality headset, allowed the user to be guided step-by-step through the Epley maneuver in a VR environment. Twenty healthy participants were recruited and randomized to undergo either assisted Epleys or self-administered Epleys following reading instructions from an Instructional Handout (IH). All participants were filmed and two expert Otologists reviewed the videos, assigning each participant a score (out of 10) for performance on each step. Participants rated their perceived workload by completing a validated task-load questionnaire (NASA Task Load Index) and averages for both groups were calculated. Results Twenty participants were evaluated with average age 26.4±7.12years old in the VREMS group and 26.1±7.72 in the IH group. The VR assisted group achieved an average score of 7.78±0.99 compared to 6.65±1.72 in the IH group. This result was statistically significant with p=0.0001 and side dominance did not appear to play a factor. Analyzing each step of the Epley maneuver demonstrated that assisted Epleys were done more accurately with statically significant results in steps 2–4. Results of the NASA-TLX scores were variable with no significant findings. Conclusion We have developed and demonstrated face validity for VREMS through our randomized controlled trial. The VREMS platform is promising technology, which may improve the accuracy and effectiveness of home Epley treatments. Level of evidence N/A.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.11.006
       
  • Total caloric eye speed in patients with vestibular migraine
    • Authors: Adam Thompson-Harvey; Anthony A. Mikulec
      Abstract: Publication date: Available online 14 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Adam Thompson-Harvey, Anthony A. Mikulec
      Purpose Vestibular migraine is a common cause of dizziness that lacks a known objective test. This study examined total eye speed on caloric testing as a diagnostic marker for vestibular migraine. Materials and methods Retrospective chart review of patients seen in a tertiary otologic practice between 2004 and 2016 who had undergone caloric testing with water irrigation and had a diagnosis of vestibular migraine (n =34). A group of patients with benign paroxysmal positional vertigo (n =10) were used as a control group. Patients were grouped into quartiles based on total eye speed. Results Only patients in the lowest quartile (total eye speed<79) had a diagnosis of vestibular migraine. All other quartiles included a mix of control and vestibular migraine patients. Conclusion Low total eye speed may be suggestive of a diagnosis of vestibular migraine, but most patients with vestibular migraine do not have low total eye speed.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.11.007
       
  • ACS NSQIP risk calculator reliability in head and neck oncology: The
           effect of prior chemoradiation on NSQIP risk estimates following
           laryngectomy
    • Authors: Angela Cao; Sarah Khayat; Elizabeth Cash; Christopher Nickel; John Gettelfinger; Paul Tennant; Jeffrey Bumpous
      Abstract: Publication date: Available online 13 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Angela Cao, Sarah Khayat, Elizabeth Cash, Christopher Nickel, John Gettelfinger, Paul Tennant, Jeffrey Bumpous
      Purpose To determine whether inclusion of chemoradiation history increases estimated risk for complications following total laryngectomy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Surgical Risk Calculator. Materials and methods A retrospective review of 96 patients with laryngeal cancer, approximately half of who had received prior chemoradiation, who underwent laryngectomy between January 2010 and December 2014. NSQIP estimates were calculated and compared to actual event occurrence using receiver operating characteristic (ROC) curves, Brier scores, and risk estimates. Results Patients who had received prior chemoradiation were at significantly greater risk for complication postoperatively (OR=2.63, 95% CI=1.145–6.043). NSQIP Calculator discriminability and accuracy were generally poor for this sample. While NSQIP estimates significantly predicted risk for any postoperative complication, pneumonia, and discharge to nursing care for primary laryngectomy patients, predictive capability was lost among salvage laryngectomy patients. NSQIP adjustments to both Somewhat Higher and Significantly Higher Risk categories did not improve predictive capability. Of the risk factors considered by NSQIP, preoperative functional status (p =0.041), age at time of surgery (p <0.008), and inclusion of neck dissection (p =0.035) emerged as significant predictors of actual postoperative complications, though again estimates lost significance among salvage laryngectomy patients. Conclusions The NSQIP Calculator may be poorly calibrated to estimate postoperative complication risk for patients previously exposed to chemoradiation undergoing salvage laryngectomy. Caution should be used when estimating postoperative risk among patients undergoing salvage procedures, especially those of older age, poorer functional status, and those requiring neck dissection.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.11.005
       
  • Guidelines for Contributing Authors
    • Abstract: Publication date: November–December 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 6


      PubDate: 2017-11-18T17:12:04Z
       
  • Pediatric airway study: Endoscopic grading system for quantifying
           tonsillar size in comparison to standard adenotonsillar grading systems
    • Authors: Neha A. Patel; Kristen Carlin; Joseph M. Bernstein
      Abstract: Publication date: Available online 29 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Neha A. Patel, Kristen Carlin, Joseph M. Bernstein
      Significance Current grading systems may not allow clinicians to reliably document and communicate adenotonsillar size in the clinical setting. A validated endoscopic grading system may be useful for reporting tonsillar size in future clinical outcome studies. This is especially important as tonsillar enlargement is the cause of a substantial health care burden on children. Objective To propose and validate an easy-to-use flexible fiberoptic endoscopic grading system that provides physicians with a more accurate sense of the three-dimensional relationship of the tonsillar fossa to the upper-airway. Methods 50 consecutive pediatric patients were prospectively recruited between February 2015 and February 2016 at a pediatric otolaryngology outpatient clinic. The patients had no major craniofacial abnormalities and were aged 1 to 16years. Each patient had data regarding BMI, Friedman palate position, OSA-18 survey results collected. For each child, digital video clips of fiberoptic nasopharyngeal, oropharyngeal and laryngeal exams were presented to 2 examiners. Examiners were asked to independently use the proposed Endoscopic tonsillar grading system, the Brodsky tonsillar grading scale, the Modified Brodsky tonsillar grading scale with a tongue depressor, and the Parikh adenoid grading system to rate adenotonsillar hypertrophy. Cohen's Kappa and weighted Kappa scores were used to assess interrater reliability for each of the four grading scales. The Spearman correlation was used to test the associations between each scale and OSA-18 scores, as well as Body Mass Index (BMI). Results 50 pediatric patients were included in this study (mean age 6.1years, range of 1year to 16years). The average BMI was 20. The average OSA-18 score was 61.7. The average Friedman palate position score was 1.34. Twelve percent of the patients had a Friedman palate position score≥3, which made traditional Brodsky grading of their tonsils impossible without a tongue depressor. All four scales showed strong agreement between the two raters. The weighted Kappa was 0.83 for the Modified Brodsky scale, 0.89 for the Brodsky scale, 0.94 for the Parikh scale to 0.98 for the Endoscopic scale (almost perfect agreement). The Endoscopic scale showed the most consistent agreement between the raters during the study. There was a moderate association between the Parikh adenoid grading system with OSA-18 scores (Spearman's ρ=0.58, p <0.001) compared to a low association of the tonsillar grading systems with OSA- 18 scores. None of the scales correlated with patient BMI. Conclusions The proposed Endoscopic tonsillar grading system is as reliable of a method of grading tonsillar size as conventional grading systems. It offers the advantage of allowing for critical evaluation of the tonsils without any anatomic distortion which may occur with the use of a tongue blade. This new validated endoscopic grading system provides a tool for communicating the degree of airway obstruction at the level of the oropharynx regardless of Friedman palate position and may be used in future outcomes projects.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.10.013
       
  • Survival in patients with parotid gland carcinoma – Results of a
           multi-center study
    • Authors: Keigo Honda; Shinzo Tanaka; Shogo Shinohara; Ryo Asato; Hisanobu Tamaki; Toshiki Maetani; Ichiro Tateya; Morimasa Kitamura; Shinji Takebayashi; Kazuyuki Ichimaru; Yoshiharu Kitani; Yohei Kumabe; Tsuyoshi Kojima; Koji Ushiro; Masanobu Mizuta; Koichiro Yamada; Koichi Omori
      Abstract: Publication date: Available online 24 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Keigo Honda, Shinzo Tanaka, Shogo Shinohara, Ryo Asato, Hisanobu Tamaki, Toshiki Maetani, Ichiro Tateya, Morimasa Kitamura, Shinji Takebayashi, Kazuyuki Ichimaru, Yoshiharu Kitani, Yohei Kumabe, Tsuyoshi Kojima, Koji Ushiro, Masanobu Mizuta, Koichiro Yamada, Koichi Omori
      Background Parotid gland carcinoma is a rare malignancy, comprising only 1–4% of head and neck carcinomas; therefore, it is difficult for a single institution to perform meaningful analysis on its clinical characteristics. The aim of this study was to update the clinical knowledge of this rare disease by a multi-center approach. Methods The study was conducted by the Kyoto University Hospital and Affiliated Facilities Head and Neck Clinical Oncology Group (Kyoto-HNOG). A total of 195 patients with parotid gland carcinoma who had been surgically treated with curative intent between 2006 and 2015 were retrospectively reviewed. Clinical results including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), local control rate (LCR), regional control rate (RCR), and distant metastasis-free survival (DMFS) were estimated. Univariate and multivariate analyses were performed to identify prognostic factors. Results The median patient age was 63years old (range 9–93years), and the median observation period was 39months. The OS, DFS, DSS, LCR, RCR, and DMFS at 3years were 85%, 74%, 89%, 92%, 88%, and 87%, respectively. Univariate analysis showed age over 74, T4, N+, preoperative facial palsy, high grade histology, perineural invasion, and vascular invasion were associated with poor OS. N+ and high grade histology were independent factors in multivariate analysis. In subgroup analysis, postoperative radiotherapy was associated with better OS in high risk patients. Conclusion Nodal metastases and high grade histology are important negative prognostic factors for OS. Postoperative radiotherapy is recommended in patients with advanced high grade carcinoma.

      PubDate: 2017-11-18T17:12:04Z
      DOI: 10.1016/j.amjoto.2017.10.012
       
  • Reconstruction of preauricular soft tissue defects using a superiorly
           based rotation advancement scalp flap - A novel approach to the surgical
           treatment of preauricular sinuses
    • Authors: Bernard Tan; Lee Tee Sin; Ian Loh
      Abstract: Publication date: Available online 10 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Bernard Tan, Lee Tee Sin, Ian Loh


      PubDate: 2017-11-10T16:24:54Z
      DOI: 10.1016/j.amjoto.2017.11.003
       
  • Tailored resections in oral and oropharyngeal cancer using narrow band
           imaging
    • Authors: Giancarlo Tirelli; Marco Piovesana; Alberto Vito Marcuzzo; Annalisa Gatto; Matteo Biasotto; Rossana Bussani; Lorenzo Zandonà; Fabiola Giudici; Francesca Boscolo Nata
      Abstract: Publication date: Available online 10 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Giancarlo Tirelli, Marco Piovesana, Alberto Vito Marcuzzo, Annalisa Gatto, Matteo Biasotto, Rossana Bussani, Lorenzo Zandonà, Fabiola Giudici, Francesca Boscolo Nata
      Purpose In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study. Materials and methods The resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined “NBI positive”, “NBI null”, and “NBI negative”, respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the “NBI-positive” and the “NBI-negative” areas were recorded. Results We obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site. Conclusions NBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.

      PubDate: 2017-11-10T16:24:54Z
      DOI: 10.1016/j.amjoto.2017.11.004
       
  • Adenoidectomy and chronic nasal obstruction developing after failure of
           nasal steroid therapy
    • Authors: Zhengcai Lou
      Abstract: Publication date: Available online 7 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Zhengcai Lou


      PubDate: 2017-11-10T16:24:54Z
      DOI: 10.1016/j.amjoto.2017.11.002
       
  • It is vital to identify the underlying cause of chronic laryngopharyngeal
           neuropathy
    • Authors: Zhengcai Lou
      Abstract: Publication date: Available online 7 November 2017
      Source:American Journal of Otolaryngology
      Author(s): Zhengcai Lou


      PubDate: 2017-11-10T16:24:54Z
      DOI: 10.1016/j.amjoto.2017.11.001
       
  • Treating laryngopharyngeal reflux: Evaluation of an anti-reflux program
           with comparison to medications
    • Authors: Jin Yang; Salem Dehom; Stephanie Sanders; Thomas Murry; Priya Krishna; Brianna K. Crawley
      Abstract: Publication date: Available online 31 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Jin Yang, Salem Dehom, Stephanie Sanders, Thomas Murry, Priya Krishna, Brianna K. Crawley
      Objective To determine if an anti-reflux induction program relieves laryngopharyngeal reflux (LPR) symptoms more effectively than medication and behavioral changes alone. Study design Retrospective study. Setting Tertiary care academic center. Subjects and methods A database was populated with patients treated for LPR. Patients were included in the study group if they completed a two-week anti-reflux program (diet, alkaline water, medications, behavioral modifications). Patients were included in the control group if they completed anti-reflux medications and behavioral modifications only. Patients completed the voice handicap index (VHI), reflux symptom index (RSI), cough severity index (CSI), dyspnea index (DI) and eating assessment tool (EAT-10) surveys and underwent laryngoscopy for examination and reflux finding score (RFS) quantification. Results Of 105 study group patients, 96 (91%) reported subjective improvement in their LPR symptoms after an average 32-day first follow-up and their RSI and CSI scores improved significantly. No significant differences were found in VHI, DI, or EAT-10 scores. Fifteen study patients who had previously failed adequate high-dose medication trials reported improvement and their CSI and EAT-10 scores improved significantly. Ninety-five percent of patients with a chief complaint of cough reported improvement and their CSI scores improved significantly from 12.3 to 8.2. Among 81 controls, only 39 (48%) patients reported improvement after an average 62-day first follow-up. Their RSI scores did not significantly change. Conclusion The anti-reflux program yielded rapid and substantial results for a large cohort of patients with LPR. It compared favorably with medication and behavioral modification alone. It was effective in improving cough and treating patients who had previously failed medications alone.

      PubDate: 2017-11-04T15:51:04Z
      DOI: 10.1016/j.amjoto.2017.10.014
       
  • Effects of intratympanic dexamethasone on noise-induced hearing loss: An
           experimental study
    • Authors: Sait Serdar Gumrukcu; İlhan Topaloglu; Ziya Salturk; Belgin Tutar; Yavuz Atar; Güler Berkiten; Ayşe Enise Göker
      Abstract: Publication date: Available online 27 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Sait Serdar Gumrukcu, İlhan Topaloglu, Ziya Salturk, Belgin Tutar, Yavuz Atar, Güler Berkiten, Ayşe Enise Göker
      Aim Aim of the study was to evaluate the effect of intratympanic steroid treatment on hearing based on oto-acoustic emission. Methods A total of 16 healthy female Wistar albino rats weighing were used in this study. They were divided in to 2 groups and each group was exposed to noise at 110dB for 25min to induce acoustic trauma. Intratympanic dexamethasone was administered to the middle ears of animals in the experimental group on the same day as exposure to noise. The control group was given 0.09% saline solution. Distortion product otoacoustic emission measurements were performed on days 7 and 10. Results There were no differences between the emission results of two groups before treatment at 4004, 4761, 5652, 6726, and 7996Hz. There were significant group differences on measurement days 7 and 10 at all frequencies. Conclusion Our study revealed a significant difference in DPOAE measurements on days 7 and 10 between the experimental and control groups. We detected a positive effect of dexamethasone on noise-induced hearing loss.

      PubDate: 2017-10-27T14:30:58Z
      DOI: 10.1016/j.amjoto.2017.10.011
       
  • The malleus cap: Anatomic description of cartilage of the lateral process
           of the malleus
    • Authors: Elias Michaelides; Ankit Kansal; Sara Rutter; Christopher A. Schutt
      Abstract: Publication date: Available online 25 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Elias Michaelides, Ankit Kansal, Sara Rutter, Christopher A. Schutt
      Purpose To anatomically describe a cartilaginous cap attached to the lateral process of the malleus. Study Design. Histologic and gross anatomic review. Methods Twenty temporal bones were histologically reviewed. The anatomical relationship between the tympanic membrane and malleus was then defined at the level of the lateral process of the malleus and the long process of the malleus. Separately, gross evaluation of these levels at the macroscopic level was undertaken through endoscopic imaging in five subjects. Results All temporal bones reviewed revealed the presence of a cartilaginous cap articulating between the tympanic membrane and the lateral process of the malleus. The cartilaginous cap was also readily identifiable in gross evaluation of the tympanic membrane from views lateral and medial to the tympanic membrane during endoscopic evaluation. Conclusion The cartilaginous cap of the lateral process of the malleus is an important and reliable anatomical structure of the middle ear that has not previously been described. Through knowledge of the structure surgeons may exploit its presence by creating a cleavage plane between the cartilaginous cap and the malleus during tympanoplasty, possibly allowing for safer and more efficient surgery.

      PubDate: 2017-10-27T14:30:58Z
      DOI: 10.1016/j.amjoto.2017.10.010
       
  • Response to the letter to the editor regarding “The outcomes of overlay
           myringoplasty: Endoscopic versus microscopic approach”
    • Authors: Yuvatiya Plodpai; Nanatphong Paje
      Abstract: Publication date: Available online 7 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Yuvatiya Plodpai, Nanatphong Paje


      PubDate: 2017-10-13T14:46:08Z
      DOI: 10.1016/j.amjoto.2017.10.001
       
  • In response to the commentary of Dr. Lou on treatment of laryngopharyngeal
           reflux using a sleep positioning device: A prospective cohort study
    • Authors: William S. Tierney; Scott L. Gabbard; Paul C. Bryson
      Abstract: Publication date: Available online 3 October 2017
      Source:American Journal of Otolaryngology
      Author(s): William S. Tierney, Scott L. Gabbard, Paul C. Bryson


      PubDate: 2017-10-06T11:56:31Z
      DOI: 10.1016/j.amjoto.2017.10.002
       
  • An unusual case of temporal bone encephalomeningocele occurring together
           with normal pressure hydrocephalus
    • Authors: Bernard Tan Wen Sheng; David Low Yong Ming; Heng Wai Yuen
      Abstract: Publication date: Available online 20 September 2017
      Source:American Journal of Otolaryngology
      Author(s): Bernard Tan Wen Sheng, David Low Yong Ming, Heng Wai Yuen
      Temporal bone encephalomeningoceles are uncommon clinical entities that can be challenging to diagnose and treat. Common presenting complaints include symptoms of aural fullness, hearing loss, clear otorrhea and meningitis. Common etiologies are chronic middle ear disease and trauma. A significant proportion of cases are spontaneous, which occurs in relation to benign intracranial hypertension. Normal pressure hydrocephalus associated with temporal bone encepahomeningoceles has not been previously described. The authors present an unusual case of spontaneous right sided temporal bone encephalomeningocele associated with symptomatic normal pressure hydrocephalus. Surgical repair of the defect was successful. The diagnostic and management approach to this unique case are discussed.

      PubDate: 2017-09-23T08:42:27Z
      DOI: 10.1016/j.amjoto.2017.09.007
       
  • The folded postauricular flap: A novel approach to reconstruction of large
           full thickness defects of the conchal bowl
    • Authors: Ansley M. Roche; Martha Griffin; Ron Shelton; Mark L. Urken
      Abstract: Publication date: Available online 19 September 2017
      Source:American Journal of Otolaryngology
      Author(s): Ansley M. Roche, Martha Griffin, Ron Shelton, Mark L. Urken
      Extensive subtotal full-thickness auriculectomy defects pose a challenge for the reconstructive surgeon. The posterior island flap (PIF), based on the posterior auricular artery, has been described as a reconstructive option for auricular defects, with reports describing a “pull-through” or “revolving door” technique to reconstruct subtotal partial thickness and full thickness auricular defects. These techniques may result in posterior “pinning” of the auricle. This patient is an 87-year-old male who presented after Mohs excision of squamous cell carcinoma of the conchal bowl, which resulted in a 4x4cm subtotal auriculectomy defect. A folded PIF was used to reconstruct the large full thickness defect, in a multistage manor. Post-operatively, the patient had a reconstructed auricle that was suitable for wearing hearing aids and glasses. We describe a novel technique of the folded PIF for an extensive full-thickness auricular defect, which utilizes a single, well camouflaged donor site, provides well-vascularized local tissue with excellent color match, and allows for the restoration of the post-auricular sulcus.

      PubDate: 2017-09-23T08:42:27Z
      DOI: 10.1016/j.amjoto.2017.09.006
       
  • Shrinkage in oral squamous cell carcinoma: An analysis of tumor and margin
           measurements in vivo, post-resection, and post-formalin fixation
    • Authors: Lauren A. Umstattd; Jonathan C. Mills; William A. Critchlow; Gregory J. Renner; Robert P. Zitsch
      Abstract: Publication date: Available online 12 September 2017
      Source:American Journal of Otolaryngology
      Author(s): Lauren A. Umstattd, Jonathan C. Mills, William A. Critchlow, Gregory J. Renner, Robert P. Zitsch
      Purpose To quantify changes in tumor size and tumor-free margins following surgical resection and formalin fixation of oral cavity squamous cell carcinoma. Materials and methods Nineteen patients were studied via cohort design. Between May and December 2011, measurements of tumor size and tumor-free margin were made in patients with squamous cell carcinoma of the oral cavity. Mucosal reference points were marked with sutures, representing tumor diameter and two separate resection margins. Measurements were recorded immediately before resection, after resection, and following fixation in formalin. Results The overall mean shrinkage in tumor size was 10.7% (95% CI 3.4–18.0, p =0.006). When comparing mean tumor measurements, most of the tumor size decrease (6.4%, 95% CI 0.4–12.4, p =0.039) occurred between pre- and post-excision measurements. To a lesser extent, tumor size decreased following formalin fixation. Comparison of tumor-free margin measurements revealed a pre-excision to post-fixation mean decrease of 11.3% (95% CI 2.9–19.6%, p =0.011), with a statistically significant decrease of 14.9% (95% CI 8.5–21.3%, p <0.001) occurring between pre- and post-excision, and no significant decrease from post-excision to post-formalin fixation. Conclusion Mucosal dimensions of both tumor and tumor-free margins in oral cavity squamous cell carcinoma specimens decrease between surgical resection and pathologic analysis. Most of this decrease occurs prior to fixation, especially for margins, and may be due to intrinsic tissue properties rather than formalin effects.

      PubDate: 2017-09-18T08:38:16Z
      DOI: 10.1016/j.amjoto.2017.08.011
       
  • Commentary on: Treatment of laryngopharyngeal reflux using a sleep
           positioning device: A prospective cohort study
    • Authors: Zhengcai Lou
      Abstract: Publication date: Available online 6 September 2017
      Source:American Journal of Otolaryngology
      Author(s): Zhengcai Lou


      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.09.002
       
 
 
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