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Publisher: Elsevier   (Total: 3043 journals)

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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
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Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
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Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
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Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 325, 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: 405, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
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Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, 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: 10, 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  
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: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
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American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, 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: 45, 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: 235, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 57, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
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: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 22, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, 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)
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Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
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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)
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Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
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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  [3043 journals]
  • Letter to the editor
    • Authors: Satvinder Singh Bakshi
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Satvinder Singh Bakshi


      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.joms.2017.07.165
       
  • KAI1 overexpression promotes apoptosis and inhibits proliferation, cell
           cycle, migration, and invasion in nasopharyngeal carcinoma cells
    • Authors: Zheng Guo; Yili Wang; Jing Yang; Jinghua Zhong; Xia Liu; Mingjun Xu
      Pages: 511 - 517
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Zheng Guo, Yili Wang, Jing Yang, Jinghua Zhong, Xia Liu, Mingjun Xu
      Objectives The purpose of this study is to characterize the effect of KAI1 overexpression on the biological behavior of nasopharyngeal carcinoma (NPC) cells. Background Nasopharyngeal carcinoma is a highly malignant tumor with a high rate of incidence in China. Currently, there are no ideal therapeutic options for patients with NPC, but a targeted therapy would have great potential for treating it. Therefore, there is an urgent need for novel therapeutic targets to provide new options for treating NPC. The KAI1 gene was originally identified as a metastasis suppressor gene for advanced human cancer. In NPC cell lines and tissues, the expression of KAI1 decreased as the metastatic potential of cells increased, but its potential as a therapeutic target has not been elucidated. Methods Non-transformed nasopharyngeal epithelium cell NP69 and NPC cell line C666-1 were cultured and KAI1 expression in these cells was detected by qRT-PCR and Western blot. After the transfection of KAI1-pCDNA3.1 to NP69 and C666-1, the KAI1 expression in these cells was detected by qRT-PCR and Western blot, the proliferation was performed by MTS, the cell cycle and apoptosis were performed by flow cytometry, the migration and invasion were examined by transwell. Results Our results showed that KAI1 was significantly upregulated in C666-1 cells compared to that in NP69 cells. In addition, KAI1 overexpression significantly inhibited the proliferation, cell cycle, migration, and invasion, and promoted apoptosis of C666-1 cells, but had no significant effect on NP69 cells. Conclusion Our findings suggest that KAI1 overexpression promotes apoptosis and inhibits proliferation, cell cycle, migration, and invasion in NPC cells. We hypothesize that KAI1 overexpression could be a potential therapeutic target for NPC.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2016.09.011
       
  • Quantitative imaging analysis of transcanal endoscopic Infracochlear
           approach to the internal auditory canal
    • Authors: Judith S. Kempfle; Benjamin Fiorillo; Vivek V. Kanumuri; Samuel Barber; Albert S.B. Edge; Marybeth Cunnane; Aaron K. Remenschneider; Daniel J. Lee; Elliott D. Kozin
      Pages: 518 - 520
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Judith S. Kempfle, Benjamin Fiorillo, Vivek V. Kanumuri, Samuel Barber, Albert S.B. Edge, Marybeth Cunnane, Aaron K. Remenschneider, Daniel J. Lee, Elliott D. Kozin
      Purpose A transcanal endoscopic infracochlear surgical approach to the internal auditory canal (IAC) in a human temporal bone model has previously been described. However, the proportion of patients with favorable anatomy for this novel surgical technique remains unknown. Herein, we perform a quantitative analysis of the transcanal endoscopic infracochlear corridor to the IAC based on computed tomography. Materials and methods High resolution computed tomography scans of adult temporal bones were measured to determine the accessibility of the IAC when using an endoscopic transcanal, cochlear-sparing surgical corridor. Results This approach to the IAC was feasible in 92% (35 of 38) specimens based on a minimum distance of 3mm between the basilar turn of the cochlear and the great vessels (jugular bulb and carotid artery). Conclusions Infracochlear access to the IAC is feasible in the majority of adult temporal bones and has implications for future hearing preservation drug delivery approaches to the IAC.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.03.014
       
  • Clinical and audiological characteristics of 1000Hz audiometric notch
           patients
    • Authors: Hyun-Min Lee; Seok-Hyun Kim; Jae-Hwan Jung; Se-Joon Oh; Soo-Keun Kong; Il-Woo Lee
      Pages: 521 - 525
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Hyun-Min Lee, Seok-Hyun Kim, Jae-Hwan Jung, Se-Joon Oh, Soo-Keun Kong, Il-Woo Lee
      Purpose Among the hearing loss patients, we can confirm that the hearing loss of the specific frequency decreases, such as the 2000Hz notch in otosclerosis and the 4000Hz notch (c5-dip) in noise-induced hearing loss. The 1000Hz notch (c3-dip), however, is rarely studied. We fortuitously encountered a group of patients with a 1kHz hearing loss and report it with a review of the literature. Methods Otological history, audiogram, diagnosis, occupation, and history of noise exposure were reviewed from charts and telephone interview, and compared between c3-dip and c5-dip patients (n =98). Results Thirty-one patients (mean age: 46.2years) demonstrated 1kHz hearing loss; these included 11 males. The pure-tone threshold was 37.97dB at 1kHz and the average threshold was 22.38dB at other frequencies. In the c3-dip group, tinnitus was the most common complaint, while sudden sensorineural hearing loss and idiopathic tinnitus (n =8 each) were the most common diagnoses. Female patients and unilateral cases were more common in the c3-dip than in the c5-dip group, and ear fullness was more common in the c3-dip group than in the c5-dip group. The duration of occupation-related noise exposure was longer in the c5 group, and head or ear trauma was more frequent in the c3-dip group. Conclusion We have defined a new clinical entity of 1kHz hearing loss in patients, defined as the c3-dip, which was clinically and audiologically distinct from the c5-dip. Further study is needed to clarify this new entity of hearing loss.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.03.016
       
  • Improving resident familiarity with the translabyrinthine approach to the
           internal auditory canal
    • Authors: Matthew M. Dedmon; Brendan P. O'Connell; Austin S. Adams; George B. Wanna; David S. Haynes
      Pages: 526 - 528
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Matthew M. Dedmon, Brendan P. O'Connell, Austin S. Adams, George B. Wanna, David S. Haynes
      Objective To increase otolaryngology resident experience with drilling and dissection of the internal auditory canal (IAC) via a translabyrinthine approach. Study design Pilot study involving temporal bone education and drilling with completion of pre- and post-drilling surveys. Methods Participants observed an educational presentation on IAC anatomy and drilling, followed by manipulation of IAC nerves using a prosected cadaveric temporal bone. Participants then drilled the IAC and identified nerves using temporal bones with previously drilled mastoidectomies and labyrinthectomies. Pre- and post-drilling 5-point Likert-based surveys were completed. Results 7 participants were included in this study ranging in experience from PGY1 through PGY 5. The median number of times the IAC had been drilled previously was 0. Participants reported statistically significantly improved familiarity with the translabyrinthine approach after the session with median scores increasing from 2 to 3 (p=0.02), and a near-significant increase in familiarity with IAC anatomy with median scores increasing from 3 to 4 (p=0.06). Prior to the session, 71% of participants either disagreed or strongly disagreed that they had an idea of what the procedure would be like in a real operating room, whereas after the session 0% reported disagreement. 100% of participants were very satisfied with the overall experience. Conclusions An educational session and temporal bone drilling experience using prosected bones significantly increased the reported familiarity with the translabyrinthine approach. Experiences such as this may enhance resident exposure to advanced lateral skull base approaches in a safe environment, and increase comprehension of the complex anatomic relationships of the IAC.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.04.005
       
  • 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
      Pages: 529 - 532
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.05.001
       
  • Utility of a multidisciplinary approach to pediatric hearing loss
    • Authors: Karen Ann Hawley; Donald M. Goldberg; Samantha Anne
      Pages: 547 - 550
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Karen Ann Hawley, Donald M. 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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.05.008
       
  • Cochlear implantation in patients with otosclerosis of the otic capsule
    • Authors: Jay Burmeister; Susan Rathgeb; Jacques Herzog
      Pages: 556 - 559
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.05.011
       
  • 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
      Pages: 565 - 570
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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 with an age range of 3months to 10years 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 that 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: 2017-09-11T08:32:16Z
      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
      Pages: 571 - 575
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.003
       
  • 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
      Pages: 576 - 581
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      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
      Pages: 582 - 587
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.005
       
  • 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
      Pages: 593 - 597
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Lei Lei, Hui Yang, Xinsheng 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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.01.039
       
  • Lateral cervical approach for supracricoid partial laryngectomy
    • Authors: Giuseppe Spriano; Giuseppe Mercante; Giovanni Cristalli; Raul Pellini; Fabio Ferreli
      Pages: 598 - 602
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Giuseppe Spriano, Giuseppe Mercante, Giovanni Cristalli, Raul Pellini, Fabio Ferreli
      Introduction The supracricoid partial laryngectomy has been described for the treatment of T3 laryngeal glottic and supraglottic tumors as well as upfront and salvage surgery. Good oncological and functional outcomes are expected, while the post-operative rehabilitation can be quite difficult for the patient. Early and late complications can occur especially in salvage surgery. Neck dissection according to the T stage is often associated with the resection of the primary tumor. Objective To verify the feasibility of a minimally invasive procedure for supracricoid partial laryngectomy by adopting the lateral cervical approach. Methods/results A 61-year old man affected by a cT3N0 glottic cancer already treated 10years prior with radiotherapy for oropharyngeal cancer underwent supracricoid laryngectomy using the lateral approach. The key point of the procedure was a subfascial dissection with the harvesting of anterior cervical flap including skin, fat, platysma, fascia superficialis, anterior jugular veins, homo- and sterno-hyoid muscles. Conclusion Supracricoid laryngectomy by a lateral approach is feasible and safe; it allows to perform a simultaneous neck dissection and the removal of the entire laryngeal specimen preserving ample healthy tissue compared to the classic anterior approach.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.011
       
  • Treatment of laryngopharyngeal reflux using a sleep positioning device: A
           prospective cohort study
    • Authors: William S. Tierney; Scott L. Gabbard; Claudio F. Milstein; Michael S. Benninger; Paul C. Bryson
      Pages: 603 - 607
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): William S. Tierney, Scott L. Gabbard, Claudio F. Milstein, Michael S. Benninger, Paul C. Bryson
      Objective Laryngopharyngeal reflux (LPR) symptoms are often resistant to management and cause significant quality of life impairment to patients with this disease. This study assesses the utility of a sleep-positioning device (SPD) in treating LPR. Design Single center prospective cohort study. Setting Tertiary medical center Participants 27 adult patients with diagnosed laryngopharyngeal reflux. Intervention An SPD consisting of a two-component wedge-shaped base pillow and a lateral positioning body pillow (Medcline, Amenity Health Inc.) was given to patients with a diagnosis of LPR. Subjects slept using the device for at least 6h per night for 28 consecutive nights. Main outcomes Primary outcomes were Nocturnal Gastroesophageal Reflux Symptom Severity and Impact Questionnaire (N-GSSIQ) and the Reflux Symptoms Index (RSI) survey instrument. Each was collected at baseline, after 14, and after 28days of SPD use. Results 27 patients (19 female and 8 male; age 57.1±12.8, BMI 29.0±8.1) were recruited. At baseline mean N-GSSIQ was 50.1±22.4 and mean RSI of 29.6±7.7. Repeated measure analysis showed that subjects' total N-GSSIQ scores decreased by an average of 19.1 (p=0.0004) points by two weeks and 26.5 points by 4weeks (p<0.0001). RSI decreased an average of 5.3 points by 2weeks (p=0.0425) and an average of 14.0 points by 4weeks (p<0.0001). Conclusions In patients with LPR, SPD treatment significantly improves self-reported symptoms of nocturnal reflux as well as symptoms specific to LPR. These results support the therapeutic efficacy of a SPD for patients with LPR.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.012
       
  • Parathyroidectomy for tertiary hyperparathyroidism: A systematic review
    • Authors: Jessica A. Tang; Jacob Friedman; Michelle S. Hwang; Anna M. Salapatas; Lauren B. Bonzelaar; Michael Friedman
      Pages: 630 - 635
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.009
       
  • How to treat a patulous Eustachian tube
    • Authors: Zhengcai Lou
      Pages: 636 - 637
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Zhengcai Lou


      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.04.015
       
  • Letter to Editors: Detection of endolymphatic hydrops using traditional MR
           imaging sequences
    • Authors: Shinji Naganawa; Michihiko Sone
      Pages: 637 - 638
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Shinji Naganawa, Michihiko Sone


      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.014
       
  • Immune thrombocytopenia of childhood responsive to tonsillectomy in the
           setting of chronic tonsillitis: A case report and literature review
    • Authors: Richard William Thompson; Anil Gungor
      Pages: 639 - 641
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Richard William Thompson, Anil Gungor
      Objectives Immune thrombocytopenia of childhood (platelet count <100,000/μL) is the most common cause of thrombocytopenia in children. Patients typically present with bruising and bleeding in the setting of thrombocytopenia. Although it is usually short-lived, some cases persist and are unresponsive to treatment. This can lead to exposure to a variety of treatment regimens including immunosuppressants and splenectomy. The goal of this report is to present a case of chronic ITP of childhood that responded to tonsillectomy addressing the tonsils as a source of chronic infection and inflammation triggering ITP. Methods A 4-year-old male with ITP of childhood presented with enlarged tonsils and obstructive sleep apnea. History and physical were consistent with chronic tonsillitis/adenoiditis including malaise, poor oral intake, congestion, rhinorrhea, tonsil hypertrophy, and lymphadenopathy persisting despite antibiotic therapy. Tonsillectomy and adenoidectomy were performed. Results One, six, and eighteen weeks post-operatively the platelet count was 371, 215, and 205 respectively. Although at 12months two relapses had occurred, during the observed period, he had decreased incidence and severity of disease. Conclusion In around 60% of ITP there is a history of prior infection within the last month but no systemic symptoms at time of diagnosis. Additionally, chronic ITP is characterized by relapses coinciding with infection. This case is unique because the patient had chronic ITP and a clinical history and physical exam concerning for a subclinical, indolent inflammatory process that responded to surgical intervention. Given that chronic ITP exacerbation has been associated with recurrent acute infections it seems probable that chronic tonsillitis could serve as a trigger for relapse or contribute to a prolonged and/or more severe disease course. Therefore, tonsillectomy may result in earlier treatment and/or an altered disease course with avoidance of the expense and morbidity associated with frequent exacerbations and multiple treatment regimens.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2016.11.002
       
  • Fungal granulomatous disease of the nasal cavity: A case report of a rare
           entity
    • Authors: Samuel N. Helman; Peter Filip; Ameet Kamat
      Pages: 642 - 644
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      Author(s): Samuel N. Helman, Peter Filip, Ameet Kamat


      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.05.005
       
  • 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
      Pages: 645 - 647
      Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5
      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: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.06.008
       
  • Prognostic significance of standardized uptake value on F18-FDG PET/CT in
           patients with extranodal nasal type NK/T cell lymphoma: A multicenter,
           retrospective analysis
    • Authors: Kyoungjune Pak; Bum Soo Kim; Keunyoung Kim; In Joo Kim; Sungmin Jun; Young Jin Jeong; Hye Kyung Shim; Sung-Dong Kim; Kyu-Sup Cho
      Abstract: Publication date: Available online 12 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Kyoungjune Pak, Bum Soo Kim, Keunyoung Kim, In Joo Kim, Sungmin Jun, Young Jin Jeong, Hye Kyung Shim, Sung-Dong Kim, Kyu-Sup Cho
      Objectives The purpose of this study was to evaluate the value of parameters assessed with F18-flurodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in predicting relapse free survival and overall survival in patients with extranodal nasal type NK/T cell lymphoma. Methods Thirty-six patients with extranodal nasal type NK/T cell lymphoma, and who underwent PET/CT prior to curative treatment, were enrolled at five institutions. Volumes of interest covering the entire tumor volume were delineated on PET/CT images, and the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using thresholds of 40% of SUVmax. Furthermore, we compared the difference in F18-FDG avidity according to Epstein-Barr virus (EBV) infection status. Results The SUVmax (p =0.041) and SUVmean (p =0.049) in patients who died were higher than the respective values of those who survived. A higher TLG (>45.8) was associated with relapse free survival (HR 7.856, p =0.034). Ann Arbor stage (III–IV, HR 14.12, p =0.004), and a higher SUVmax (>12.6, p =0.024) and SUVmean (>6.4, p =0.024) were associated with poor survival. However, neither the MTV nor the TLG (volumetric parameters) were significant predictors of death. The PET parameters SUVmax (p =0.181), SUVmean (p =0.237), MTV (p =0.636), and TLG (p =0.469) did not differ significantly between patients with and without EBV infections. Conclusions High TLG was the only significant predictive factor on relapse free survival. The SUVmax and SUVmean measured by F18-FDG PET/CT could be significant prognostic factors in patients with extranodal nasal type NK/T cell lymphoma.

      PubDate: 2017-10-13T14:46:08Z
      DOI: 10.1016/j.amjoto.2017.10.009
       
  • Outcome of spray cryotherapy plus functional endoscopic sinus surgery on
           management of healing in nasal polyposis
    • Authors: Ahmad Rezaeian
      Abstract: Publication date: Available online 10 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Ahmad Rezaeian
      Background Nasal Polyposis is a benign tumor in nasal or paranasal mucosa, which confronts difficulties in management of healing after treatments with surgery. The aim of this study was to evaluate the effects of Spray Cryotherapy (SCT) on management of healing in patients with nasal polyposis who undergone functional endoscopic sinus surgery. Methods In this prospective, clinical trial study, we investigated on 40 patients with nasal polyposis that had indication for functional endoscopic sinus surgery. Patients were divided randomly into two parallel group; cryotherapy (with SCT) and placebo (without SCT). Evaluation of healing after surgery was evaluated with Lund-Mackay and The Sino-nasal outcome test (SNOT-22)-22 scores. Result Postoperatively, Lund-Mackay and SNOT-22 scores were significantly decreased in both groups, however these scores were significantly lower in cryotherapy group in comparison with placebo group. Also there were no reported serious side effects in both groups. Conclusion In this paper, we concluded that usage of SCT is an effective and safe method on management of healing and develops recovery rates in patients with nasal polyposis undergoing functional endoscopic sinus surgery.

      PubDate: 2017-10-13T14:46:08Z
      DOI: 10.1016/j.amjoto.2017.10.007
       
  • Endoscopic versus microscopic approach in attic cholesteatoma surgery
    • Authors: Giuseppe Magliulo; Giannicola Iannella
      Abstract: Publication date: Available online 10 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Giuseppe Magliulo, Giannicola Iannella
      Purpose Compare the outcomes of primary exclusive endoscopic ear surgery with those of the microscopic ear surgery in a group of patients affected by attic cholesteatoma. Materials and methods Eighty patients suffered from attic cholesteatoma. Forty patients surgical treated with endoscopic ear surgery and forty patients surgical treated with microscopic ear surgery. Results No statistical differences were found in the parameters analysed (frequency of facial nerve dehiscence, age, disease duration, site of dehiscence) between the endoscopic and microscopic groups indicating a homogeneous selection thus providing a good comparison of the outcomes between the two groups. None of the patients in our survey developed postoperative iatrogenic facial palsy. Graft success rate was 100% in both groups. The overall operation time of endoscopic ear surgery presented a mean value of 87.8min, while in the group of patients treated via microscopic ear surgery a lower mean value of 69.9min was reported. The average healing time was 36.3days for the endoscopic subgroup and 47.8days for the microscopic subgroup. Conclusion The surgical outcomes of endoscopic ear surgery are comparable to those of the conventional approach in terms postoperative air-conduction, graft success rate and taste sensation. The analysis of postoperative pain and healing times showed better results for EES. The mean operative times of endoscopic ear surgery gradually shortened as the surgeons gained expertise in performing one-hand surgery.

      PubDate: 2017-10-13T14:46:08Z
      DOI: 10.1016/j.amjoto.2017.10.003
       
  • Landmarks for the preservation of the middle temporal artery during
           mastoid surgery: Cadaveric dissection study
    • Authors: Pedram Daraei; Douglas E. Mattox
      Abstract: Publication date: Available online 9 October 2017
      Source:American Journal of Otolaryngology
      Author(s): Pedram Daraei, Douglas E. Mattox
      Importance The middle temporal artery flap is a vascularized periosteal flap that is highly useful for otologic reconstruction including the middle cranial fossa, mastoidectomy defect, and external auditory canal. The course of the artery is close to the external auditory canal and is easily injured during preliminary exposure and elevation of flaps. Objectives To describe the course of the middle temporal artery in relation to the external auditory canal and the superficial temporal artery in order to enhance preservation and use in otologic reconstruction. Design Dissection of preserved, injected cadaveric temporal bones. Setting Anatomical laboratory. Participants Seven cadaveric temporal bones. Intervention Temporal bones were dissected in a planar manner to identify the middle temporal artery along the squamous temporal bone to its origin. The superior border of the external auditory canal was divided, horizontally, into thirds to create three measurement points. Distances between the middle temporal artery and the bony portion of the external auditory canal were then determined. Main outcomes and measures Horizontal diameter of the external auditory canal, distance from the superior-most border of the external auditory canal to the middle temporal artery, various patterns of the middle temporal artery. Results The middle temporal artery branched from the superficial temporal artery in all specimens. Mean horizontal diameter of the external auditory canal was 9.97mm. Mean distances between the bony portion of the external auditory canal and middle temporal artery for the first, second, and third points along the horizontal diameter of the external auditory canal were 1.57, 2.96, and 4.02mm, respectively. In at least one specimen, the artery dipped into the external auditory canal. Conclusions and relevance The middle temporal artery runs closest to the external auditory canal at the anterosuperior border. To preserve the middle temporal artery for use in reconstruction after otologic surgery, the surgeon should avoid dissection superior to the external auditory canal until the artery is positively identified.

      PubDate: 2017-10-13T14:46:08Z
      DOI: 10.1016/j.amjoto.2017.10.008
       
  • The role of explorative tympanotomy in patients with sudden sensorineural
           hearing loss with and without perilymphatic fistula
    • Authors: N.K. Prenzler; B. Schwab; D.M. Kaplan; S. El-Saied
      Abstract: Publication date: Available online 9 October 2017
      Source:American Journal of Otolaryngology
      Author(s): N.K. Prenzler, B. Schwab, D.M. Kaplan, S. El-Saied
      Purpose The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome. Study design Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005. Settings Tertiary care university-affiliated hospital. Subjects and methods Eighty-two patients were diagnosed with unilateral profound SSNHL and underwent tympanotomy with sealing of the round and oval windows. Values of pure tone audiograms and percentage hearing loss of patients with and without intraoperative diagnosed perilymphatic fistula (PLF) were compared and analyzed. Results PLF was diagnosed in 28% cases intraoperatively. In most cases, hearing improved significantly after surgery. Interestingly, patients with PLF had a 2.4 times greater decrease of percentage hearing loss compared to patients without PLF. Conclusions Explorative tympanotomy seems to be useful in patients with profound SSNHL. Patients with PLF benefit more from the surgical procedure and have better outcome than patients without PLF.

      PubDate: 2017-10-13T14:46:08Z
      DOI: 10.1016/j.amjoto.2017.10.006
       
  • 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
       
  • Application of endoscopy in otology: Changes over the last 8years in
           Korean Otological Society
    • Authors: Se-Joon Oh; Eui-Kyung Goh; Hyun-Min Lee; Jae-Hoon Jung; Il Joon Moon; Jong-Woo Chung; Il-Woo Lee
      Abstract: Publication date: Available online 22 September 2017
      Source:American Journal of Otolaryngology
      Author(s): Se-Joon Oh, Eui-Kyung Goh, Hyun-Min Lee, Jae-Hoon Jung, Il Joon Moon, Jong-Woo Chung, Il-Woo Lee
      Objectives Despite the worldwide availability of endoscope in otology, it still has not replaced the microscopic surgery as it has for nose surgery. In 2008, we administered a questionnaire on the preference of using otoscopes in Korea. In light of the worldwide availability of endoscopic ear surgery, we have now conducted a more detailed survey to determine if this preference has changed over 8years. Subjects and methods A questionnaire consisting of 10 questions was used to survey members of the Korean Otological Society who were actively performing middle ear surgery. The responses to this questionnaire were compared to those from 2008. The study also determined the preference for endoscope use based on the surgeon's experience. Results The mean surgical experience of the otologists was 12.7years. Endoscopy for tympanoplasty and tympanomastoidectomy increased over a period of 8years. In the outpatient clinic, the use of endoscopy also increased; over 8-year period, it surpassed the microscope as the most preferred diagnostic tool in the outpatient clinic. Greater than half of the operating rooms were equipped with endoscopic sets; however, only 4.5% of otologists acknowledged having endoscopic instruments. Conclusion Endoscopy for surgery and in outpatient clinic assessment increased in otology in Korea; however, endoscopes have consistently been used as an adjuvant to the microscope to improve visualization of the tympanic cavity rather than as a tool for totally endoscopic ear surgery.

      PubDate: 2017-09-23T08:42:27Z
      DOI: 10.1016/j.amjoto.2017.09.008
       
  • 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
       
  • Intraoperative imaging during minimally invasive transoral robotic surgery
           using near-infrared light
    • Authors: Nicholas Scott-Wittenborn; Ryan S. Jackson
      Abstract: Publication date: Available online 6 September 2017
      Source:American Journal of Otolaryngology
      Author(s): Nicholas Scott-Wittenborn, Ryan S. Jackson
      Purpose The purpose of this study was to determine if the use of the FIREFLY imaging system could be an asset in transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). The system uses indocyanine green dye (ICG), which fluoresces when illuminated by near-infrared light from the Da Vinci robot. The system may improve visualization of tumor margins, highlight important vascular structures, and help identify the location of tumors and unknown primary head and neck cancers. Methods Six patients with OPSCC were enrolled in the study. Two of these cases were unknown primaries, one was base of tongue, and three were palatine tonsils. Each patient was given two 3ml doses of ICG, one at the beginning of the surgical case and one during resection of the tumor. The oropharynx was then visualized using the near-infrared light of the Da Vinci robot for a minute after injection. Results The FIREFLY system was unable to detect gross tumors, positive margins, unknown primaries, or vascular structures in any of the six subjects in the study. In addition, there were no adverse events or side effects in any of the subjects. Conclusion The use of the FIREFLY system with indocyanine green fluorescence did not identify tumor boundaries, unknown primary head and neck cancers, or vascular structures in the oropharynx.

      PubDate: 2017-09-11T08:32:16Z
      DOI: 10.1016/j.amjoto.2017.09.001
       
  • 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
       
  • Guidelines for Contributing Authors
    • Abstract: Publication date: September–October 2017
      Source:American Journal of Otolaryngology, Volume 38, Issue 5


      PubDate: 2017-09-11T08:32:16Z
       
  • Eosinophilic hyperplastic lymphogranuloma: Clinical diagnosis and
           treatment experience of 41 cases
    • Authors: Yang Jiang; Qingquan Hua; Jie Ren; Feng Zeng; Jianfei Sheng; Hua Liao; Zhijian Zhang; Hongxia Guan
      Abstract: Publication date: Available online 12 July 2017
      Source:American Journal of Otolaryngology
      Author(s): Yang Jiang, Qingquan Hua, Jie Ren, Feng Zeng, Jianfei Sheng, Hua Liao, Zhijian Zhang, Hongxia Guan
      Purpose The purpose of this study was to investigate the clinical features of eosinophilic hyperplastic lymphogranuloma (EHLG) in the head and neck. Materials and methods Collecting the patients who diagnose with EHLG by pathological examination. The EHLG patients with the masses involved regions, such as involved inguinal region, chest wall, abdominal wall, anterior superior iliac spine or clavicle, instead of head and neck were excluding. All of the participants will sign the informed consent form. The history data includes: clinical history, blood routine test, pathological examination, and recurrence will be collected. Results A total of 41 patients of EHLG were included. These patients predominantly presented as an enlarging and painless single or multiple masses with a history of repeated swelling. There were the complaint of itchy skin and pigmentation. The routine blood test showed that the percentage value of eosinophil increased in almost patients including 26 cases had raised absolute eosinophil count. The serum level of lgE was increased in 29 cases remarkably. With the methods of treatments, 36 patients received surgical excision, 3 patients accepted hormonotherapy, and another 2 patients for radiotherapy. The recurrence of EHLG was in 9 patients. Conclusions EHLG is a rare disease. The clinical manifestation (itchy skin and pigmentation) and increased eosinophil play critical values to the diagnosis of EHLG. Confirmed diagnosis always depends on pathological examination. Surgery is a preferred treatment, while low dose of radiotherapy is necessary for preventing relapse after operation and hormonotherapy.

      PubDate: 2017-07-12T23:45:41Z
      DOI: 10.1016/j.amjoto.2017.07.007
       
  • Total lower lip and chin reconstruction with radial forearm free flap: A
           novel approach
    • Authors: Eliza H. Dewey; Ansley M. Roche; Cathy L. Lazarus; Mark L. Urken
      Abstract: Publication date: Available online 8 July 2017
      Source:American Journal of Otolaryngology
      Author(s): Eliza H. Dewey, Ansley M. Roche, Cathy L. Lazarus, Mark L. Urken
      Background The management of large chin and lower lip defects is challenging due to this facial subunit's tremendous functional and aesthetic importance. Specific methods for total lower lip and mentum reconstruction are not well chronicled. Aesthetic and functional goals of this reconstruction include restoration of oral competence by maintaining lower lip height, vermilion reestablishment, color-matched skin introduction to the chin, sensation restoration, and ideally restoration of dynamic activity to the lower lip. Methods Literature review performed. Results Presentation of novel, two-stage technique for lower lip and chin reconstruction with a submental flap and a radial forearm free flap, suspension of the lower lip and chin with a tensor fascia lata graft, and vermilion reconstruction with a buccal mucosal flap. Conclusions This procedure meets all goals of total lower lip reconstruction with the exception of the introduction of dynamic tissue and represents a novel solution to a challenging reconstructive problem.

      PubDate: 2017-07-12T23:45:41Z
      DOI: 10.1016/j.amjoto.2017.07.004
       
  • Histopathological investigation of intranodular echogenic foci detected by
           thyroid ultrasonography
    • Authors: Suat Bilici; Ozgur Yigit; Firat Onur; Bahtiyar Hamit; Mehmet Ali Nazli; Feray Gunver; Yesim Karagoz
      Abstract: Publication date: Available online 5 July 2017
      Source:American Journal of Otolaryngology
      Author(s): Suat Bilici, Ozgur Yigit, Firat Onur, Bahtiyar Hamit, Mehmet Ali Nazli, Feray Gunver, Yesim Karagoz
      Objective To determine the predictability of sonography for detection of calcifications in thyroid nodules by histopathologic examination and to demonstrate the association between calcification pattern and malignancy. Methods We prospectively evaluated 81 dominant nodules from 81 patients. Thyroid glands were assessed preoperatively with thyroid ultrasonography, and the presence of sonographic calcification was specified as intranodular macro (coarse) and micro calcification. Micro and macro calcification in surgery specimens were specified postoperatively as present or absent in the histopathological evaluation. The correlation between sonographic and histopathologic calcifications and the relationship between malignancy and calcification patterns were determined. Results Calcification was detected histopathologically in 66.7% of the sonographically calcified nodules and in 12.8% of the sonographically noncalcified nodules. The sensitivity and specificity of sonography for detecting histopathologic calcification were 84.8 and 70.8%, respectively, while positive and negative predictive values were 66.7 and 87.2%, respectively. The sonographical and histopathological outcomes for detection of macro and micro calcification showed 85 and 50% compatibility, respectively. The difference in malignancy rates between sonographic macro and micro calcified nodules was not significant (p=0.976). Histopathologic detection of calcification showed no significant difference between malignant and benign nodules (p=0.129). Conclusion Histopathology confirmed a high rate of sonographic macrocalcifications. The micro and macro patterns of sonographic calcification showed no particular association with thyroid malignancy. The preoperative risk of malignancy should be determined in conjunction with other known sonographic risk factors and diagnostic tests.

      PubDate: 2017-07-12T23:45:41Z
      DOI: 10.1016/j.amjoto.2017.07.002
       
 
 
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