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Publisher: Sage Publications   (Total: 1079 journals)

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Showing 1 - 200 of 1079 Journals sorted alphabetically
AADE in Practice     Hybrid Journal   (Followers: 5)
Abstracts in Anthropology     Full-text available via subscription   (Followers: 21)
Academic Pathology     Open Access   (Followers: 5)
Accounting History     Hybrid Journal   (Followers: 17, SJR: 0.527, CiteScore: 1)
Acta Radiologica     Hybrid Journal   (Followers: 2, SJR: 0.754, CiteScore: 2)
Acta Radiologica Open     Open Access   (Followers: 3)
Acta Sociologica     Hybrid Journal   (Followers: 37, SJR: 0.939, CiteScore: 2)
Action Research     Hybrid Journal   (Followers: 48, SJR: 0.308, CiteScore: 1)
Active Learning in Higher Education     Hybrid Journal   (Followers: 334, SJR: 1.397, CiteScore: 2)
Adaptive Behavior     Hybrid Journal   (Followers: 10, SJR: 0.288, CiteScore: 1)
Administration & Society     Hybrid Journal   (Followers: 14, SJR: 0.675, CiteScore: 1)
Adoption & Fostering     Hybrid Journal   (Followers: 22, SJR: 0.313, CiteScore: 0)
Adsorption Science & Technology     Open Access   (Followers: 7, SJR: 0.258, CiteScore: 1)
Adult Education Quarterly     Hybrid Journal   (Followers: 201, SJR: 0.566, CiteScore: 2)
Adult Learning     Hybrid Journal   (Followers: 39)
Advances in Dental Research     Hybrid Journal   (Followers: 7, SJR: 1.791, CiteScore: 4)
Advances in Developing Human Resources     Hybrid Journal   (Followers: 29, SJR: 0.614, CiteScore: 2)
Advances in Mechanical Engineering     Open Access   (Followers: 131, SJR: 0.272, CiteScore: 1)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 9)
Advances in Structural Engineering     Full-text available via subscription   (Followers: 46, SJR: 0.599, CiteScore: 1)
Advances in Tumor Virology     Open Access   (Followers: 3, SJR: 0.108, CiteScore: 0)
AERA Open     Open Access   (Followers: 9)
Affilia     Hybrid Journal   (Followers: 4, SJR: 0.496, CiteScore: 1)
Agrarian South : J. of Political Economy     Hybrid Journal   (Followers: 2)
Air, Soil & Water Research     Open Access   (Followers: 14, SJR: 0.214, CiteScore: 1)
Alexandria : The J. of National and Intl. Library and Information Issues     Full-text available via subscription   (Followers: 63)
AlterNative : An Intl. J. of Indigenous Peoples     Full-text available via subscription   (Followers: 11, SJR: 0.194, CiteScore: 0)
Alternative Law J.     Hybrid Journal   (Followers: 9, SJR: 0.176, CiteScore: 0)
Alternatives : Global, Local, Political     Hybrid Journal   (Followers: 12, SJR: 0.351, CiteScore: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 22, SJR: 0.982, CiteScore: 2)
American Economist     Hybrid Journal   (Followers: 5)
American Educational Research J.     Hybrid Journal   (Followers: 197, SJR: 2.913, CiteScore: 3)
American J. of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 18, SJR: 0.67, CiteScore: 2)
American J. of Cosmetic Surgery     Hybrid Journal   (Followers: 6)
American J. of Evaluation     Hybrid Journal   (Followers: 16, SJR: 0.646, CiteScore: 2)
American J. of Health Promotion     Hybrid Journal   (Followers: 31, SJR: 0.807, CiteScore: 1)
American J. of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 41, SJR: 0.65, CiteScore: 1)
American J. of Law & Medicine     Full-text available via subscription   (Followers: 11, SJR: 0.204, CiteScore: 1)
American J. of Lifestyle Medicine     Hybrid Journal   (Followers: 5, SJR: 0.431, CiteScore: 1)
American J. of Medical Quality     Hybrid Journal   (Followers: 10, SJR: 0.777, CiteScore: 1)
American J. of Men's Health     Open Access   (Followers: 8, SJR: 0.595, CiteScore: 2)
American J. of Rhinology and Allergy     Hybrid Journal   (Followers: 9, SJR: 0.972, CiteScore: 2)
American J. of Sports Medicine     Hybrid Journal   (Followers: 183, SJR: 3.949, CiteScore: 6)
American Politics Research     Hybrid Journal   (Followers: 33, SJR: 1.313, CiteScore: 1)
American Review of Public Administration     Hybrid Journal   (Followers: 18, SJR: 2.062, CiteScore: 2)
American Sociological Review     Hybrid Journal   (Followers: 295, SJR: 6.333, CiteScore: 6)
American String Teacher     Full-text available via subscription   (Followers: 2)
Analytical Chemistry Insights     Open Access   (Followers: 25, SJR: 0.224, CiteScore: 1)
Angiology     Hybrid Journal   (Followers: 3, SJR: 0.849, CiteScore: 2)
Animation     Hybrid Journal   (Followers: 13, SJR: 0.197, CiteScore: 0)
Annals of Clinical Biochemistry     Hybrid Journal   (Followers: 9, SJR: 0.634, CiteScore: 1)
Annals of Otology, Rhinology & Laryngology     Hybrid Journal   (Followers: 15, SJR: 0.807, CiteScore: 1)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 51, SJR: 1.096, CiteScore: 2)
Annals of the American Academy of Political and Social Science     Hybrid Journal   (Followers: 46, SJR: 1.225, CiteScore: 3)
Annals of the ICRP     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Anthropocene Review     Hybrid Journal   (Followers: 9, SJR: 3.341, CiteScore: 7)
Anthropological Theory     Hybrid Journal   (Followers: 41, SJR: 0.739, CiteScore: 1)
Antitrust Bulletin     Full-text available via subscription   (Followers: 10)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2, SJR: 0.635, CiteScore: 2)
Antyajaa : Indian J. of Women and Social Change     Hybrid Journal  
Applied Biosafety     Hybrid Journal   (SJR: 0.131, CiteScore: 0)
Applied Psychological Measurement     Hybrid Journal   (Followers: 23, SJR: 1.17, CiteScore: 1)
Applied Spectroscopy     Full-text available via subscription   (Followers: 26, SJR: 0.489, CiteScore: 2)
Armed Forces & Society     Hybrid Journal   (Followers: 16, SJR: 0.29, CiteScore: 1)
Arts and Humanities in Higher Education     Hybrid Journal   (Followers: 40, SJR: 0.305, CiteScore: 1)
Asia Pacific Media Educator     Hybrid Journal   (Followers: 1, SJR: 0.23, CiteScore: 0)
Asia-Pacific J. of Management Research and Innovation     Full-text available via subscription   (Followers: 3)
Asia-Pacific J. of Public Health     Hybrid Journal   (Followers: 9, SJR: 0.558, CiteScore: 1)
Asian and Pacific Migration J.     Full-text available via subscription   (Followers: 99, SJR: 0.324, CiteScore: 1)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2, SJR: 0.305, CiteScore: 0)
Asian J. of Comparative Politics     Hybrid Journal   (Followers: 4)
Asian J. of Legal Education     Full-text available via subscription   (Followers: 4)
Asian J. of Management Cases     Hybrid Journal   (Followers: 6, SJR: 0.101, CiteScore: 0)
ASN Neuro     Open Access   (Followers: 2, SJR: 1.534, CiteScore: 3)
Assessment     Hybrid Journal   (Followers: 16, SJR: 1.519, CiteScore: 3)
Assessment for Effective Intervention     Hybrid Journal   (Followers: 15, SJR: 0.578, CiteScore: 1)
Australasian Psychiatry     Hybrid Journal   (Followers: 9, SJR: 0.433, CiteScore: 1)
Australian & New Zealand J. of Psychiatry     Hybrid Journal   (Followers: 18, SJR: 1.801, CiteScore: 2)
Australian and New Zealand J. of Criminology     Hybrid Journal   (Followers: 518, SJR: 0.612, CiteScore: 1)
Australian J. of Career Development     Hybrid Journal   (Followers: 4)
Australian J. of Education     Hybrid Journal   (Followers: 42, SJR: 0.403, CiteScore: 1)
Australian J. of Management     Hybrid Journal   (Followers: 12, SJR: 0.497, CiteScore: 1)
Autism     Hybrid Journal   (Followers: 306, SJR: 1.739, CiteScore: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 10)
Behavior Modification     Hybrid Journal   (Followers: 12, SJR: 0.877, CiteScore: 2)
Behavioral and Cognitive Neuroscience Reviews     Hybrid Journal   (Followers: 25)
Bible Translator     Hybrid Journal   (Followers: 12)
Biblical Theology Bulletin     Hybrid Journal   (Followers: 18, SJR: 0.184, CiteScore: 0)
Big Data & Society     Open Access   (Followers: 47)
Biochemistry Insights     Open Access   (Followers: 7)
Bioinformatics and Biology Insights     Open Access   (Followers: 12, SJR: 1.141, CiteScore: 2)
Biological Research for Nursing     Hybrid Journal   (Followers: 7, SJR: 0.685, CiteScore: 2)
Biomarker Insights     Open Access   (Followers: 1, SJR: 0.81, CiteScore: 2)
Biomarkers in Cancer     Open Access   (Followers: 9)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 13)
Biomedical Informatics Insights     Open Access   (Followers: 8)
Bioscope: South Asian Screen Studies     Hybrid Journal   (Followers: 3, SJR: 0.235, CiteScore: 0)
BMS: Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique     Hybrid Journal   (Followers: 4, SJR: 0.226, CiteScore: 0)
Body & Society     Hybrid Journal   (Followers: 25, SJR: 1.531, CiteScore: 3)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Breast Cancer : Basic and Clinical Research     Open Access   (Followers: 8, SJR: 0.823, CiteScore: 2)
British J. of Music Therapy     Hybrid Journal   (Followers: 8)
British J. of Occupational Therapy     Hybrid Journal   (Followers: 173, SJR: 0.323, CiteScore: 1)
British J. of Pain     Hybrid Journal   (Followers: 25, SJR: 0.579, CiteScore: 2)
British J. of Politics and Intl. Relations     Hybrid Journal   (Followers: 31, SJR: 0.91, CiteScore: 2)
British J. of Visual Impairment     Hybrid Journal   (Followers: 13, SJR: 0.337, CiteScore: 1)
British J.ism Review     Hybrid Journal   (Followers: 17)
Building Acoustics     Hybrid Journal   (Followers: 4, SJR: 0.215, CiteScore: 1)
Building Services Engineering Research & Technology     Hybrid Journal   (Followers: 3, SJR: 0.583, CiteScore: 1)
Bulletin of Science, Technology & Society     Hybrid Journal   (Followers: 7)
Business & Society     Hybrid Journal   (Followers: 12)
Business and Professional Communication Quarterly     Hybrid Journal   (Followers: 7, SJR: 0.348, CiteScore: 1)
Business Information Review     Hybrid Journal   (Followers: 15, SJR: 0.279, CiteScore: 0)
Business Perspectives and Research     Hybrid Journal   (Followers: 2)
Cahiers Élisabéthains     Hybrid Journal   (Followers: 1, SJR: 0.111, CiteScore: 0)
Calcutta Statistical Association Bulletin     Full-text available via subscription  
California Management Review     Hybrid Journal   (Followers: 30, SJR: 2.209, CiteScore: 4)
Canadian J. of Kidney Health and Disease     Open Access   (Followers: 6, SJR: 1.007, CiteScore: 2)
Canadian J. of Nursing Research (CJNR)     Hybrid Journal   (Followers: 13)
Canadian J. of Occupational Therapy     Hybrid Journal   (Followers: 123, SJR: 0.626, CiteScore: 1)
Canadian J. of Psychiatry     Hybrid Journal   (Followers: 26, SJR: 1.769, CiteScore: 3)
Canadian J. of School Psychology     Hybrid Journal   (Followers: 11, SJR: 0.266, CiteScore: 1)
Canadian Pharmacists J. / Revue des Pharmaciens du Canada     Hybrid Journal   (Followers: 3, SJR: 0.536, CiteScore: 1)
Cancer Growth and Metastasis     Open Access   (Followers: 1)
Cancer Informatics     Open Access   (Followers: 4, SJR: 0.64, CiteScore: 1)
Capital and Class     Hybrid Journal   (Followers: 7, SJR: 0.282, CiteScore: 1)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiovascular and Thoracic Open     Open Access  
Career Development and Transition for Exceptional Individuals     Hybrid Journal   (Followers: 8, SJR: 0.44, CiteScore: 1)
Cartilage     Hybrid Journal   (Followers: 5, SJR: 0.889, CiteScore: 3)
Cell and Tissue Transplantation and Therapy     Open Access   (Followers: 2)
Cell Transplantation     Open Access   (Followers: 4, SJR: 1.023, CiteScore: 3)
Cephalalgia     Hybrid Journal   (Followers: 7, SJR: 1.581, CiteScore: 3)
Child Language Teaching and Therapy     Hybrid Journal   (Followers: 31, SJR: 0.501, CiteScore: 1)
Child Maltreatment     Hybrid Journal   (Followers: 9, SJR: 1.22, CiteScore: 3)
Child Neurology Open     Open Access   (Followers: 6)
Childhood     Hybrid Journal   (Followers: 18, SJR: 0.894, CiteScore: 2)
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
China Information     Hybrid Journal   (Followers: 7, SJR: 0.767, CiteScore: 2)
China Report     Hybrid Journal   (Followers: 10, SJR: 0.221, CiteScore: 0)
Chinese J. of Sociology     Full-text available via subscription   (Followers: 4)
Christianity & Literature     Full-text available via subscription   (Followers: 7)
Chronic Illness     Hybrid Journal   (Followers: 6, SJR: 0.672, CiteScore: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 6, SJR: 0.808, CiteScore: 2)
Chronic Stress     Open Access  
Citizenship, Social and Economics Education     Full-text available via subscription   (Followers: 6, SJR: 0.145, CiteScore: 0)
Cleft Palate-Craniofacial J.     Hybrid Journal   (Followers: 7, SJR: 0.757, CiteScore: 1)
Clin-Alert     Hybrid Journal   (Followers: 1)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 16, SJR: 0.49, CiteScore: 1)
Clinical Case Studies     Hybrid Journal   (Followers: 3, SJR: 0.364, CiteScore: 1)
Clinical Child Psychology and Psychiatry     Hybrid Journal   (Followers: 44, SJR: 0.73, CiteScore: 2)
Clinical EEG and Neuroscience     Hybrid Journal   (Followers: 6, SJR: 0.552, CiteScore: 2)
Clinical Ethics     Hybrid Journal   (Followers: 10, SJR: 0.296, CiteScore: 1)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3, SJR: 0.537, CiteScore: 2)
Clinical Medicine Insights : Blood Disorders     Open Access   (SJR: 0.314, CiteScore: 2)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6, SJR: 0.686, CiteScore: 2)
Clinical Medicine Insights : Case Reports     Open Access   (Followers: 1, SJR: 0.283, CiteScore: 1)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 3, SJR: 0.425, CiteScore: 2)
Clinical Medicine Insights : Ear, Nose and Throat     Open Access   (Followers: 1)
Clinical Medicine Insights : Endocrinology and Diabetes     Open Access   (Followers: 32, SJR: 0.63, CiteScore: 2)
Clinical Medicine Insights : Oncology     Open Access   (Followers: 3, SJR: 1.129, CiteScore: 3)
Clinical Medicine Insights : Pediatrics     Open Access   (Followers: 3)
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 9)
Clinical Medicine Insights : Reproductive Health     Open Access   (Followers: 2, SJR: 0.776, CiteScore: 0)
Clinical Medicine Insights : Therapeutics     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 2)
Clinical Medicine Insights : Women's Health     Open Access   (Followers: 4)
Clinical Nursing Research     Hybrid Journal   (Followers: 29, SJR: 0.471, CiteScore: 1)
Clinical Pathology     Open Access   (Followers: 3)
Clinical Pediatrics     Hybrid Journal   (Followers: 22, SJR: 0.487, CiteScore: 1)
Clinical Psychological Science     Hybrid Journal   (Followers: 11, SJR: 3.281, CiteScore: 5)
Clinical Rehabilitation     Hybrid Journal   (Followers: 69, SJR: 1.322, CiteScore: 3)
Clinical Risk     Hybrid Journal   (Followers: 5, SJR: 0.133, CiteScore: 0)
Clinical Trials     Hybrid Journal   (Followers: 21, SJR: 2.399, CiteScore: 2)
Clothing and Textiles Research J.     Hybrid Journal   (Followers: 23, SJR: 0.36, CiteScore: 1)
Common Law World Review     Full-text available via subscription   (Followers: 18)
Communication & Sport     Hybrid Journal   (Followers: 8, SJR: 0.385, CiteScore: 1)
Communication and the Public     Hybrid Journal   (Followers: 1)
Communication Disorders Quarterly     Hybrid Journal   (Followers: 15, SJR: 0.458, CiteScore: 1)
Communication Research     Hybrid Journal   (Followers: 20, SJR: 2.171, CiteScore: 3)
Community College Review     Hybrid Journal   (Followers: 8, SJR: 1.451, CiteScore: 1)
Comparative Political Studies     Hybrid Journal   (Followers: 217, SJR: 3.772, CiteScore: 3)
Compensation & Benefits Review     Hybrid Journal   (Followers: 8)
Competition & Change     Hybrid Journal   (Followers: 11, SJR: 0.843, CiteScore: 2)
Competition and Regulation in Network Industries     Full-text available via subscription   (Followers: 8, SJR: 0.143, CiteScore: 0)
Concurrent Engineering     Hybrid Journal   (Followers: 3, SJR: 0.642, CiteScore: 2)
Conflict Management and Peace Science     Hybrid Journal   (Followers: 35, SJR: 2.441, CiteScore: 1)
Contemporary Drug Problems     Full-text available via subscription   (Followers: 2, SJR: 0.609, CiteScore: 2)
Contemporary Education Dialogue     Hybrid Journal   (Followers: 5, SJR: 0.102, CiteScore: 0)
Contemporary Issues in Early Childhood     Full-text available via subscription   (Followers: 6, SJR: 0.766, CiteScore: 1)
Contemporary Review of the Middle East     Full-text available via subscription   (Followers: 12)
Contemporary Sociology : A J. of Reviews     Full-text available via subscription   (Followers: 34, SJR: 0.195, CiteScore: 0)
Contemporary Voice of Dalit     Full-text available via subscription  
Contexts     Hybrid Journal   (Followers: 6)
Contributions to Indian Sociology     Hybrid Journal   (Followers: 4, SJR: 0.376, CiteScore: 0)
Convergence The Intl. J. of Research into New Media Technologies     Hybrid Journal   (Followers: 50, SJR: 0.521, CiteScore: 1)
Cooperation and Conflict     Hybrid Journal   (Followers: 21, SJR: 0.945, CiteScore: 2)
Cornell Hospitality Quarterly     Hybrid Journal   (Followers: 8, SJR: 1.198, CiteScore: 2)
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 12, SJR: 0.279, CiteScore: 1)

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Similar Journals
Journal Cover
Annals of Otology, Rhinology & Laryngology
Journal Prestige (SJR): 0.807
Citation Impact (citeScore): 1
Number of Followers: 15  
 
Hybrid Journal Hybrid journal   * Containing 2 Open Access Open Access article(s) in this issue *
ISSN (Print) 0003-4894 - ISSN (Online) 1943-572X
Published by Sage Publications Homepage  [1079 journals]
  • Incidence and Radiological Findings of Incidental Sinus Opacifications in
           Patients Undergoing Septoplasty or Septorhinoplasty
    • Authors: Sung Hee Kim, Jin Seok Oh, Yong Ju Jang
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Although the routine use of computed tomography (CT) is controversial, it is employed in the preoperative screening of patients undergoing septoplasty or septorhinoplasty. The aim of this study was to evaluate the incidence and radiological characteristics of incidentally found sinus pathologies on screening CT in patients who underwent elective septoplasty or septorhinoplasty.Methods:We retrospectively reviewed the patients who underwent septoplasty and septorhinoplasty performed by a single surgeon (Y.J.J.) at Asan Medical Center between January 2016 and December 2017. CT images of 372 patients who had agreed to undergo preoperative CT were reviewed to determine the location and extent of incidental sinus opacifications.Results:Of the 372 patients, 107 (28.8%) showed incidental sinus lesions on CT images. Opacifications were mainly found in the maxillary sinus (73, 68.2%), followed by the ethmoid (34, 31.8%), sphenoid (10, 9.3%), and frontal (3, 2.8%) sinuses. The most common sinus lesion was retention cyst (55, 51.4%), and the second most common one was opacification and mucosal thickening (46, 43%). Other lesions such as osteoma (3, 2.8%), dental cyst (2, 1.9%), and mucocele (1, 0.9%) were rarely found.Conclusions:In patients undergoing septoplasty or septorhinoplasty, the incidence of incidental sinus lesions was approximately 28.8% (107/372). This results indicate that preoperative CT in patients undergoing septoplasty or septorhinoplasty might be helpful to surgeons not only for better understanding the anatomical detail but also for detecting hidden paranasal sinus disease.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-21T05:17:39Z
      DOI: 10.1177/0003489419878453
       
  • Assessment of Tracheostomy and Laryngectomy Knowledge among
           Non-Otolaryngology Physicians
    • Authors: Tsung-yen Hsieh, Leah Timbang, Maggie Kuhn, Hilary Brodie, Lane Squires
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:Identify knowledge deficits about alternate airways (AAs) (tracheostomy and laryngectomy) among physicians across multiple specialties a tertiary institution and to assess the impact of an educational lecture on improving deficits.Methods:Study Design: Cross-sectional assessment. Setting: Academic medical center. Subjects and Methods: An anonymous 10-item, multiple choice assessment was given to physicians at a tertiary care center in the departments of Otolaryngology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, and Pediatrics. An educational lecture on AAs was presented. Scores between a pre-lecture and a 3-month post-lecture assessment were compared. Data was analyzed using ANOVA and chi-squared analysis.Results:Otolaryngology physicians scored an average of 97.8%, while non-otolaryngology physicians scored 58.3% (P < .05). Non-otolaryngology surgical physicians scored 68.4% while non-surgical physicians were lower at 55.1% (P < .0001). Comparing pre-lecture to post-lecture scores, all non-otolaryngology physicians improved their scores significantly from 58.3% to 86.5% (P < .005). Non-surgical physicians had significant improvement after the instructional lecture, closing the score gap with surgical physicians for the post-lecture assessment.Discussion:The care of patients with AAs requires an understanding of their basic principles. Our findings identify significant knowledge deficits among non-otolaryngologists. Through an instructional lecture, we demonstrated improvement in knowledge among non-otolaryngology physicians and durability of the knowledge after 3 months.Conclusions:Through an instructional lecture, we found tracheostomy and laryngectomy knowledge deficits can be identified and improved upon. Periodic reinforcement of basic principles for non-otolaryngology physicians may be a promising strategy to ensure the proper care of patients with AAs.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-17T06:11:30Z
      DOI: 10.1177/0003489419877198
       
  • Revisit Rates for Pediatric Tonsillectomy: An Analysis of Admit and
           Discharge Times
    • Authors: Sapideh Gilani, Neil Bhattacharyya
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:To determine the association between intraday timing of outpatient pediatric tonsillectomy and revisit outcomes and complications.Study Design:Cross-sectional analysis of New York databases.Setting:Ambulatory surgery, emergency department and inpatient hospital settings.Subjects and Methods:The State Ambulatory Surgery, State Emergency Department and State Inpatient Databases for 2010-2011 were analyzed for revisits. Outcomes assessed were revisits for any reason, bleeding, acute pain or fever, nausea, vomiting and dehydration. The relationships between the hour of admission for surgery, the hour of discharge and the revisit outcomes were analyzed.Results:The study included 33,611 children (mean age, 6.62 years; 45.7% female) and 62.0% were admitted in the early morning. Discharges were most common in the early afternoon (28.3%). Revisit rates were significantly higher for the early evening discharges (6.0%) versus late morning discharges (3.1%) (P 
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-17T06:10:42Z
      DOI: 10.1177/0003489419875758
       
  • Microlaryngeal Teaching Courses: A National Survey on Prevalence, Value,
           and Barriers to Implementation
    • Authors: Vaninder K. Dhillon, Seth H. Dailey, Lee M. Akst
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:To assess the prevalence of microlaryngeal teaching course in Accreditation Council for Graduate Medical Education (ACGME)-accredited otolaryngology residency programs in an effort to evaluate the nature, perceived value and barriers to implementation of microlaryngeal courses.Method:A 14-question survey to all ACGME-accredited otolaryngology programs in the United States.Result:Out of 119 ACGME-accredited otolaryngology programs identified on the ACGME Fellowship and Residency Electronic Interactive Database, responses were received from 67 programs (56%). Although 90% of respondents indicated that instruction courses in one discipline or another existed at their institution for their otolaryngology residents, only 33% indicated that their program offers a hands-on instruction course in microlaryngeal surgery. Of those programs that offered a microlaryngeal surgery course, 100% felt the residents appreciated the course; 95% of those programs that did not have a course felt their residents would appreciate a microlaryngeal course at their institution if they were able to offer one. Among programs without a microlaryngeal teaching course, the largest perceived barriers were cost and availability of appropriate equipment.Conclusion:Microlaryngeal courses for otolaryngology residency training are limited in availability in the United States, and there is variability in training across the country. All respondents in our survey indicated the value in these courses for microlaryngeal surgical skill training. There is a clear role for increasing availability of low-cost microlaryngeal stations and courses.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-16T04:30:04Z
      DOI: 10.1177/0003489419876290
       
  • Atypical Laryngeal Infections: Localized Lesions from Unusual Organisms
           May Simulate Malignancy
    • Authors: Kenneth Yan, Jerome B. Taxy, Ajit Paintal, Aaron D. Friedman
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:The identification of rare sources of laryngeal infection in immunocompetent patients. Recovered organisms were Mycobacterium tuberculosis (laryngeal tuberculosis [LTB]), Mycobacterium fortuitum (laryngeal Mycobacterium fortuitum [LMF]), and Blastomyces dermatiditis (laryngeal blastomycosis [LB]).Method:Single institution retrospective case series of three patients over a 2.5-year period and review of the literature on laryngeal infections by three atypical organisms.Results:Three patients presented with hoarseness and cough; one additionally had throat pain (LTB). Indirect laryngoscopy demonstrated diffuse laryngeal ulceration (LTB, LMF) and an exophytic, contiguous glottic mass (LB). Direct microlaryngoscopic biopsies and cultures established the diagnoses, including a frozen section in one case (LB), which prevented a simultaneously planned surgical resection. Appropriate antimicrobial therapy yielded dramatic laryngeal and corresponding vocal improvement, for which we provide unique photo and audio documentation. In the last 10 years, fewer than 500 cases of LTB have been reported in the English language medical literature, principally outside the United States. To date, there have been reports of only 34 LB and no cases of LMF.Conclusion:Atypical infections of the larynx may be localized and mimic laryngeal cancer on endoscopy. Tissue examination as well as microbiologic samples are diagnostic and complementary.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-14T11:42:49Z
      DOI: 10.1177/0003489419875755
       
  • A Practical Mathematic Method to Predict and Manage Hypocalcemia After
           Parathyroidectomy and Thyroidectomy
    • Authors: Changxing Liu, Liyang Tang, Pedram Goel, Tamara Chambers, Niels Kokot, Uttam Sinha, Dennis Maceri
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:Prediction and early intervention for hypocalcemia following parathyroidectomy and total thyroidectomy can decrease hospital cost and prevent severe hypocalcemia-related complications. This study aims to predict the severity of hypocalcemia after parathyroidectomy or thyroidectomy and to stratify patients into groups with different levels of risk for developing severe hypocalcemia, so that higher risk patients may be monitored more closely and receive earlier interventions.Methods:This was a retrospective cohort study of 100 patients with primary hyperparathyroidism who underwent parathyroidectomy as the primary treatment modality at a tertiary care hospital. Clinical information, including demographic information, perioperative PTH and calcium levels, vitamin D levels, weight of the pathologic glands removed, gland pathology, and re-admission rates, were retrieved. Statistical analysis was performed to analyze the association between collected variables and percentage of calcium drop following parathyroidectomy with statistical significant set at P-values  0.7. The formula has been tested primarily in our patient population with good reliability.Conclusions:The highest preoperative, lowest postoperative, and change in PTH level can help us reliably calculate the trend of postoperative calcium level. Decision to pursue early interventions can be made based on the calculated result from the formula we obtained.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-12T05:57:28Z
      DOI: 10.1177/0003489419876291
       
  • An Anatomic Variant of the Ansa Cervicalis Precluding Its Use as a Donor
           Nerve
    • Authors: Alexander Zhu, Suresh Mohan, Jeremy D. Richmon, Nate Jowett
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Background:The ansa cervicalis is useful for cranial nerve repair, and may be harvested without apparent morbidity. Herein we report an unusual and surgically relevant anatomic variant of the ansa cervicalis.Methods:An adult male with left parotid adenoid cystic carcinoma underwent parotidectomy with upper-division facial nerve resection and planned interposition repair using the ansa cervicalis. The ipsilateral hypoglossal nerve was identified, together with a descending branch producing strap muscle contraction when stimulated. This presumed descendens hypoglossi was unusually large in caliber; further dissection revealed continuity with the vagus nerve.Results:Ansa cervicalis harvest was aborted when its separation from vagus nerve epineurium was not possible. The sural nerve was alternatively harvested. The patient awoke with left vocal fold palsy, which completely resolved within 3 months.Conclusion:Anatomic variants of the ansa cervicalis exist that may preclude graft harvest and place the vagus nerve at risk of inadvertent injury.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-12T05:55:07Z
      DOI: 10.1177/0003489419875975
       
  • Repair of the Protruding Lobule
    • Authors: Hermann Raunig, Grant S. Hamilton
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Background:In this paper, the author describes a novel step-by-step setback procedure for correcting protruding lobules; the success of correcting protruding lobules depends on the nature and severity of the auricular lobule deformity. Although the auricular lobules occupy small areas on either side of the head, protruding or misshapen lobules exert a significant and sometimes exaggerated disfiguring influence on the otherwise aesthetically pleasing appearance of the ears. Because the lobule is a soft structure without a cartilage skeleton, the correction of a protruding ear and lobule is always a challenge.Methods:Protruding lobule abnormalities stem from deformities of the cauda helicis (cartilaginous helical tail) of the auricular lobule, soft tissue, and/or a shortage of anterior skin; however, the abnormalities are usually a combination of all of the above. Therefore, surgical procedures should address all of the causes of lobule deformity and preserve as much tissue and blood supply as possible. Achieving a successful intervention depends on reducing the tension that affects the entire lobule.Results:This is a retrospective analysis of 660 patients who had otoplasty performed by the first author between January 2010 and December 2017. Correction of the ear lobule was needed in 398 (60.3%) patients. Of these, 44.6% patients were male, 55.4% female and the average age was 9 years (range 4-18 years). In this patient cohort, 356 (89.4%) required bilateral and 42 (10.5%) unilateral ear lobule correction. Standardized pre- and postoperative images were recorded for each patient.Conclusion:The goal of a setback procedure is a natural and harmonious auricular lobule appearance that is achieved through simple, optimal surgery that addresses all of the features of the auricular anatomy.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-10T12:48:02Z
      DOI: 10.1177/0003489419875160
       
  • How Pediatric Anesthesiologists Manage Children with OSA Undergoing
           Tonsillectomy
    • Authors: Christopher Roberts, Raihanah Al Sayegh, Pavithra Ranganathan Ellison, Khaled Sedeek, Michele M. Carr
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:The purpose of this study was to describe typical anesthesia practices for children with obstructive sleep apnea (OSA).Study Design:Online surveyMethod:A sample of pediatric anesthesiologists received the survey by email.Results:110 respondents were included. 46.4% worked in a free-standing children’s hospital and 32.7% worked in a children’s facility within a general hospital. 73.6% taught residents. 44.4% saw at least one child with OSA per week, 25.5% saw them daily. On a 100-mm visual analog scale, respondents rated their comfort with managing these children as 84.94 (SD 17.59). For children with severe OSA, 53.6% gave oral midazolam preoperatively, but 24.5% typically withheld premedication and had the parent present for induction. 68.2% would typically use nitrous oxide for inhalational induction. 68.2% used fentanyl intraoperatively, while 20.0% used morphine. 61.5% reduced their intraop narcotic dose for children with OSA. 98.2% used intraoperative dexamethasone, 58.2% used 0.5 mg/kg for the dose. 98.2% used ondansetron, 62.7% used IV acetaminophen, and 8.2% used IV NSAIDs. 83.6% extubated awake. 27.3% of respondents stated that their institution had standardized guidelines for perioperative management of children with OSA undergoing adenotonsillectomy.People who worked in children’s hospitals, who had>10 years of experience, or who saw children with OSA frequently were significantly more comfortable dealing with children with OSA (P < 0.05).Conclusion:Apart from using intraoperative dexamethasone and ondansetron, management varied. These children would likely benefit from best practices perioperative management guidelines.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-05T11:29:36Z
      DOI: 10.1177/0003489419874371
       
  • Comments on “Nasolacrimal Duct Management During Endoscopic Sinus and
           Skull Base Surgery”
    • Authors: Diego Cazzador, Daniele Borsetto, Enrico Alexandre, Francesca Angela Chiumenti, Alessandro Pusateri, Fabio Pagella, Enzo Emanuelli
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-09-05T11:28:57Z
      DOI: 10.1177/0003489419873353
       
  • Letter to the Editor Regarding “Sublingual Immunotherapy Attenuates
           Nasal Symptoms upon Allergen Exposure in Murine Allergic Rhinitis Model
           via an Induction of IL-10 producing T cells in Submandibular Lymph Node”
           
    • Authors: GuanYang Kang
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-31T06:14:42Z
      DOI: 10.1177/0003489419874378
       
  • Response to: Comments on “Nasolacrimal Duct Management During Endoscopic
           Sinus and Skull Base Surgery”
    • Authors: Seth M. Lieberman, Janine M. Rotsides, Alexa Franco, Roy R. Casiano
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-31T06:14:22Z
      DOI: 10.1177/0003489419873000
       
  • Validation of Animal Models for Simulation Training in Pediatric
           Laryngotracheal Reconstruction
    • Authors: Saleh Okhovat, Thomas D. Milner, William A. Clement, David M. Wynne, Thushitha Kunanandam
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To assess and compare the face (FV) and content validity (CV) of three ex vivo animal models for simulation training in pediatric laryngotracheal reconstruction (LTR).Methods:Feasibility of performing LTR was assessed on the head and neck of three different animals (lamb/suckling-pig/rabbit) and laryngeal dimensions and qualitative observations were recorded. A 19-item five-point Likert scale questionnaire was completed for each model to assess FV and CV. Data was prospectively collected and analyzed using descriptive and nonparametric statistics.Results:All three models were suitable for LTR simulation with laryngeal dimensions corresponding to 0-2 years (rabbit), 5-10 (pig) and>10 years (lamb model). Five trainees and five expert pediatric otolaryngologists performed LTR on each model. The overall median FV score was 5 for the lamb model (IQR 4-5), 3 for the rabbit (IQR 2-3), and 4 for the pig (IQR 4-4). The overall median CV score was 5 for the lamb (IQR 5-5), 2 for the rabbit (IQR 2-3), and 4 for the pig model (IQR 4-4). Comparison of the models demonstrated the lamb to be favored as the most realistic and practical model for simulation training in pediatric LTR, with both the lamb and the porcine model attaining validation thresholds.Conclusion:Our study is the first comparative validation assessment of animal models for use in pediatric LTR simulation and it supports the use of ex vivo lamb and porcine models for use in LTR surgical skills training. The lamb model was the favored simulation model while the rabbit was considered inferior for simulation training in pediatric LTR.Level of Evidence:3b
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-30T08:17:52Z
      DOI: 10.1177/0003489419870820
       
  • Affordable Rapid Olfaction Measurement Array: A Novel, Essential Oil-Based
           Test Strongly Correlated with UPSIT and Subjective Outcome Measures
    • Authors: Jennifer A. Villwock, Jennifer Li, Chelsea Moore, Alexander G. Chiu, Kevin J. Sykes
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Background:Olfactory dysfunction is an important facet of numerous disease states ranging from sinonasal disease to neurocognitive disorders. Due to expense and/or logistical barriers, objective olfactory testing is not common. We describe the creation of a novel, essential oil-based smell test, Affordable Rapid Olfaction Measurement Array (AROMA), composed at 14 scents at different concentrations and demonstrate correlation of AROMA with the University of Pennsylvania Smell Identification Test (UPSIT), patient age, Sinonasal Outcomes Test (SNOT-22), and perceived loss of smell.Methods:AROMA was developed for point-of-care olfactory testing and compared to the UPSIT, as well as subjective outcome measures as noted above. About 37 healthy controls were prospectively recruited to assess the reliability of AROMA using a test–retest protocol. An additional cohort of 38 participants with sinonasal disease were prospectively recruited to complete the AROMA and UPSIT, and were compared with a cohort of 30 healthy controls. Spearman correlation correlated AROMA and UPSIT results, patient age, SNOT-22, and perceived loss of smell.Results:AROMA demonstrated good test–retest reliability (r = 0.85, P < .001). Spearman’s rho correlation of AROMA to UPSIT was statistically significant at ρ = 0.75 (P < .001). SNOT-22, age, and perceived sense of smell were all significantly correlated with both AROMA (ρ = −0.548, −0.557, −0.642, respectively) and UPSIT (ρ = −0.367, −0.460, −0.552, respectively).Conclusion:AROMA has a strong correlation with UPSIT and may be more strongly correlated with sinonasal outcomes. Additionally, AROMA is reusable; level of odorant is not static; and AROMA can test both odor detection and identification.Level of evidence:2b
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-16T07:03:47Z
      DOI: 10.1177/0003489419870833
       
  • Rhinotillexomania Manifesting as Empty Nose Syndrome
    • Authors: Eve Tranchito, Nipun Chhabra
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To highlight a severe case of rhinotillexomania (compulsive nasal picking) and its potential to manifest as empty nose syndrome (ENS).Methods:A single case report with the presentation and management of a patient with severe rhinotillexomania who presented with chronic obstructive symptoms. We review the current literature on rhinotillexomania and ENS.Results:This patient’s manifestations mimic the obstructive symptoms of ENS, despite widely patent nasal passages.Conclusion:This is the first report of rhinotillexomania manifesting with features of ENS.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-16T07:02:27Z
      DOI: 10.1177/0003489419870832
       
  • Morphometric Differences in the Recurrent Laryngeal Nerve in Patients with
           Vocal Fold Paralysis
    • Authors: Melissa R. Chao, Katherine A. Howe, Jennifer L. Pierce, Amanda C. Stark, Marshall E. Smith, Michael B. Christensen
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Injury to the recurrent laryngeal nerve (RLN), if severe enough, can result in vocal fold paralysis. Reinnervation surgery can improve patient outcomes, but previous studies have reported a negative correlation between time since onset of paralysis and surgical outcomes. The ability of the paralyzed nerve to serve as a conduit for donor nerve fibers may be a factor in the success of reinnervation; however, changes in RLN composition after paralysis have not been well studied. Therefore, we investigated the morphometric composition of explanted RLN sections from patients who had experienced vocal fold paralysis for varying length of times.Methods:Nine nerve sections from unilateral vocal fold paralysis (UVP) patients and seven control nerve sections were analyzed for morphometric parameters including fascicular area, fiber count, fiber density, fiber packing, mean g-ratio, and fiber diameter distribution. Nerves from UVP patients were also compared as a function of time since UVP onset.Results:In comparison to control nerves, paralyzed nerves were found to have significantly lower fiber densities and fiber packing, higher mean g-ratio values, and a shift in diameter distributions toward smaller diameter fibers. With respect to paralysis duration, no significant differences were observed except in fiber diameter distributions, where those with paralysis for>2 years had distributions that were significantly shifted toward smaller diameter fibers.Conclusions:The morphometric data presented here suggest that correlations between the time since onset of vocal fold paralysis and reinnervation outcomes may be due to fiber size changes in the paralyzed nerve over time.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-14T05:14:01Z
      DOI: 10.1177/0003489419870829
       
  • Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for
           Lung Cancer Using Low-Dose Computed Tomography
    • Authors: Kimberly Dukes, Aaron T. Seaman, Richard M. Hoffman, Alan J. Christensen, Nicholas Kendell, Andrew L. Sussman, Miriam Vélez-Bermúdez, Robert J. Volk, Nitin A. Pagedar
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:National guidelines recommend lung cancer screening (LCS) using low-dose computed tomography (LDCT) for high-risk patients, including survivors of other tobacco-related cancers like head and neck cancer (HNC). This qualitative study investigated clinicians’ practices and attitudes toward LCS with LDCT with patients who have survived HNC, in the context of mandated requirements for shared decision making (SDM) using decision aids.Methods:Thematic analysis of transcribed semi-structured clinician interviews and focus group.Results:Clinicians recognized LCS’ utility for some HNC survivors with smoking histories. However, they identified many challenges to SDM in diverse clinic settings, including time, workflow, uncertainty about guidelines and reimbursement, decision aids, competing patient priorities, unclear evidence, potentially heightened patient receptivity and stress, and the complexity of discussions. They also identified challenges to LCS implementation.Conclusions:While clinicians feel that LDCT LCS may benefit some HNC survivors, there are barriers both to implementing LCS SDM for these patients in primary care as currently recommended and to integrating it into cancer clinics. Challenges for SDM across settings include a lack of decision aids tailored to patients with cancer histories. Given recommendations to broaden LCS eligibility criteria, more research may be required before refinement of current guidelines.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-14T05:13:21Z
      DOI: 10.1177/0003489419868245
       
  • Causative Factors for Complications in Transpalatal Advancement
    • Authors: Lyndon Chan, Leon Kitpornchai, Stuart Mackay
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Introduction:Transpalatal advancement (TPA) is a procedure that is used when modern variants of uvulopharyn-gopalatoplasty are unable to provide enough anterior traction. Although successful in reduction of obstructive sleep apnea (OSA) parameters, it also comes with procedure-specific risks. Formation of an oro-nasal fistula (ONF) is a complication that results in significant morbidity and a protracted treatment course.Methods:After approval from the University of Wollongong Health Research Ethics Committee, a retrospective chart review of all cases undergoing TPA performed by a single surgeon over a 10-year period from 2008 to 2018 was performed. Patients underwent pre- and postoperative level 1 or 2 polysomnography. Factors potentially contributing to palatal complications, as well as pre- and postoperative polysomnographic parameters, subjective sleep questionnaires, and body mass index (BMI) were statistically analyzed where a P value
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-14T05:13:00Z
      DOI: 10.1177/0003489419867969
       
  • Validation of the Maxillary Sinus Roof as a Landmark for Navigating the
           Pediatric Skull Base
    • Authors: Sean S. Evans, Catherine Banks, Joshua Richman, Audie Woolley, Do Yeon Cho, Bradford Woodworth
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:To define a new anatomic relationship in pediatric sinus surgery, assessing the maxillary roof as a constant safe landmark to avoid skull base injury in the pediatric population.Study Design:Retrospective analysis.Setting:Tertiary care children hospital.Subjects and Methods:A retrospective analysis was performed of all computed tomography scans of the sinuses and facial bones at the emergency department of a tertiary children’s hospital over the course of a year. Radiographic measurements included the lowest cribriform plate and planum sphenoidale (PS) heights, or posterior skull base when not yet pneumatized, as well as the highest maxillary roof height. The nasal floor was used for reference. Statistics were performed via Shapiro-Wilks test with a P-value of .05 indicating statistical significance.Results:Three hundred and seven unique scans were reviewed (38.9% female; n = 122; P = .58). Age stratification was based on previously described sinus growth patterns. In all patients, the maximum maxillary height was inferior to the lowest measured cribriform lamella and PS (P 
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-09T07:13:52Z
      DOI: 10.1177/0003489419867967
       
  • Intranasal Septal Splints: Prophylactic Antibiotics and Nasal Microbiology
    • Authors: Amit Ritter, Uri Alkan, Dafna Yahav, Ethan Soudry, Ella Reifen
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections.Methods:Fifty-five patients underwent septoplasty by a single surgeon between March 2015 and April 2016. All had intranasal septal splints and were given antibiotic prophylaxis for 7 days until removal of splints. Nasal cultures were taken before surgery, and septal splints were examined for bacterial colonization following their removal.Results:Thirty-six patients (65%) had positive nasal culture prior to surgery. The most common isolates were Staphylococcus aureus (30%) and Enterobacteriaceae species (66%). All these patients had postoperative bacterial colonization on septal splints. In 15 patients with negative preoperative cultures, bacteria were isolated postoperatively. An increased resistance profile was documented postoperatively in 9 patients (16%), including two with multidrug resistance. In two of these patients preoperative wild-type strains acquired antibiotic resistance postoperatively. No adverse drug reactions to antibiotics were reported.Conclusions:Increased bacterial growth and emergence of resistant strains were observed on intranasal septal splints despite prophylactic antibiotic treatment. Nonetheless, this did not translate into clinical infection. Thus, considering antibiotics overuse and increasing bacterial resistance, further research is needed to determine the role of antibiotic prophylaxis in the setting of intranasal splints.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-08T07:16:43Z
      DOI: 10.1177/0003489419867976
       
  • Caudal Septal Division and Interposition Batten Graft: A Novel Technique
           to Correct Caudal Septal Deviation in Septoplasty
    • Authors: Shin Ae Kim, Yong Ju Jang
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Background:Correction of caudal septal deviation is a challenging task that may require multiple surgical approaches.Objective:To introduce a novel technique – caudal septal division and interposition batten graft – and evaluate its surgical outcomes in patients undergoing correction of caudal septal deviation.Method:The surgical procedure includes a division of the deviated caudal L-strut preserved after resection of the deviated quadrangular septal cartilage at the central portion. A batten graft made of septal cartilage or bone is interposed between the cut ends of the caudal L-strut, the upper part of which mobilized toward the more concave side of the nasal cavity, and then sutured. The medical records of 29 patients with caudal septal deviation who underwent septoplasty using caudal L-strut division and interposition batten graft technique between January 2016 and March 2018 were retrospectively reviewed. Patient satisfaction and symptom improvement were evaluated by using the Nasal Obstruction Symptoms Evaluation scores. Endoscopic assessment of deviation correction was performed and postoperative complications were analyzed.Results:Of the 29 patients, 19 (65.5%) answered the telephonic interview. Mean Nasal Obstruction Symptoms Evaluation scores were 62.1 preoperatively and 9.2 postoperatively, exhibiting significant improvement (P 
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-07T06:10:24Z
      DOI: 10.1177/0003489419866214
       
  • Clinical Analysis of Pediatric Thyroid Cancer: A Single Medical
           Institution Experience of 18 Years
    • Authors: Hyung Kwon Byeon, Sang Bin Kim, Hyeon Seok Oh, Hong Kyu Kim, In Hak Choi, Hyunjung Kim, Jae-Gu Cho, Kyung Ho Oh, Seung-Kuk Baek, Jeong-Soo Woo, Soon-Young Kwon, Hoon Yub Kim, Kwang Yoon Jung
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:The incidence of pediatric thyroid cancer is relatively low compared to the disease in adults. This study aims to present the data in our institution on pediatric thyroid cancer patients, with particular emphasis on the risk factors of recurrence together with treatment outcomes.Subjects and Methods:Between January 2000 and July 2018, patients 1 cm showed higher rate of lymph node metastasis and extrathyroidal extension than tumors ≤1 cm. All patients survived with nine PTC patients who displayed treatment failure. Age, tumor size, multifocality, lateral lymph node metastasis, and postoperative thyroglobulin levels were significant prognosticators for disease recurrence.Conclusion:Pediatric thyroid cancer is relatively rare and should be considered a specific disease entity with respect to the thyroid cancer in adults, since there are several distinctive characteristics.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-03T05:24:15Z
      DOI: 10.1177/0003489419868251
       
  • Cochlear-Vestibular Impairment due to West Nile Virus Infection
    • Authors: Daniela Parrino, Giuseppe Brescia, Maria Vittoria Trimarchi, Giulia Tealdo, Lolita Sasset, Anna Maria Cattelan, Roberto Bovo, Gino Marioni
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:West Nile virus (WNV) has been spreading over the last 20 years. Human infection is asymptomatic in most cases. When the disease becomes clinically manifest, it may involve a range of issues, from a mild infection with flu-like symptoms to a neuroinvasive disease. Albeit rarely, WNV-associated sensorineural hearing loss (SNHL) has also been reported. Here we describe two new cases of SNHL and balance impairment caused by WNV infection.Methods:The patients were investigated with repeated audiometric tests and, for the first time, videonystagmography was also used.Results:Unlike findings in the few other published cases, an improvement in audiometric thresholds and vestibular function was documented in both of our patients.Conclusions:In the light of our findings, a prospective study would be warranted on a large series of patients with WNV infection in order: (i) to better define the epidemiology of the related cochlear-vestibular involvement; and (ii) to elucidate the virus-related changes to peripheral and central auditory and vestibular functions.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-01T07:37:23Z
      DOI: 10.1177/0003489419866219
       
  • Blast-Induced Cholesteatomas After Spontaneous Tympanic Membrane Healing
    • Authors: Omer J. Ungar, Shahaf Shilo, Wengier Anat, Oren Cavel, Ophir Handzel, Yahav Oron
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To characterize blast-induced cholesteatomas (BIC) in terms of symptoms, presentation, and location within the middle ear cleft (MEC).Design:A search for all English language articles in “MEDLINE” via “PubMed” and “Google Scholar” was conducted.Results:A total of 67 ears with BIC were included. Fifty-eight ears in which the traumatic perforation failed to spontaneously close were excluded, leaving seven case reports (eight patients, nine ears) for statistical analysis. Time between blast exposure to spontaneous tympanic membrane (TM) closure was 16 days to 10 months. Time between blast exposure and cholesteatoma diagnosis was 5 months to 4 years. The cholesteatomas were diagnosed due to symptoms in two ears, as asymptomatic finding on physical examination in one ear and as asymptomatic finding in axial imaging in three ears.Conclusions:BICs can develop behind intact tympanic membrane or along with TM perforation. Based on the current review, when a TM perforation and spontaneous healing were documented, after blast exposure, MRI scan is an integral component of the follow-up. The optimal timing for MRI performance after blast exposure, is yet to be identified.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-08-01T07:37:16Z
      DOI: 10.1177/0003489419865568
       
  • Open Airway Surgery in a Paraplegic: The Importance of an Adequate Cough
    • Authors: Shaunak N. Amin, Jennifer P. Rodney, Alexander Gelbard
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To describe a case of open airway surgery with postoperative respiratory complications in a paraplegic woman and to review the unique respiratory physiology seen in patients with a history of cervical or thoracic spinal cord injury (SCI).MethodsCase report and literature review.Results:We describe the case of a 25-year-old paraplegic who developed tracheal stenosis after tracheotomy, eventually requiring tracheal resection and re-anastomosis. Her postoperative course was complicated by mucus plugging and severe atelectasis, necessitating reintubation. After extubation, the patient reported difficulty expectorating secretions ever since her SCI, requiring manual abdominal pressure from her family members to assist her when she needed to cough.Conclusion:This first report of cricotracheal resection in a patient with paraplegia following SCI highlights the importance of an adequate cough and demonstrates the unique respiratory management necessary for patients with SCI.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-31T10:22:59Z
      DOI: 10.1177/0003489419866471
       
  • Clinical Approach After Complicated Ear Mold Fitting: A Case Series of Six
           Patients and Evaluation of Literature

         This is an Open Access Article Open Access Article

    • Authors: Cindy van den Boer, Erik van Spronsen, Carlijn T. Q. Holland, Fenna A. Ebbens, Jérôme J. Waterval
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Insertion of mold material into the middle ear is a complication of molding procedure for ear impression. These cases are referred to an ENT specialist. There is no standardized approach to this problem. Literature shows different clinical strategies. The aim of this study is to share our experience and to analyze the adverse outcome of different clinical approaches.Methods:A case series of six patients with molding material inside the middle ear after complicated molding procedure for swimming earplugs are described. Additionally, available literature was reviewed to analyze results of the clinical approach after iatrogenic molding procedures. Forty-nine ears were included.Results:In-office removal of the material is associated with a significant risk of adverse outcome if the eardrum cannot be examined. This also accounts for ossicular involvement.Conclusions:Temporal bone CT is advised in patients after complicated ear mold fitting if the tympanic membrane cannot be examined completely or the middle ear is involved. Blind removal should be avoided. Retroauricular transcanal tympanotomy or transmastoidal tympanotomy with facial recess approach is best practice in case the mold material has entered the middle ear. A clinical treatment algorithm is presented.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-31T10:22:19Z
      DOI: 10.1177/0003489419865562
       
  • Anterior Skull Base Reconstruction following Ablative Surgery for
           Osteoradionecrosis: Case Report and Review of Literature
    • Authors: Katya Chapchay, Jeffrey Weinberger, Ron Eliashar, Neta Adler
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Introduction:Osteoradionecrosis is one of many potentially severe complications of radiotherapy for nasopharyngeal carcinoma. Osteoradionecrosis of the skull base is life-threatening due to the critical proximity of the pathological process to vital structures, for example, the intracranial cavity, the upper spine, and major blood vessels. Reconstructive options following surgical debridement of the anterior skull base and upper spine osteonecrosis have been scarcely described in the literature.Case presentation and management:We present a rare case of osteoradionecrosis of the clivus and cervical vertebrae C1-C2 in a patient previously treated with chemoradiotherapy for nasopharyngeal carcinoma, presenting as severe soft tissue infection of the neck. Aggressive surgical debridement and reconstruction with a two-paddle free anterolateral thigh flap was performed using a combination of transcervical and transnasal endoscopic approaches. A novel endoscopic procedure in the sphenoid sinus enabled flap anchoring in this complex area.Discussion:Surgical modalities for osteoradionecrosis of the skull base and upper spine are discussed and review of the literature is presented.Conclusion:Reconstruction of the anterior skull base with a well-vascularized free flap following ablative surgery should be considered in management of life-threatening osteoradionecrosis of the area. Endoscopic opening of the sphenoid sinus and creating a funnel-shaped stem is a newly described technique that guarantees precise placement of the flap and is a valuable adjunct to the reconstructive armamentarium.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-27T09:13:59Z
      DOI: 10.1177/0003489419865558
       
  • Acellular Dermal Matrix Mistaken as Recurrence of Malignancy Following
           Surgery on Positron Emission Tomography/Computed Tomography: A Case Report
           
    • Authors: Seokhwan Lee, Soo-Keun Kong, Seong Hwan Bae, Kyoungjune Pak, Se-Joon Oh
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To report a rare clinical presentation of an acellular dermal matrix (ADM) used during lateral temporal bone resection mimicking recurrence of cancer of external auditory canal (EAC) on positron emission tomography/computed tomography (PET/CT) 9 months after surgery.Methods:Case report and literature review.Results:A 71-year-old woman underwent lateral temporal bone resection 9 months earlier for management of squamous cell carcinoma of the EAC. She exhibited recurrence of the tumor on 18F-FDG PET/CT with an intense uptake value (SUVmax 12.8) at the operated site. Exploration was conducted as the location of the lesion was unfavorable to perform biopsy. However, histopathologic evaluation revealed that the lesion was the ADM implanted during surgery.Conclusions:Care should be taken when using an ADM during malignant tumor surgery if the site of surgery is not conducive for fine needle aspiration or biopsy.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-27T09:06:42Z
      DOI: 10.1177/0003489419863448
       
  • Ectopic Thymus: An Unusual Case of Subglottic Mass
    • Authors: Irene Paraboschi, Federica Fati, Francesca Rizzo, Oliviero Sacco, Nicola Stagnaro, Girolamo Mattioli, Alessandro Simonini, Oscar Mazzei, Michele Torre
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:The aim of our study is to report a case of a child with subglottic thymus that was suspected during diagnostic work-up for severe airway obstruction, excised surgically and confirmed with final histopathological examination. Moreover, we performed a narrative literature review to outline clinical and diagnostic features of this rare condition and to report suggestions for the management of subglottic masses.Methods:We report the case of a 7-month-old boy who was admitted to our Pediatric Airway Team Unit due to a history of worsening biphasic stridor and recurrent episodes of upper airway obstruction. The successful diagnostic work-up and a narrative literature of analogous cases of subglottic thymus were reported.Results:Ectopic thymus is a very rare condition in which thymic tissue is found outside the normal pathway of its embryonic migration. It usually presents as a cystic or, more rarely, solid mass, showing an indolent course toward spontaneous involution. In some cases, however, it becomes symptomatic exerting compression on surrounding vital structures. Due to its rarity, the initial diagnosis is normally mistaken with inflammatory diseases or malignancies and the definitive diagnosis is only achieved after histological examination of the excised specimen. To our knowledge, only four other cases of subglottic ectopic thymic tissue have been reported in the English literature so far and the diagnosis has never been suspected preoperatively.Conclusion:It is mandatory to consider ectopic thymic tissue in the differential diagnosis in children presenting with airways obstruction in order to prevent unnecessary, extensive, and exploratory surgery.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-19T06:15:32Z
      DOI: 10.1177/0003489419863828
       
  • Unsupervised Learning Techniques for the Investigation of Chronic
           Rhinosinusitis
    • Authors: Abigail Walker, Pavol Surda
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:This article reviews the principles of unsupervised learning, a novel technique which has increasingly been reported as a tool for the investigation of chronic rhinosinusitis (CRS). It represents a paradigm shift from the traditional approach to investigating CRS based upon the clinically recognized phenotypes of “with polyps” and “without polyps” and instead relies upon the application of complex mathematical models to derive subgroups which can then be further examined. This review article reports on the principles which underlie this investigative technique and some of the published examples in CRS.Methods:This review summarizes the different types of unsupervised learning techniques which have been described and briefly expounds upon their useful applications. A literature review of studies which have unsupervised learning is then presented to provide a practical guide to its uses and some of the new directions of investigations suggested by their findings.Results:The commonest unsupervised learning technique applied to rhinology research is cluster analysis, which can be further subdivided into hierarchical and non-hierarchical approaches. The mathematical principles which underpin these approaches are explained within this article. Studies which have used these techniques can be broadly divided into those which have used clinical data only and that which includes biomarkers. Studies which include biomarkers adhere closely to the established canon of CRS disease phenotypes, while those that use clinical data may diverge from the typical “polyp versus non-polyp” phenotypes and reflect subgroups of patients who share common symptom modifiers.Summary:Artificial intelligence is increasingly influential in health care research and machine learning techniques have been reported in the investigation of CRS, promising several interesting new avenues for research. However, when critically appraising studies which use this technique, the reader needs to be au fait with the limitations and appropriate uses of its application.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-19T06:14:01Z
      DOI: 10.1177/0003489419863822
       
  • The Effects of Endoscopic Sinus Surgery on Voice Characteristics in
           Chronic Rhinosinusitis Patients
    • Authors: Danny B. Jandali, Ashwin Ganti, Inna A. Husain, Pete S. Batra, Bobby A. Tajudeen
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed.Methods:Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms.Results:18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001).Conclusions:Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-18T05:08:06Z
      DOI: 10.1177/0003489419861124
       
  • Transoral Tubed Supraglottoplasty: A New Minimally Invasive Procedure for
           Aspiration
    • Authors: Yue Ma, Matthew R. Naunheim, Jill Gregory, Peak Woo
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:We describe a new procedure for aspiration called tubed supraglottoplasty (TS). TS is a transoral procedure that approximates the aryepiglottic (AE) folds and arytenoids. This narrows the laryngeal inlet. This procedure has been used to improve swallowing and reduce aspiration in patients with vocal fold paralysis. We describe the technical aspects of TS and report on 11 patients.Methods:TS is done by oral intubation followed by suspension laryngoscopy. An incision is made along the AE fold into the posterior commissure and then continued to the opposite AE fold. Dissection within this incision creates two mucosal flaps, one based on the laryngeal surface and the other on the pharyngeal surface. Two 1-cm releasing incisions are made at each end of the AE fold. The laryngeal mucosal flap is approximated using a 3-0 self-locking running suture. The pharyngeal mucosal flap is approximated as a second layer. This double-layered mucosal V-Y advancement flap builds up the posterior laryngeal height. It narrows and “tubes” the supraglottis.Results:All patients tolerated TS without airway complications. Ten of the 11 patients reported improved swallowing function with less aspiration. Six of the 8 patients with prior G-tubes had their gastrostomy tube removed. Postoperative laryngoscopy showed a narrowed “tubed” supraglottis with a higher posterior wall preventing spillover and aspiration. An improved Functional Oral Intake Scale was recorded in ten of eleven patients.Conclusion:TS is a minimally invasive procedure that can improve swallowing and reduce aspiration.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-17T07:23:59Z
      DOI: 10.1177/0003489419862581
       
  • Investigation of Novel Grafts in Use for Pediatric Tympanoplasty
    • Authors: Christine Barron, Jordan Lukens, Weston Niermeyer, Amanda Onwuka, Tendy Chiang, Charles Elmaraghy
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To evaluate the impact of allograft and xenograft in pediatric tympanoplasty on patient outcomes.Methods:A retrospective cohort study of 50 pediatric patients undergoing tympanoplasty at a single tertiary pediatric hospital system that received either autograft, allograft, or xenograft. Patients were evaluated for persistent perforation, recurrent perforation, revision surgery, and postoperative infection. Hearing outcomes, operative charges, and operative time were also evaluated. Statistical analyses included chi-square and Fisher exact tests for categorical data and Wilcoxon-Mann-Whitney tests for continuous data.Results:Half of the cohort received autografts, whereas 38% received xenografts and 14% received allografts. Although there was not a significant difference in charges associated with these procedures, xenografts had the shortest mean operative time (mean: 39 vs 68 minutes in autografts, p = .05). Overall, the rate of persistent perforation was 10%, recurrent perforation was 20%, revision surgery was 16%, and postoperative infection was 18%. There were no differences in the rates of these outcomes by graft type. Furthermore, there was no observed difference in hearing outcomes among autograft and xenograft recipients, but allograft recipients had significantly improved hearing postoperatively.Conclusions:Similar rates of complications were observed among autografts, xenografts, and allografts, providing preliminary evidence that they are safe to use in pediatric tympanoplasty.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-13T10:18:16Z
      DOI: 10.1177/0003489419862575
       
  • Detection of Microbiota in Post Radiation Sinusitis
    • Authors: Timothy J. Stoddard, Varun V. Varadarajan, Peter T. Dziegielewski, Brian J. Boyce, Jeb M. Justice
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:A shift in the microbiota of chronic rhinosinusitis has been described after radiotherapy to the sinonasal cavity and skull base. There is a paucity of literature characterizing the bacteriology of post radiation sinusitis using next-generation gene sequencing techniques. This study aims to describe and compare the microbial flora of rhinosinusitis after radiotherapy using both culture and molecular techniques for microbial DNA detection.Methods:The medical records of patients treated with external beam radiation for sinonasal, nasopharyngeal, or skull base malignancy were reviewed at a tertiary care facility. Patients’ sinonasal cavities were swabbed for routine culture or brushed for molecular gene sequencing. Swab specimens were processed for standard microbial culture, and brush specimens were sent for gene sequencing at Micro GenX Laboratory (Lubbock, Texas, USA).Results:Twenty-two patients were diagnosed with chronic sinusitis after undergoing radiotherapy. Staphylococcus aureus was the most common organism identified by both culture and gene sequencing, followed by Pseudomonas aeruginosa. Several additional organisms were detected by gene sequencing that were not isolated by routine culture techniques. Gene sequencing identified pathogens differing from culture results in 50% of patients examined.Conclusion:The bacteriology of post radiation sinusitis appears to resemble the microorganisms responsible for chronic sinusitis in healthy adults. Next generation gene sequencing techniques may reveal additional organisms responsible for sinusitis and provide complementary results that may impact the medical treatment of post radiation sinusitis.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-13T10:17:36Z
      DOI: 10.1177/0003489419862583
       
  • Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold
           Paralysis After Thyroid Surgery
    • Authors: Rudolf Reiter, Adrienne Heyduck, Thomas Karl Hoffmann, Sibylle Brosch, Maria Anna Buchberger, Katharina Schorer, Theresa Weber, Anja Pickhard
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:This study is set to analyze clinicopathological factors predicting the recovery of unilateral vocal fold paralysis (UVP) in patients after thyroid gland surgery. The quality of voice was additionally assessed in these patients.Methods:The charts and videolaryngostroboscopy (VLS) examinations of 84 consecutive patients with a complete UVP after surgery of the thyroid gland were retrospectively reviewed. Patients were divided into 2 groups: patients who fully recovered from vocal fold paralysis and those who failed to recover after a follow-up of 12 months. The quality of voice was analyzed among other things by determining the Voice Handicap Index (VHI).Results:The UVP fully recovered in 52 of 84 (61.9%) patients. Positive mucosal waves (pMWs) on the paralyzed side, a minimal glottic gap
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-12T06:47:59Z
      DOI: 10.1177/0003489419858629
       
  • Submental Island Flap: A Technical Update
    • Authors: Joseph Zenga, Kevin S. Emerick, Daniel G. Deschler
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:In recent years, the submental island flap has demonstrated decreased cost and morbidity as compared with free tissue transfer and has been widely applied to a range of head and neck defects. Several studies, however, continue to report a high rate of submental flap complications including partial necrosis and venous congestion. The object of this report is to describe a technical modification to the submental flap harvest which increases efficiency and reliability.Methods:Single institutional case series with chart review. The essential technical details and technique modifications of the submental flap harvest are described, and a case example is discussed.Results:Between January 2018 through January 2019, 24 submental island flaps were performed. All flaps included the mylohyoid muscle which was delineated with manual blunt dissection. Reconstructive indications included oral cavity and oropharyngeal wounds as well as facial cutaneous and lateral skullbase defects. There were no flap-related complications.Conclusions:Manual blunt dissection of the mylohyoid muscle and its inclusion in the submental island flap increases efficiency and reliability.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-11T06:28:35Z
      DOI: 10.1177/0003489419862582
       
  • Spindle Cell Lipomas of the Respiratory Tract: A Case Report and
           Comprehensive Literature Review
    • Authors: Jonathan Reid, Bret Wehrli, Leigh J. Sowerby
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Background:Spindle cell lipomas (SCLs) are benign tumors that are characteristically present on the upper back and neck, but in rare cases present throughout the respiratory mucosa, causing hoarseness, stridor, dyspnea, and obstruction.Objective:To highlight the importance of considering SCL in the diagnosis of benign respiratory tract tumors, a literature review identified all published cases of respiratory tract SCLs, including 2 from our institution: one case in the nasopharynx and 1 in the nasal valve.Methods:All case reports, series and literature reviews from the English literature from 1975 through March 2018 were systematically identified for review in the MEDLINE, EMBASE, and Scopus databases. Two additional cases from our institution were described.Results:In total, 24 cases of SCL in the respiratory tract were identified for review. Two cases from our institution are described here, bringing the total of reported cases to 26. Extensive analyses of oral cavity SCLs already exist, so we excluded this site from our review and focused on sites where SCLs may present with respiratory symptoms. Excluding the oral cavity and oropharynx, the most common location described is the larynx. All 26 cases were treated with excision. One tumor required a second surgery, but there were no other complications nor recurrences.Conclusion:Although rare, SCLs may arise from throughout the respiratory tract and cause dyspnea, hoarseness and stridor. Spindle cell lipoma should be considered in the differential diagnosis of a respiratory tract mass. This diagnosis confers a good prognosis and patients may be reassured that surgery is almost always curative.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-11T06:27:15Z
      DOI: 10.1177/0003489419862577
       
  • Diagnostic Protocol for Detecting Otosclerosis on High-Resolution Temporal
           Bone CT
    • Authors: Lisa A. Brown, Burce Ozgen Mocan, Miriam I. Redleaf
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To present a systematic checklist to improve diagnosing otosclerosis (OS) on high-resolution computed tomography (HRCT) of the temporal bones and review this protocol’s efficacy in diagnosing OS on HRCT.Methods:A retrospective case series was performed at a University Referral Hospital in urban Chicago, Illinois. High-resolution computed tomographies of the temporal bone were reviewed including 17 ears in the test group with surgically confirmed OS and 21 ears in the control group surgically confirmed to not have OS. Preoperative HRCTs were evaluated by a single neuroradiologist using a systematic protocol created to assist in diagnosing OS. This looked for radiolucency at the fissula ante fenestram and pericochlear region, and new bone formation around the oval and round windows.Results:The radiologist accurately diagnosed OS in all 17 test group ears and ruled out OS in all 21 control group ears using the protocol. All 17 test ears were read to have lucency at the fissula ante fenestram, 9 (53.0%) to have new bone formation, and 8 (47.1%) to have cochlear lucency. The radiologist was more confident in diagnosing OS when cochlear lucency was present with the fissula ante fenestram lucency.Conclusions:This HRCT checklist is a highly accurate tool for evaluating the presence of OS when images are reviewed in the systematic fashion described. Imaging prior to surgery aids in counseling patients, preparing surgically, and excluding other pathologies.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-10T05:26:37Z
      DOI: 10.1177/0003489419859036
       
  • Why Central Neck Dissection Works (and Fails) for Recurrent Thyroglossal
           Duct Remnants
    • Authors: Glenn Isaacson, Adam Kaplon, Derrick Tint
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objective:To review the patient characteristics and outcomes for children and undergoing central neck dissection for control of recurrent thyroglossal duct cysts and fistula following prior Sistrunk procedures and children requiring surgery for refractory infection.Methods:We performed a computerized review of all children who were evaluated for thyroglossal duct cysts during the years 1999-2018 by a single surgeon operating at an urban children’s hospital and an outpatient surgical center. Those requiring a central neck dissection for control of recurrent disease or intractable infection were identified. Age at time of surgery, sex, surgical procedure, and postoperative complications were recorded. These data were combined with similar data from a published report by the same surgeon in the years 1990-1998 to complete a 28-year review.Results:18 central neck dissections were performed including 13 for recurrent thyroglossal duct remnants after Sistrunk procedures and 5 primary surgeries for intractable infection. Ages ranged from 3 to 19 years (median = 10 years) and 13 of 18 were girls (72%). Four children had their first Sistrunk surgery performed by the senior author. Three children operated elsewhere had intact hyoid bones at the time of revision surgery, suggesting less-than-Sistrunk primary surgeries. Central neck dissection controlled disease in the lower neck in all cases. One child re-fistulized at the level of the hyoid.Conclusions:Central neck dissection in combination with a Sistrunk-type dissection of the tongue base is effective in the control of recurrent infection following unsuccessful Sistrunk surgery and aids in dissection for children with intractable infection. Although this technique reliably controls infrahyoid disease and improves access to the hyoid and posterior hyoid space, it does nothing to address the difficulties of following the thyroglossal tract into the tongue base.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-04T11:53:10Z
      DOI: 10.1177/0003489419859033
       
  • Direct Visualization of Laryngeal Mucociliary Clearance in Adults
    • Authors: Luke M. O’Neil, Niall D. Jefferson
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Mucociliary clearance is a protective mechanism of the respiratory tract that facilitates the removal of foreign particles and microorganisms. There is a paucity of data on the mucociliary clearance in the adult larynx. Our study aims to visualize and describe the mucociliary clearance of the adult larynx in healthy subjects.Methodology:Subjects were identified from a volunteer database. Exclusion criteria included laryngeal disease, previous laryngeal surgery, recent upper respiratory infection, and current smoking. A high-definition videolaryngoscope was used to visualize the larynx. The larynx was topicalised with local anesthetic. Methylene blue was placed on both false vocal cords and at the petiole of the epiglottis. Dye clearance was recorded and analyzed.Results:In total, 10 participants participated, 7 men and 3 women, with a mean age of 42 ± 15.7 years (range: 25-71). The average reflux symptom index score was 1.4. Clearance of the dye from the false vocal cords followed a uniform lateral flow, up onto the aryepiglottic folds. The dye from the petiole had minimal vertical movement. Swallowing cleared dye from the aryepiglottic folds. The average time for dye clearance to the aryepiglottic fold was 2.21 ± 1.14 minutes.Conclusions:This is the first study visualizing the mucociliary clearance of the larynx. Ciliary directionality was consistent in the participants studied, with dye moving superolateral from the false cords to the aryepiglottic fold. Swallowing was an effective mechanism for clearance from the endolarynx, when the dye had reached the aryepiglottic fold. Future research can study potential alterations in laryngeal mucociliary clearance in chronic disease states.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-04T11:51:49Z
      DOI: 10.1177/0003489419859376
       
  • Three Cases of Primary Ciliary Dyskinesia Combined With Reduced Exhaled
           Nitric Oxide
    • Authors: Sung Min Han, Chi Sang Hwang, Hyun Jong Jeon, Ho Young Lee, Hyung-Ju Cho, Dong-Joon Park
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:The diagnosis of primary ciliary dyskinesia (PCD) is often delayed in part related to the limitations of the available diagnostic tests. We present 3 cases of PCD diagnosed using an exhaled nitric oxide (eNO) measurement.Methods:Three cases with a clinical phenotype consistent with PCD were evaluated using an eNO assay with additional transmission electron microscopy (TEM) and/or genetic panel testing.Results:One male and 2 female patients presented with common symptoms included recurrent respiratory infection from early childhood and a history of neonatal respiratory distress as term newborn. Two of them had situs inversus totalis. Fractional eNO measurement revealed extremely low NO levels, and subsequently, TEM analysis confirmed ciliary ultrastructural defects in all patients. One patient had compound heterozygous mutation of the PCD-causative gene (DNAH5) identified using next generation sequencing.Conclusion:Our report stresses the reliability of eNO measurement in the diagnosis of PCD, accompanied by clinical phenotypes and additional diagnostic tools, such as TEM analysis and genetic testing.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-04T11:50:30Z
      DOI: 10.1177/0003489419861119
       
  • Awareness of European Otolaryngologists and General Practitioners Toward
           Laryngopharyngeal Reflux
    • Authors: Jerome R. Lechien, Francois Mouawad, Geoffrey Mortuaire, Marc Remacle, Francois Bobin, Kathy Huet, Andrea Nacci, Maria Rosaria Barillari, Lise Crevier-Buchman, Stéphane Hans, Camille Finck, Lee M. Akst, Petros D. Karkos
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To investigate the current trends in management of laryngopharyngeal reflux (LPR) among young European otolaryngologists and general practitioners (GP).Methods:An international survey was sent to European general practitioners and all otolaryngologists under 45 years old from the 2017 IFOS meeting. This survey was conducted by the LPR Study Group of YO-IFOS (Young Otolaryngologists of the International Federation of Otolaryngological Societies).Results:Among the 2500 attendees, 230 European otolaryngologists (response rate = 9%) completed the survey; an additional 70 GPs also completed the survey. GPs did not differentiate between gastroeosophageal reflux disease (GERD) and LPR, overstating GERD-related symptoms (ie, heartburn and regurgitations) in LPR clinical presentation and relying on gastrointestinal endoscopy for LPR diagnosis. Otolaryngologists also believe that GERD-related symptoms are prevalent in LPR. Knowledge of nonacid and mixed LPR and use of multichannel intraluminal impedance-pH monitoring are still limited in both groups. A therapeutic dichotomy exists between groups: GPs mainly use a 4-week once daily empiric proton pump inhibitors (PPIs) trial, while otolaryngologists use PPIs twice daily for a longer therapeutic period ranging from 8 to 12 weeks. More than 50% of GPs and otolaryngologists believe that they are not adequately knowledgeable and skilled about LPR.Conclusion:The majority of GPs and otolaryngologists do not believe themselves to be sufficiently informed about LPR, leading to different practice patterns and grey areas. The elaboration of international recommendations in the management of reflux is needed to improve practices.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-07-01T10:32:24Z
      DOI: 10.1177/0003489419858090
       
  • Curved Laryngopharyngoscope With Flexible Next-Generation Robotic Surgical
           System for Transoral Hypopharyngeal Surgery: A Preclinical Evaluation
    • Authors: Kohtaro Eguchi, Jason Y. K. Chan, Ichiro Tateya, Akira Shimizu, F. Christopher Holsinger, Taro Sugimoto
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:The indication of transoral robotic surgery for hypopharyngeal cancer is limited because of poor accessibility. The aim of this study was to explore the efficacy of a curved laryngopharyngoscope used in combination with a next-generation flexible robotic surgical system for accessing and resecting the hypopharynx.Methods:A comparative evaluation of the curved laryngopharyngoscope versus standard straight-blade retractors using the flexible robotic surgical system was conducted on 2 cadavers. End points measured included visualization, accessibility, and ease of dissection for accessing and resecting the hypopharynx.Results:Visualization, accessibility, and dissection were superior with the curved laryngopharyngoscope in all subareas of the hypopharynx. The advantages of accessibility and visualization were much more evident in the cadaver with a high body mass index.Conclusions:These preclinical data suggest that using a curved laryngopharyngoscope in combination with a flexible robotic surgical system may lead to technical innovations concerning transoral surgery of the hypopharynx.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-21T05:55:31Z
      DOI: 10.1177/0003489419856391
       
  • Management of Vocal Fold Paralysis and Dysphagia for Neurologic
           Malignancies in Children
    • Authors: Peter Nagy, Nicholas Beckmann, Steven Cox, Anthony Sheyn
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:To evaluate our experience with a significant number of brain malignancy–related vocal fold paralysis patients and their response to vocal cord–related therapies.Background:Vocal fold paralysis is a potentially devastating complication of various types of pediatric diseases and surgeries that can lead to significant vocal and swallowing difficulties. While there is significant data in the literature on outcomes of children treated for vocal fold paralysis following cardiac or thyroid surgery, there is a scarcity of such information on children following the treatment of neurologic malignancy.Methods:Records of 19 patients at a tertiary center who were treated for neurologic malignancies and developed either unilateral or bilateral vocal fold paralysis were reviewed for vocal fold pathology and vocal fold paralysis treatment-related variables, including initial diagnosis, management with observation or speech therapy, duration of therapy, pre- and postintervention swallow studies, and surgical intervention.Results:Bilateral vocal fold paralysis was noted in 26% (5/19) patients. Eighty-four percent (16/19) of patients had stable or improved ability to vocalize and swallow following therapy. There was no statistically significant difference in speech or swallowing improvement after speech therapy alone or speech therapy in combination with injection laryngoplasty (P = .25). No complications were noted with surgical intervention.Conclusions:Patients with vocal fold paralysis secondary to neurologic malignancy can have an improvement in speech and swallowing after a variety of treatments, including speech therapy or early injection laryngoplasty. There was no statistically significant difference in improvement based on the type of intervention utilized. A larger sample size is needed to conclude whether surgical intervention combined with speech therapy leads to more rapid and significant functional improvement than speech therapy alone.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-19T11:58:58Z
      DOI: 10.1177/0003489419857757
       
  • Unusual Nasal Insufficiency in an Infant: What’s Behind the
           Nostril'
    • Authors: Fabian Alzate Amaya, Liliana F. Invencio da Costa, Alejandro Martinez Moran, Roberto Alvarez Rodriguez
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:Inflammatory myofibroblastic tumor (IMT) is a rare benign lesion, especially in the pediatric age. There are several cases described in pulmonary, digestive and renal localizations, but involvement in head and neck area is infrequent.Methods:Case report and review of the literature.Results:A 1 year and 11 months old child, during 2 months had clinical signs of nasal respiratory insufficiency and epistaxis subsequently developing a purulent rhinorrhea and a sleep apnea. His pediatrician previously requested a sinus and cavum X-ray with the finding of an image compatible with an intranasal mass. Endoscopic resection was performed of the mass with further immunohistochemical analysis showing the result of a lesion compatible with IMT.Conclusions:Even though there are very few cases in scientific literature of a tumor with these characteristics in infants, IMT must be present as a differential diagnosis of intranasal masses. The role of the pathologist is essential to reach the definitive diagnosis and the performance of an early surgical treatment decreases aesthetic consequences in this pathology.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-17T06:14:28Z
      DOI: 10.1177/0003489419856907
       
  • eHealth Literacy in Otolaryngology Patients
    • Authors: Christopher Eric Bailey, William J. Kohler, Chadi Makary, Kristin Davis, Nicholas Sweet, Michele Carr
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.
      Objectives:The aim of this study was to compare eHealth literacy—one’s perception of one’s ability to use the Internet for health care—among otolaryngology patients in 3 geographic settings of the same department.Setting:An academic otolaryngology department.Method:Patients’ opinions and perceptions of their eHealth literacy were assessed with a validated paper survey administered in the summer of 2017.Results:Of 381 asked, 351 people completed the survey, 149 at a university town teaching hospital clinic (group A), 101 at a nearby rural clinic (group B), and 101 at a remote rural clinic (group C). Mean scores were 30.80, 28.97, and 29.03 for groups A, B, and C, respectively. The overall mean was 29.76 ± 5.97. Three surveys reported the minimum score of 8, and 26 reported the maximum score of 40. Results were statistically significantly different among all sites (P = .001), between groups A and B (P = .027), and between groups A and C (P = .0175). Women reported higher eHealth literacy (30.13 ± 6.27) than men (28.87 ± 5.11) (P = .045). Participant age and role (patient or parent of a patient) were statistically insignificant. Mean scores were similar to those previously reported in other patient populations.Conclusions:Otolaryngology patients in a university town had better eHealth literacy than patients in more rural settings, suggesting that online medical resources and access points are less likely to be useful in rural populations.
      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-14T06:38:32Z
      DOI: 10.1177/0003489419856377
       
  • Type I Posterior Glottic Stenosis: Natural History and In-Office
           Management
    • Authors: Valeria Silva Merea, Babak Sadoughi
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-04T10:49:39Z
      DOI: 10.1177/0003489419854777
       
  • Small Cell Carcinoma in the Head and Neck
    • Authors: Takahiro Wakasaki, Ryuji Yasumatsu, Muneyuki Masuda, Mioko Matsuo, Akihiro Tamae, Kazuhiko Kubo, Ryunosuke Kogo, Ryutaro Uchi, Masahiko Taura, Takashi Nakagawa
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-04T10:42:38Z
      DOI: 10.1177/0003489419853601
       
  • Revision Stapes Surgery in a Tertiary Referral Center: Surgical and
           Audiometric Outcomes

         This is an Open Access Article Open Access Article

    • Authors: Esther E. Blijleven, Inge Wegner, Rinze A. Tange, Hans G.X.M. Thomeer
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-06-04T10:40:38Z
      DOI: 10.1177/0003489419853304
       
  • The Genetic and Molecular Determinants of Juvenile Nasopharyngeal
           Angiofibroma: A Systematic Review
    • Authors: Jaime Doody, Eelam A. Adil, Cameron C. Trenor, Michael J. Cunningham
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-31T11:01:58Z
      DOI: 10.1177/0003489419850194
       
  • Salivary Clear Cell Carcinoma Clinicopathologic Characteristics and
           Outcomes: A Population-Based Analysis
    • Authors: Daniel D. Sharbel, Aykut A. Unsal, Michael W. Groves, William G. Albergotti, J. Kenneth Byrd
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-30T04:46:29Z
      DOI: 10.1177/0003489419853597
       
  • Outcomes Using a Postoperative Protocol in Pediatric Single-Stage
           Laryngotracheal Reconstruction
    • Authors: Prasad John Thottam, Taylor Gilliland, Nicholas Ettinger, Rahul Baijal, Deepak Mehta
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-02-15T11:30:20Z
      DOI: 10.1177/0003489419830107
       
  • The Value of Dynamic Voice CT Scan for Complex Airway Patients Undergoing
           Voice Surgery
    • Authors: Mathieu Bergeron, Robert J. Fleck, Stephanie R.C. Zacharias, Meredith E. Tabangin, Alessandro de Alarcon
      First page: 885
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-22T05:38:16Z
      DOI: 10.1177/0003489419846138
       
  • Automatic Registration for Navigation at the Anterior and Lateral Skull
           Base
    • Authors: Julia Kristin, Manuel Burggraf, Dirk Mucha, Christoph Malolepszy, Silvan Anderssohn, Joerg Schipper, Thomas Klenzner
      First page: 894
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-09T05:03:22Z
      DOI: 10.1177/0003489419849086
       
  • Candidiasis Causing Vocal Fold Leukoplakia: Review of Clinical and
           Pathological Results of 289 Cases With Vocal Fold Leukoplakia
    • Authors: Murat Gumussoy, Ulku Kucuk
      First page: 903
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-10T06:22:05Z
      DOI: 10.1177/0003489419848792
       
  • Stapedectomy Is Rewarding: But How to Prove It'
    • Authors: Johanna Wickemeyer, Virginie Achim, Miriam Redleaf
      First page: 911
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-13T06:11:46Z
      DOI: 10.1177/0003489419849615
       
  • Perceived Preparedness of Facial Plastic Surgery Fellows Over Time: A
           Survey of AAFPRS Fellowship Directors
    • Authors: Tsung-yen Hsieh, Daniel Columcille O’Brien, Jonathan Sykes, Lane Darwin Squires
      First page: 915
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-13T06:11:16Z
      DOI: 10.1177/0003489419849611
       
  • Quantification of Voice Type Components Present in Human Phonation Using a
           Modified Diffusive Chaos Technique
    • Authors: Boquan Liu, Evan Polce, Hayley Raj, Jack Jiang
      First page: 921
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-14T09:17:34Z
      DOI: 10.1177/0003489419848451
       
  • Nasolacrimal Duct Management During Endoscopic Sinus and Skull Base
           Surgery
    • Authors: Janine M. Rotsides, Alexa Franco, Abdullah Albader, Roy R. Casiano, Seth M. Lieberman
      First page: 932
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-15T06:32:27Z
      DOI: 10.1177/0003489419848454
       
  • Effects of OSA Surgery on Ophthalmological Microstructures
    • Authors: Pei-Wen Lin, Hsin-Ching Lin, Michael Friedman, Hsueh-Wen Chang, Anna M. Salapatas, Meng-Chih Lin, Chien-Hung Chin
      First page: 938
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-16T06:54:08Z
      DOI: 10.1177/0003489419849082
       
  • Survival Outcomes for Advanced Cutaneous Squamous Cell Carcinoma of the
           Head and Neck
    • Authors: Christopher Blake Sullivan, Nicholas S. Andresen, Nicholas Kendell, Zaid Al-Qurayshi, Nitin A. Pagedar
      First page: 949
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-16T06:53:52Z
      DOI: 10.1177/0003489419848786
       
  • Tympanomastoidectomy for Cholesteatoma in Children: Audiometric Results
    • Authors: Sharon Tzelnick, Dan Yaniv, Eyal Raveh, David Ulanovski, Ohad Hilly
      First page: 956
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-29T07:11:45Z
      DOI: 10.1177/0003489419853312
       
  • Symptom Profile of Chronic Rhinosinusitis Versus Obstructive Sleep Apnea
           in a Tertiary Rhinology Clinic
    • Authors: Keven Ji, Thomas J. Risoli, Maragatha Kuchibhatla, Lyndon Chan, Ralph Abi Hachem, David W. Jang
      First page: 963
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-23T05:58:24Z
      DOI: 10.1177/0003489419851527
       
  • Safety and Efficacy of a Trans-Eyelid Facial Rejuvenation Surgery
           Combining Partial Repositioning of Orbital Fat and Midface Lift in Chinese
           Patients: A Prospective Case Series
    • Authors: Yin Liu, Minqin Xiao, Yanan Zhao, Wei Qiu, Hong Xiao
      First page: 970
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-28T04:37:37Z
      DOI: 10.1177/0003489419850845
       
  • Outcomes Following Transoral Laser Microsurgery With Resection of
           Cartilage for Laryngeal Cancer
    • Authors: Brent A. Chang, David G. Lott, Thomas H. Nagel, Brittany E. Howard, Richard E. Hayden, Michael L. Hinni
      First page: 978
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-28T04:41:28Z
      DOI: 10.1177/0003489419851521
       
  • Book Review: Clinical Esophagology and Transnasal Esophagoscopy
    • Authors: Michael Z. Lerner
      First page: 983
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-17T06:23:04Z
      DOI: 10.1177/0003489419851032
       
  • Review: Thieme MedOne Otolaryngology
    • Authors: Danielle Bottalico
      First page: 984
      Abstract: Annals of Otology, Rhinology & Laryngology, Ahead of Print.

      Citation: Annals of Otology, Rhinology & Laryngology
      PubDate: 2019-05-29T07:10:04Z
      DOI: 10.1177/0003489419851031
       
 
 
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