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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Communications Technology and Electronics     Hybrid Journal   (Followers: 1, SJR: 0.267, h-index: 14)
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.699, h-index: 8)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.676, h-index: 39)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 0.98, h-index: 63)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 3, SJR: 0.981, h-index: 50)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.284, h-index: 16)
J. of Computational Electronics     Hybrid Journal   (Followers: 3, SJR: 0.457, h-index: 17)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 19, SJR: 1.419, h-index: 54)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.252, h-index: 11)
J. of Computer Science and Technology     Open Access   (Followers: 4, SJR: 0.342, h-index: 26)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 5)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 4, SJR: 0.951, h-index: 70)
J. of Computers in Education     Hybrid Journal   (Followers: 5)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.725, h-index: 16)
J. of Consumer Policy     Hybrid Journal   (Followers: 3, SJR: 0.44, h-index: 23)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.115, h-index: 4)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 1, SJR: 0.174, h-index: 4)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 3, SJR: 0.441, h-index: 16)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.406, h-index: 13)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 6, SJR: 0.168, h-index: 8)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 3, SJR: 0.412, h-index: 23)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.757, h-index: 6)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.598, h-index: 49)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.445, h-index: 24)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.183, h-index: 5)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 8, SJR: 0.207, h-index: 3)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.615, h-index: 23)
J. of Digital Imaging     Hybrid Journal   (Followers: 8, SJR: 0.535, h-index: 29)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 6, SJR: 0.296, h-index: 3)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.556, h-index: 22)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.33, h-index: 29)
J. of Earth Science     Hybrid Journal   (Followers: 6, SJR: 0.299, h-index: 11)
J. of Earth System Science     Open Access   (Followers: 27, SJR: 0.466, h-index: 27)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.669, h-index: 15)
J. of Echocardiography     Hybrid Journal   (Followers: 3, SJR: 0.136, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 25, SJR: 5.251, h-index: 54)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.231, h-index: 11)
J. of Economics     Hybrid Journal   (Followers: 9, SJR: 0.463, h-index: 20)
J. of Economics and Finance     Hybrid Journal   (Followers: 7, SJR: 0.238, h-index: 15)
J. of Educational Change     Hybrid Journal   (Followers: 7, SJR: 0.694, h-index: 14)
J. of Elasticity     Hybrid Journal   (Followers: 4, SJR: 0.821, h-index: 38)
J. of Electroceramics     Hybrid Journal   (SJR: 0.566, h-index: 49)
J. of Electronic Materials     Hybrid Journal   (Followers: 2, SJR: 0.752, h-index: 68)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.241, h-index: 24)
J. of Electronics (China)     Hybrid Journal   (Followers: 3, SJR: 0.127, h-index: 7)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.707, h-index: 32)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.132, h-index: 8)
J. of Engineering Research     Open Access  
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.294, h-index: 7)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.484, h-index: 21)
J. of Evolution Equations     Hybrid Journal   (SJR: 1.312, h-index: 22)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.127, h-index: 9)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.878, h-index: 42)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 2, SJR: 0.565, h-index: 34)
J. of Experimental Criminology     Hybrid Journal   (Followers: 26, SJR: 1.587, h-index: 22)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.256, h-index: 12)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.532, h-index: 27)
J. of Family Violence     Hybrid Journal   (Followers: 15, SJR: 0.552, h-index: 45)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.241, h-index: 6)
J. of Financial Services Research     Hybrid Journal   (Followers: 16, SJR: 1.196, h-index: 29)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.467, h-index: 10)
J. of Fluorescence     Hybrid Journal   (Followers: 4, SJR: 0.553, h-index: 47)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.104, h-index: 1)
J. of Food Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.839, h-index: 21)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.578, h-index: 22)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.271, h-index: 10)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.248, h-index: 36)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.263, h-index: 6)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.389, h-index: 16)
J. of Gambling Studies     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 50)
J. of Gastroenterology     Hybrid Journal   (Followers: 13, SJR: 1.724, h-index: 73)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.371, h-index: 36)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 5, SJR: 1.632, h-index: 87)
J. of General Internal Medicine     Hybrid Journal   (Followers: 13, SJR: 2.379, h-index: 115)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.357, h-index: 17)
J. of Genetic Counseling     Hybrid Journal   (Followers: 4, SJR: 0.535, h-index: 32)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.42, h-index: 24)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 4.049, h-index: 48)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.58, h-index: 14)
J. of Geographical Systems     Hybrid Journal   (Followers: 2, SJR: 0.839, h-index: 32)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.496, h-index: 23)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.349, h-index: 13)
J. of Global Optimization     Hybrid Journal   (Followers: 3, SJR: 0.919, h-index: 51)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
J. of Grid Computing     Hybrid Journal   (SJR: 0.727, h-index: 32)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 14, SJR: 0.785, h-index: 30)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.194, h-index: 11)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.718, h-index: 43)
J. of High Energy Physics     Hybrid Journal   (Followers: 4, SJR: 1.027, h-index: 139)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.102, h-index: 1)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 6, SJR: 0.553, h-index: 21)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.317, h-index: 15)
J. of Ichthyology     Hybrid Journal   (Followers: 4, SJR: 0.28, h-index: 7)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 8, SJR: 0.573, h-index: 29)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.459, h-index: 41)
J. of Indian Philosophy     Hybrid Journal   (Followers: 10, SJR: 0.179, h-index: 7)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.165, h-index: 5)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 10, SJR: 1.064, h-index: 68)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 7, SJR: 0.411, h-index: 11)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.65, h-index: 39)
J. of Information Technology     Hybrid Journal   (Followers: 45, SJR: 1.659, h-index: 43)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 5)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 1, SJR: 0.902, h-index: 31)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.182, h-index: 66)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 6, SJR: 0.316, h-index: 27)
J. of Insect Behavior     Hybrid Journal   (Followers: 8, SJR: 0.537, h-index: 36)
J. of Insect Conservation     Hybrid Journal   (Followers: 9, SJR: 0.775, h-index: 36)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.501, h-index: 36)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.427, h-index: 39)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.095, h-index: 44)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 1.073, h-index: 38)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 25, SJR: 4.835, h-index: 108)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 8, SJR: 0.489, h-index: 16)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.385, h-index: 9)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 18, SJR: 0.35, h-index: 15)
J. of Labor Research     Hybrid Journal   (Followers: 14, SJR: 0.228, h-index: 21)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 5, SJR: 0.63, h-index: 20)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 1, SJR: 0.773, h-index: 48)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 4)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, SJR: 1.845, h-index: 32)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 3.22, h-index: 73)
J. of Management and Governance     Hybrid Journal   (Followers: 12, SJR: 0.383, h-index: 26)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.134, h-index: 4)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.343, h-index: 8)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.317, h-index: 22)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.19, h-index: 5)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 2)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, SJR: 0.392, h-index: 16)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 24, SJR: 0.666, h-index: 31)
J. of Materials Science     Hybrid Journal   (Followers: 18, SJR: 1.006, h-index: 101)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3, SJR: 0.697, h-index: 48)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4, SJR: 0.926, h-index: 77)
J. of Mathematical Biology     Hybrid Journal   (Followers: 13, SJR: 1.183, h-index: 61)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.407, h-index: 41)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 5, SJR: 1.709, h-index: 17)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 3, SJR: 1.25, h-index: 44)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.358, h-index: 19)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.32, h-index: 20)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 13, SJR: 1.042, h-index: 14)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 2)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 4, SJR: 0.589, h-index: 20)
J. of Medical and Biological Engineering     Hybrid Journal   (SJR: 0.434, h-index: 13)
J. of Medical Humanities     Hybrid Journal   (Followers: 18, SJR: 0.251, h-index: 13)
J. of Medical Systems     Hybrid Journal   (Followers: 2, SJR: 0.604, h-index: 32)
J. of Medical Toxicology     Hybrid Journal   (Followers: 6, SJR: 0.765, h-index: 21)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.209, h-index: 11)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.971, h-index: 75)
J. of Micro-Bio Robotics     Hybrid Journal  
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.641, h-index: 35)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.296, h-index: 11)
J. of Molecular Evolution     Hybrid Journal   (Followers: 11, SJR: 1.07, h-index: 99)
J. of Molecular Histology     Hybrid Journal   (Followers: 2, SJR: 0.791, h-index: 43)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.452, h-index: 100)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.55, h-index: 42)
J. of Molecular Neuroscience     Partially Free   (Followers: 8, SJR: 1.242, h-index: 61)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 11)
J. of Muscle Research and Cell Motility     Hybrid Journal   (SJR: 1.052, h-index: 51)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 2, SJR: 0.777, h-index: 66)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.586, h-index: 22)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.857, h-index: 48)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.331, h-index: 23)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.302, h-index: 77)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.342, h-index: 80)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.239, h-index: 36)
J. of Neurology     Hybrid Journal   (Followers: 13, SJR: 1.406, h-index: 91)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 1.367, h-index: 63)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 7, SJR: 0.452, h-index: 22)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.772, h-index: 36)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 3, SJR: 1.122, h-index: 38)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.456, h-index: 60)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 18, SJR: 0.886, h-index: 50)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 7, SJR: 0.174, h-index: 3)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 11, SJR: 1.166, h-index: 43)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (SJR: 0.144, h-index: 8)
J. of Oceanography     Hybrid Journal   (Followers: 7, SJR: 1.031, h-index: 46)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.228, h-index: 8)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 2, SJR: 0.831, h-index: 2)
J. of Optics     Hybrid Journal   (Followers: 4)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.928, h-index: 55)
J. of Ornithology     Hybrid Journal   (Followers: 21)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthop√§die     Hybrid Journal   (SJR: 0.667, h-index: 27)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.684, h-index: 42)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 1.284, h-index: 58)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.272, h-index: 5)
J. of Pediatric Neuropsychology     Hybrid Journal  
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.002, h-index: 21)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 8, SJR: 0.617, h-index: 14)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.16, h-index: 2)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 22, SJR: 0.567, h-index: 41)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.367, h-index: 31)

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Journal Cover European Archives of Oto-Rhino-Laryngology
  [SJR: 0.849]   [H-I: 42]   [3 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1434-4726 - ISSN (Online) 0937-4477
   Published by Springer-Verlag Homepage  [2335 journals]
  • Stapes malformations: the contribute of the endoscopy for diagnosis and
    • Abstract: Abstract The aim of this study is to investigate the contribute of the endoscopic exclusive transcanalar approach for the management of stapes malformations. A retrospective chart review was made at our tertiary referral centers. 17 patients with stapes malformations underwent surgery with endoscopic exclusive transcanal approach. A complete audiological and radiological assessment before and after surgery was performed. 12/17 (70 %) underwent a surgical endoscopic correction, In case of fixed platina underwent five endoscopic stapedotomy and one endoscopic stapedectomy were performed. In case of mobile platina five endoscopic ossiculoplasties with partial ossiculoplasty replacement prosthesis were performed, 3 with autologous remodeling incus and 2 with malleus head remodeling. In 1 case, only an endoscopic stapes mobilization was made. In 5/17 (30 %), due to difficult anatomical findings an endoscopic explorative tympanotomy was finally performed. The mean preoperative air conduction (AC), bone conduction (BC) and air-bone gap (ABG) were, respectively, 60.7, 26.3 and 34.4 dB. The mean postoperative AC, BC and ABG were, respectively, 33.8, 26.5 and 7.3 dB, with a mean improvement of the ABG of 27.1 dB. Discharge from hospital was on the first post-surgery day. No relevant postoperative complications were noted. The median follow-up was 3.6 years (range 1–6). The endoscopic approach results very adequate for the diagnosis and treatment of stapes malformations, checking variations of the ossicles conformation and functioning and performing safe surgery, under direct control of middle ear structures.
      PubDate: 2016-07-01
  • Aeroallergens in West Crete, Greece: A five year (2010–2014)
           aerobiological study
    • Abstract: Abstract The objective of the analytic observational study was to present air-pollen counting program results for a 5-year period. Airborne pollens and fungi collection, from both urban and sub-urban areas, were obtained using a special Burkard pollen trap installed on the roof of Chania General Hospital. Aeroallergen concentration measurement was made in a standardized way with fixation of the material collected and then counting using an optical microscope. Annual and total circulating pollen and fungi counts for the study period are presented. In the year 2014, the highest total annual count was recorded, while 2013 was the year with the lowest one. Months with the highest average concentrations were June for the years 2010 and 2011 (1291 and 1114.6 grains/m3, respectively) and May for the consecutive 3 years 2012–2014 (1120, 890 and 1353.1 g/m3, respectively). Peak periods for circulating aeroallergens were April–June. Trees pollen accounted for the majority of circulating aeroallergens (615.9 and 677.1 g/m3 during peak periods in the years 2012 and 2014), while fungi accounted for the majority of circulating aeroallergens (818.5, 729.4, 890.7 spores/m3), during the peak periods in the years 2010, 2011 and 2013. Variability in peak airborne allergen periods could be partly explained by the differences in climatic conditions during the study period.
      PubDate: 2016-07-01
  • The functional outcome of blow-out fractures managed surgically and
           conservatively: our experience in 100 patients
    • Abstract: Abstract The proportion of orbital blow-out fractures (BOFs) which are operated upon varies. The purpose of this study was to determine the treatment pattern of BOFs at our tertiary trauma centre and to evaluate the functional outcomes in patients according to whether they were managed surgically or conservatively. The study design is a retrospective cohort study and the setting is Tertiary care University Hospital. The participants include patients with isolated BOFs admitted to our Trauma Unit from 2010 to 2013. Of the 100 consecutive patients included, 60 had available follow-up data. The presence of diplopia and enophthalmus was determined by reviewing the medical records. Data from the patients’ initial consultation and their 3-month follow-up were also collected. Of the 60 patients whose data could be analysed, 36 had been managed surgically and 24 conservatively. Of the patients managed surgically, 25 had diplopia in peripheral gaze before surgery and 12 at 3-month follow-up. Nine had diplopia in primary gaze before surgery and none at 3-month follow-up. Five had enophthalmus before surgery and two at 3-month follow-up. Of the patients managed conservatively, eight had diplopia in peripheral gaze initially and seven at 3-month follow-up. Three had diplopia in primary gaze initially and one at 3-month follow-up. One had enophthalmus initially which was still present at 3-month follow-up. Primary gaze diplopia disappeared while secondary gaze diplopia was present in about a third of patients, whether managed surgically or conservatively at the 3-month follow-up. Standardised follow-up as well as clear indications for and against surgery are warranted.
      PubDate: 2016-07-01
  • The contralateral ear in cholesteatoma
    • Abstract: Abstract Middle ear cholesteatoma has been extensively studied. Theories of cholesteatoma pathogenesis involving previous tympanic membrane retraction are the most widely accepted, but the contralateral ear in patients with cholesteatoma remains unstudied. This study aimed to investigate the contralateral ear in patients with cholesteatoma, and to determine whether the characteristics of it differ according to patient age and cholesteatoma growth patterns. This study was cross sectional. We evaluated 356 patients with middle ear cholesteatoma in at least one ear, and no history of surgery, between August 2000 and March 2013. Otoendoscopy was conducted on both the affected and the contralateral ear. They were classified as normal, tympanic membrane perforation, moderate to severe tympanic membrane retraction and cholesteatoma. The mean age of the patients was 32.77 years, and 53.1 % of the cohort were female. Only 34.8 % of the contralateral ears were normal. The most common abnormality was moderate to severe tympanic membrane retraction (41.6 %). Cholesteatoma was identified in 16 %. Children exhibited a greater frequency of tympanic membrane retractions, whereas adults exhibited a greater frequency of cholesteatoma. All of the contralateral ears in the anterior epitympanic group were normal, but otherwise there were no differences in the contralateral ear when we compared the cholesteatoma growth patterns. We conclude that patients diagnosed with acquired cholesteatoma of one ear are significantly more likely to exhibit abnormalities of the contralateral ear.
      PubDate: 2016-07-01
  • Prognostic factors of locally invasive well-differentiated thyroid
           carcinoma involving the trachea
    • Abstract: Abstract To report our experience with tracheal invasive thyroid carcinoma with emphasis on clinical characteristics and treatment modalities, and to identify the prognostic factors for tracheal invasive thyroid carcinoma. Totally 1919 patients underwent surgical extirpation of thyroid cancer from 1990 to 2010. Among them, 65 patients had well-differentiated thyroid cancer with tracheal invasion. The incidence was higher in male and older patients. Patients were treated with tracheal shave excision (n = 18), tracheal resection (n = 37) and total laryngectomy (n = 10). Locoregional recurrence occurred in 39 patients, and metastasis occurred in 25 patients. Simultaneous involvement of the trachea and the esophagus was associated with locoregional recurrence (p = 0.039) in univariate analysis, but not confirmed by multivariate analysis. There was significant difference in the disease-specific survival (DSS) according to laryngeal involvement (p = 0.002). All the patient in the shave excision group survived until the end of the study period. Although it is categorized in same classification of T4a, simultaneous involvement of the trachea and the esophagus showed higher locoregional recurrence and laryngeal involvement showed lower DSS. Despite the invasion of thyroid cancer into the adjacent aerodigestive tract, many patients showed long survival when they underwent appropriate surgery.
      PubDate: 2016-07-01
  • Primary radiotherapy for squamous cell carcinoma of the pyriform sinus
    • Abstract: Abstract The objective of this study is to report the long-term outcomes of primary radiotherapy (RT) for patients with T1–T2 squamous cell carcinomas (SCC) of the pyriform sinus. Between November 1964 and March 2008, 135 patients with T1–T2 pyriform sinus SCC were treated with primary RT at the University of Florida. Adjuvant chemotherapy was employed in 21 patients (16 %) and 62 patients (46 %) underwent a planned neck dissection. Median follow-up was 3.5 years (range 0.2–24.7 years); median follow-up on living patients was 8.3 years (range 3.8–24.0 years). The 5-year outcomes were as follows: local control, 85 %; regional control, 81 %; local–regional control, 71 %; distant metastasis-free survival, 76 %; cause-specific survival, 62 %; and overall survival, 38 %. The 5-year local control rate was 88 % for T1 cancers and 84 % for those with T2 SCCs (p = 0.5429). Sixteen patients (12 %) experienced severe late complications. Primary RT results in a high probability of cure with a relatively modest risk of severe late complications for patients with T1–T2 SCCs of the pyriform sinus.
      PubDate: 2016-07-01
  • Numerical simulation of humidification and heating during inspiration in
           nose models with three different located septal perforations
    • Abstract: Abstract Nasal septum perforations (SP) are characterized by nasal obstruction, bleeding and crusting. The disturbed heating and humidification of the inhaled air are important factors, which cause these symptoms due to a disturbed airflow. Numerical simulations offer a great potential to avoid these limitations and to provide valid data. The aim of the study was to simulate the humidification and heating of the inhaled air in digital nose models with three different SPs and without SP. Four realistic bilateral nose models based on a multi-slice CT scan were created. The SP were located anterior caudal, anterior cranial and posterior caudal. One model was without SP. A numerical simulation was performed. Boundary conditions were based on previous in vivo measurements. Heating and humidification of the inhaled air were displayed, analyzed in each model and compared to each other. Anterior caudal SPs cause a disturbed decrease of temperature and humidity of the inhaled air. The reduced temperature and humidity values can still be shown in the posterior nose. The anterior cranial and the posterior caudal perforation have only a minor influence on heating and humidification. A reduced humidification and heating of the air can be shown by numerical simulations due to SP depending on their localization. The anterior caudal SP representing a typical localization after previous surgery has the biggest influence on heating and humidification. The results explain the typical symptoms such as crusting by drying-out the nasal mucosa. The size and the localization of the SP are essential for the symptoms.
      PubDate: 2016-07-01
  • No benefit for regional control and survival by planned neck dissection in
           primary irradiated oropharyngeal cancer irrespective of p16 expression
    • Abstract: Abstract The aim of the study was to assess regional control and survival in primary irradiated oropharyngeal cancer patients with advanced neck disease (≥cN2a) receiving planned neck dissection (PND) irrespective of the nodal response compared to salvage neck dissection (SND) in case of regional persistence or reccurence in relation to tumoral p16 overexpression. 96 consecutive patients treated at the University Hospital of Zurich, Switzerland were included. Tissue microarray-based scoring of p16 expression was obtained. 5 years overall (OS) and disease-specific survival (DSS) in the PND and SND cohort were 70 vs. 57 % (p = 0.20) and 80 vs. 65 % (p = 0.14), respectively. Regional control in PND and SND achieved 95 vs. 87 % (p = 0.29), respectively. There was no statistically significant impact of neck treatment (PND vs. SND) on regional control or survival among patients with p16-negative tumors (5 years OS 59 vs. 50 %, p = 0.66; 5 years DSS 59 vs. 57 %, p = 0.89) nor among patients with p16-positive tumors (5 years OS 84 vs. 67 %, p = 0.21; 5 years DSS 95 vs. 81 %, p = 0.24). The type of neck dissection after primary intensity-modulated radiotherapy (IMRT) had no impact on regional control and survival even in human papillomavirus (HPV)-associated disease. Therefore we are convinced that based on the accuracy of newer diagnostic modalities the surveillance of a radiologically negative neck after primary chemoradiation (CRT) is oncologically safe irrespective of p16 expression of the tumor.
      PubDate: 2016-07-01
  • Cartilage invasion patterns in laryngeal cancer
    • Abstract: Abstract The cartilaginous invasion determines the T and is one of the most common sources of mistake in tumor staging. Also it is of great importance when planning any therapeutic alternative. In the latest revision of the TNM classification a clear distinction is made between infiltration of cartilage without going through it, considered a T3 recently and that would be a T4 according to the previous classification, and those going through the cartilage, classified as T4a. While this classification makes the difference in depth of infiltration, it does not emphasize the extent of invasion. This paper provides a detailed description of the laryngeal cartilage tumor infiltration by whole organ serial section in which the invasion is considered both horizontal (transcartilaginous) and vertical (extent of invasion) and establishing patterns of three-dimensional infiltration of the cartilage. This is a cross-sectional study of prevalence. 275 records of patients treated for laryngeal squamous cell carcinoma between 1995 and 2000 were reviewed. The pathological processing of laryngectomy surgical specimens was performed following the method of whole organ serial section described by G. F. Tucker. The following patterns of cartilaginous infiltration were defined: (1) transcartilaginous infiltration; (2a) partial focal infiltration of the cartilage: infiltration not going through the cartilage but occupying one third or less of its extent; (2b) partial extensive infiltration of the cartilage: infiltration occupying two thirds or more of its length and (3) no cartilage infiltration: tumor in contact with the cartilage (paraglottic space) but without affecting it. 161 patients met the inclusion criteria. The most frequent tumor location was supraglottic (58 cases) followed by glottic (47). 109 patients (67.7 %) were treated with total laryngectomy. Partial surgical techniques were performed in the remaining cases. TNM tumor staging was performed according to the results of pathological study (pTNM). 72.06 % (116) were classified as advanced laryngeal tumors (pT3 and pT4). 46 % of patients showed some extent of laryngeal cartilage infiltration (thyroid, cricoid, arytenoids, epiglottis). The cartilage most frequently infiltrated was the thyroid in 48 patients (29.8 %) and when it is affected, in most cases (66.7 %), the infiltration is transcartilaginous. The next most common pattern is partial focal infiltration (27 %). In the cricoid cartilage, the most common pattern of infiltration is focal partial infiltration (52.6 %). Of the 19 cases with infiltration of the cricoid, there are 12 cases with extra laryngeal invasion through a cricothyroid membrane perforation. The study of laryngeal cancer by laryngeal whole serial section has been proved to be very useful in offering a high precision pTNM staging and a detailed description of the infiltration of cartilage. We have seen that when the thyroid cartilage is infiltrated the tumor often passes through the cartilage. However, there are cases where the tumor is extremely aggressive, being very widespread in cartilage thickness without actually crossing it. The isolated infiltration of the cricoid cartilage is exceptional.
      PubDate: 2016-07-01
  • Oncological and surgical outcome of total laryngectomy in combination with
           neck dissection in the elderly
    • Abstract: Abstract There are controversial data on oncological and surgical outcome after major head and neck cancer surgery in the elderly. The aim of this study was to evaluate the outcome of elderly cancer patients after total laryngectomy in combination with neck dissection. A total of 58 patients separated into two age groups (28 < 65 vs. 30 ≥ 65 years) with hypopharyngeal and laryngeal cancer who underwent total laryngectomy and neck dissection were enrolled. Comorbidities of both age groups using the Charlson comorbidity index, hospitalization days as well as surgical complications evaluated by the Clavien–Dindo classification were examined. Overall and disease-free survivals of all patients were analyzed. The average follow-up was 2.9 years. Surgical complication rate was significantly increased in elderly (p = 0.04). However, complications could be treated without surgical intervention in most cases without significant extension of hospitalization. Locoregional and distant control did not significantly differ in both age groups. Disease-free and overall survival showed no significant differences for the two age groups by the Kaplan–Meier analysis (p = 0.66 and 0.08, respectively). Total laryngectomy in combination with neck dissection can be considered in elderly patients with satisfactory oncological and surgical outcome.
      PubDate: 2016-07-01
  • The endoscopic study of human middle ear mucociliary transport
    • Abstract: Abstract The mucociliary clearance (MCC) is an important defence mechanism of the middle ear. The mucociliary transport (MCT) is a part of MCC. We measured the duration of MCT and visualised its routes in middle ears of 31 patients (mean age 45 years; range 7–61 years; SD 11.6) with intact tympanic membrane, with ventilated middle ears and without a history of prolonged otitis media. The transition time of indigo carmine dye from the promontory mucosa to the middle ear orifice of the Eustachian tube (ET) was observed with a rigid 30°, 1.7-mm-diameter tympanoscope. The dye took an average of 7 min (range 4.5–15 min; SD 3.4; median 4.5) to reach the ET orifice in 25 (81 %) patients. Three main ciliary pathways were detected: (1) below and parallel to the tensor tympani muscle; (2) downwards, anterior to the round window, and then ascending to the ET; and (3) straight across the promontory.
      PubDate: 2016-07-01
  • First use of a new retractor in transoral robotic surgery (TORS)
    • Abstract: Abstract Transoral robotic surgery (TORS) has gained importance in head and neck surgery due to the possibility to visualize regions within the pharynx and larynx which are difficult to access. The success of transoral surgery depends on the exposure of the region of interest in order to allow visualization using a camera system. The Medrobotics Flex® Robotic System is a new flexible endoscopic system designed to overcome difficulties experienced in transoral surgery using other robotic systems with rigid endoscopes and instruments. In this article, we describe the first use of the Medrobotics Flex® Retractor in humans, a retractor designed for advanced transoral procedures. We report our experience in 11 patients requiring surgery of the oropharynx, hypopharynx, and supraglottic larynx. In all cases, we successfully exposed all targeted surgical regions. We experienced easy handling of the retractor alongside comparable positioning times and no observed mucosal damage.
      PubDate: 2016-07-01
  • Tracheoesophageal fistula length decreases over time
    • Abstract: Abstract The objectives of this study were to demonstrate that the length of the tracheoesophageal voice prosthesis changes over time and to determine whether the prosthesis length over time increased, decreased, or showed no predictable change in size. A retrospective chart review was performed at a tertiary care referral center. Patients who underwent either primary or secondary tracheoesophageal puncture between January 2006 and August 2014 were evaluated. Patients were excluded if the tracheoesophageal prosthesis size was not consistently recorded or if they required re-puncturing for an extruded prosthesis. Data analyzed included patient demographics and the length of the tracheoesophageal voice prosthesis at each change. A total of 37 patients were identified. The mean age was 64 years. Seventy-six percent were male. 24 % underwent primary tracheoesophageal puncture and 76 % underwent secondary tracheoesophageal puncture. The length of the prosthesis decreased over time (median Kendall correlation coefficient = −0.60; mean = −0.44) and this correlation between length and time was significant (p = 0.00085). Therefore, in conclusion, tracheoesophageal prosthesis length is not constant over time. The tracheoesophageal wall thins, necessitating placement of shorter prostheses over time. Patients with a tracheoesophageal voice prosthesis will require long-term follow-up and repeat sizing of their prosthesis. Successful tracheoesophageal voicing will require periodic reevaluation of these devices, and insurers must, therefore, understand that long-term professional care will be required to manage these patients and their prostheses.
      PubDate: 2016-07-01
  • Small access postaural parotidectomy: an analysis of techniques,
           feasibility and safety
    • Abstract: Abstract For cosmetic consideration of parotidectomy, the surgical approaches have evolved from Blair incision through modified facelift incision to postaural-hairline incision. The present study aims at evaluating the feasibility and safety of the new technique of postaural approach. Parotidectomy was performed with a 4–5 cm incision in the postaural sulcus. There were 69 patients who were assessed pre-operatively feasible for consideration of the postaural parotidectomy. There were 56 (81 %) patients who could have the postaural parotidectomy successfully without complications. The minimally invasive postaural approach is a further step in cosmetic consideration of parotidectomy. It is a feasible and safe approach for most small to medium size benign parotid tumors located in the mid and lower pole regions of the parotid gland.
      PubDate: 2016-07-01
  • Prognostic impact of second primary tumors in head and neck cancer
    • Abstract: Abstract The incidence of Second Primary Tumors in the upper aerodigestive tract varies from 5 to 30 %. Most of them are located either in the same anatomical region or in the lungs, and are related to a poor overall survival. Our objective is to assess the incidence of Second Primary Tumors, factors related to its outcome, frequent associations, and impact on overall survival. 27 patients with Second Primary Tumors were reviewed out of 307 with head and neck cancer, between 2002 and 2011. Patients had a minimum follow-up period of 3 years, or until their death after the last treatment. Sex: 85.2 % were male; male:female ratio of 23:4. The mean age of appearance for the primary tumor was 66.8 years. Only 1 patient had a synchronous Second Primary Tumor, while 26 had metachronous Second Primary Tumors. Second neoplasms were grouped into synchronous and metachronous for statistical analysis. The following parameters were considered: age at diagnosis of the first tumor, gender, smoking and persistence of the habit, primary tumor’s location in the larynx, association between two squamous cell carcinomas (index and second primary tumor), and radiotherapy for the primary tumor. The incidence of Second Primary Tumors was 8.79 %. Overall survival of metachronous tumors was 95 months (7.9 years). The primary tumor’s location that prevailed when developing a Second Primary Tumor was the larynx. Regarding the histology, the most common association was head and neck squamous cell carcinoma with head and neck squamous cell carcinoma (9 patients). The Second Primary Tumor was the cause of death in 51.9 % of the patients and its most frequent location was the lungs. 19 patients underwent radiotherapy. Second Primary Tumors are common in the head and neck. The authors would like to enforce the importance of an extended follow-up, since second neoplasms worsen considerably the patient’s prognosis. Patients who keep on smoking after treatment decrease even more their overall survival.
      PubDate: 2016-07-01
  • Parathyroid function following total thyroidectomy using energy devices
    • Abstract: Abstract LigaSure precise (LP) and harmonic scalpel (HS) are two energy-based devices used in thyroidectomy surgery. We aimed to compare the effect of these two devices in patients who had undergone total thyroidectomy, by highlighting the post-operative parathyroid function. A total of 201 consecutive patients for whom total thyroidectomy had been planned were prospectively classified into two groups. There were 104 patients in LP group and 97 patients in HS group. Hypoparathyroidism was followed up by serially measuring the levels of intact parathyroid hormone (iPTH) and serum calcium. The early iPTH level was 29 (8–50) pg/mL in group LP, and 17 (4–43) pg/mL in group HS. The early iPTH level was significantly lower in the HS group (p < 0.001). However, these levels were within the reference interval in both groups. The early iPTH level was lower than 20 pg/mL in 23 (23.1 %) patients in HS group, and 15 (13.7 %) patients in LP group (p < 0.001). Also, the late iPTH levels were not statistically significance between two groups. The early and late serum calcium levels were not statistically significant between groups. However, the amount of calcium replacement was higher in the HS group than the LP group and the duration of treatment was longer in the HS group than the LP group (p < 0.05). In conclusion, although parathyroid hormone levels impaired in the HS group more than LP group in the early period, these levels were in the normal limits in both groups. These levels were not significant between groups in the long time period.
      PubDate: 2016-07-01
  • Paranasal sinus opacification at MRI in lower airway disease (the HUNT
    • Abstract: Abstract The study builds on the concept of united airways, which describes the link between the upper and lower airways. Explorations of this concept have mainly related to asthma and less to chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate paranasal sinus opacification at magnetic resonance imaging (MRI) in COPD, self-reported asthma and respiratory symptoms. In this cross-sectional study, 880 randomly selected participants in the Nord-Trøndelag health survey (HUNT) (mean age 57.7 years, range 50–66 years, 463 women) were investigated using MRI of the paranasal sinuses. Participants were allocated to four mutually exclusive groups: (1) COPD (n = 20), (2) asthma (n = 89), (3) respiratory symptoms (n = 199), and (4) reference group (n = 572). Paranasal sinus opacifications were categorised as mucosal thickening, polyps and retention cysts, and fluid. In each participant, measurements ≥1 mm from all sinuses were summed to give a total for each category of opacities. The sums for these three categories were further added together, and referred to as the total sum. Using the 75th percentile cut-off values, the likelihood of having paranasal sinus opacifications was more than six times higher in participants with COPD and twice as high in participants with asthma than among the reference group. Respiratory symptoms were only associated with mucosal thickening. The present study shows that paranasal sinus opacification is associated not only with asthma, but also with COPD and respiratory symptoms. This is in accordance with the united airways hypothesis, and should be kept in mind when handling patients with these conditions.
      PubDate: 2016-07-01
  • Erratum to: Diagnostic value of cone-beam CT in histologically confirmed
    • PubDate: 2016-07-01
  • A comprehensive 6-year retrospective study on medialisation thyroplasty in
           the Indian population
    • Abstract: Abstract The purpose of this paper is to describe a series of patients who have undergone medialisation thyroplasty (with or without arytenoid adduction) at our centre with respect to demographics, aetiology for unilateral vocal fold paralysis, pre- and postoperative maximum phonation time, amount of anterior and posterior medialisation required and complications. A comparative analysis with international studies was also performed. A retrospective analysis was performed on 67 patients, who underwent medialisation thyroplasty at our centre from August 2008 to August 2014. All the medialisation thyroplasty were performed using Netterville’s technique. The average anterior medialisation needed was 2.25 mm (SD 1.05 mm) while the average posterior medialisation needed was 6.75 mm (SD 1.79 mm). Our study is the first to determine the amount of anterior and posterior medialisation needed in the Indian population. Mean anterior and posterior medialisation required was found to be the same, regardless of the age, gender of the patient and side of surgery.
      PubDate: 2016-07-01
  • Prevalence of swallowing and speech problems in daily life after
           chemoradiation for head and neck cancer based on cut-off scores of the
           patient-reported outcome measures SWAL-QOL and SHI
    • Abstract: Abstract The objective of this study is to assess swallowing and speech outcome after chemoradiation therapy for head and neck cancer, based on the patient-reported outcome measures Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI), both provided with cut-off scores. This is a cross-sectional study. Department of Otolaryngology/Head and Neck Surgery of a University Medical Center. Sixty patients, 6 months to 5 years after chemoradiation for head and neck squamous cell carcinoma. Swallowing Quality of Life Questionnaire (SWAL-QOL) and SHI, both validated in Dutch and provided with cut-off scores. Associations were tested between the outcome measures and independent variables (age, gender, tumor stage and site, and radiotherapy technique, time since treatment, comorbidity and food intake). Fifty-two patients returned the SWAL-QOL and 47 the SHI (response rate 87 and 78 %, respectively). Swallowing and speech problems were present in 79 and 55 %, respectively. Normal food intake was noticed in 45, 35 % had a soft diet and 20 % tube feeding. Patients with soft diet and tube feeding reported more swallowing problems compared to patients with normal oral intake. Tumor subsite was significantly associated with swallowing outcome (less problems in larynx/hypopharynx compared to oral/oropharynx). Radiation technique was significantly associated with psychosocial speech problems (less problems in patients treated with IMRT). Swallowing and (to a lesser extent) speech problems in daily life are frequently present after chemoradiation therapy for head and neck cancer. Future prospective studies will give more insight into the course of speech and swallowing problems after chemoradiation and into efficacy of new radiation techniques and swallowing and speech rehabilitation programs.
      PubDate: 2016-07-01
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