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Publisher: Springer-Verlag   (Total: 2210 journals)

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Dynamic Games and Applications     Hybrid Journal   (Followers: 2)
Dysphagia     Hybrid Journal   (Followers: 215, SJR: 0.684, h-index: 46)
e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 8, SJR: 0.146, h-index: 8)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 13, SJR: 0.367, h-index: 12)
Earth Science Informatics     Hybrid Journal   (Followers: 3, SJR: 0.245, h-index: 5)
Earth, Moon, and Planets     Hybrid Journal   (Followers: 5, SJR: 0.436, h-index: 28)
Earthquake Engineering and Engineering Vibration     Hybrid Journal   (Followers: 7, SJR: 0.433, h-index: 17)
Earthquake Science     Hybrid Journal   (Followers: 8, SJR: 0.486, h-index: 7)
East Asia     Hybrid Journal   (Followers: 7, SJR: 0.165, h-index: 9)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 8, SJR: 0.289, h-index: 23)
EcoHealth     Hybrid Journal   (Followers: 1, SJR: 0.651, h-index: 22)
Ecological Research     Hybrid Journal   (Followers: 8, SJR: 0.698, h-index: 38)
Economic Botany     Hybrid Journal   (Followers: 9, SJR: 0.666, h-index: 40)
Economic Bulletin     Hybrid Journal   (Followers: 4)
Economic Change and Restructuring     Hybrid Journal   (Followers: 1, SJR: 0.263, h-index: 6)
Economic Theory     Hybrid Journal   (Followers: 7, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal   (Followers: 1)
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.367, h-index: 12)
Ecosystems     Hybrid Journal   (Followers: 19, SJR: 1.793, h-index: 83)
Ecotoxicology     Hybrid Journal   (Followers: 10, SJR: 1.041, h-index: 53)
Education and Information Technologies     Hybrid Journal   (Followers: 209, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 15, SJR: 0.519, h-index: 14)
Educational Psychology Review     Hybrid Journal   (Followers: 14, SJR: 1.781, h-index: 52)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 7, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 10, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 204, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 12, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 4, SJR: 0.636, h-index: 14)
Electronic Markets     Hybrid Journal   (Followers: 6, SJR: 0.326, h-index: 5)
Electronic Materials Letters     Hybrid Journal   (Followers: 3, SJR: 0.566, h-index: 11)
Elemente der Mathematik     Hybrid Journal   (Followers: 1)
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.446, h-index: 22)
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.185, h-index: 12)
Empirical Economics     Hybrid Journal   (Followers: 8, SJR: 0.5, h-index: 29)
Empirical Software Engineering     Hybrid Journal   (Followers: 4, SJR: 2.319, h-index: 33)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.21, h-index: 13)
Endocrine     Hybrid Journal   (Followers: 5, SJR: 0.659, h-index: 55)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.555, h-index: 27)
Energy Efficiency     Hybrid Journal   (Followers: 11, SJR: 1.056, h-index: 10)
Energy Systems     Hybrid Journal   (Followers: 10, SJR: 0.589, h-index: 5)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 26)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.128, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 28, SJR: 0.319, h-index: 26)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.389, h-index: 29)
Environmental and Resource Economics     Hybrid Journal   (Followers: 17, SJR: 1.651, h-index: 46)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 4, SJR: 0.486, h-index: 53)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 2, SJR: 0.664, h-index: 22)
Environmental Earth Sciences     Hybrid Journal   (Followers: 10, SJR: 0.601, h-index: 55)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 6, SJR: 0.35, h-index: 3)
Environmental Evidence     Open Access  
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.732, h-index: 23)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 0.909, h-index: 32)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 14)
Environmental Management     Hybrid Journal   (Followers: 32, SJR: 0.773, h-index: 60)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 10, SJR: 0.413, h-index: 27)
Environmental Monitoring and Assessment     Hybrid Journal   (Followers: 8, SJR: 0.671, h-index: 46)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 14, SJR: 0.878, h-index: 42)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 2, SJR: 1.002, h-index: 14)
Epileptic Disorders     Hybrid Journal   (Followers: 1, SJR: 0.669, h-index: 34)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (Followers: 1, SJR: 1.435, h-index: 58)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (Followers: 3, SJR: 0.749, h-index: 85)
EPJ direct     Hybrid Journal  
EPJ E - Soft Matter and Biological Physics     Hybrid Journal   (Followers: 1, SJR: 0.661, h-index: 57)
EPMA J.     Open Access   (SJR: 0.161, h-index: 4)
ERA-Forum     Hybrid Journal   (Followers: 2, SJR: 0.13, h-index: 2)
Erkenntnis     Hybrid Journal   (Followers: 11, SJR: 0.62, h-index: 14)
Erwerbs-Obstbau     Hybrid Journal   (SJR: 0.173, h-index: 8)
Esophagus     Hybrid Journal   (SJR: 0.268, h-index: 9)
Estuaries and Coasts     Hybrid Journal   (Followers: 4, SJR: 1.111, h-index: 61)
Ethical Theory and Moral Practice     Hybrid Journal   (Followers: 7, SJR: 0.278, h-index: 8)
Ethics and Information Technology     Hybrid Journal   (Followers: 207, SJR: 0.363, h-index: 20)
Ethik in der Medizin     Hybrid Journal   (SJR: 0.204, h-index: 6)
Euphytica     Hybrid Journal   (Followers: 7, SJR: 0.709, h-index: 57)
Eurasian Soil Science     Hybrid Journal   (Followers: 2, SJR: 0.271, h-index: 10)
EURO J. of Transportation and Logistics     Hybrid Journal   (Followers: 4)
EURO J. on Computational Optimization     Hybrid Journal  
EURO J. on Decision Processes     Hybrid Journal  
Europaisches J. fur Minderheitenfragen     Hybrid Journal  
European Actuarial J.     Hybrid Journal   (Followers: 3)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (Followers: 4, SJR: 0.737, h-index: 37)
European Archives of Paediatric Dentistry     Hybrid Journal   (Followers: 1, SJR: 0.446, h-index: 12)
European Archives of Psychiatry and Clinical Neuroscience     Hybrid Journal   (Followers: 2, SJR: 1.334, h-index: 62)
European Biophysics J.     Hybrid Journal   (Followers: 4, SJR: 0.979, h-index: 53)
European Child & Adolescent Psychiatry     Hybrid Journal   (Followers: 5, SJR: 1.269, h-index: 51)
European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (Followers: 5)
European Food Research and Technology     Hybrid Journal   (Followers: 8, SJR: 0.773, h-index: 49)
European J. for Education Law and Policy     Hybrid Journal   (Followers: 6)
European J. for Philosophy of Science     Partially Free   (Followers: 4, SJR: 0.165, h-index: 2)
European J. of Ageing     Hybrid Journal   (Followers: 10, SJR: 0.49, h-index: 17)
European J. of Applied Physiology     Hybrid Journal   (Followers: 8, SJR: 1.044, h-index: 74)
European J. of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (Followers: 11, SJR: 0.958, h-index: 74)
European J. of Clinical Pharmacology     Hybrid Journal   (Followers: 9, SJR: 0.916, h-index: 69)
European J. of Dermatology     Hybrid Journal   (Followers: 7)
European J. of Drug Metabolism and Pharmacokinetics     Hybrid Journal   (Followers: 7, SJR: 0.24, h-index: 25)
European J. of Epidemiology     Hybrid Journal   (Followers: 17, SJR: 1.946, h-index: 60)
European J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.864, h-index: 25)

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Journal Cover European Archives of Oto-Rhino-Laryngology     [SJR: 0.737]   [H-I: 37]
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1434-4726 - ISSN (Online) 0937-4477
   Published by Springer-Verlag Homepage  [2210 journals]
  • The effect of nasal structure on olfactory function in patients with OSA
    • Abstract: Abstract The aim of this study was to investigate the relationship between nasal structure and olfactory function in patients with obstructive sleep apnea (OSA). Olfaction and nasal structure of 76 adults with OSA diagnosed by polysomnography were measured using acoustic rhinometry and the Sniffin, Sticks (SS) smell test at Anzhen Hospital, a major academic center in Beijing, China. We tested the hypothesis that nasal structure in these patients would correlate with objectively measured olfactory performance. Minimum cross-sectional area (MCA) of the nose was significantly correlated with SS composite score (r = 0.434, p < 0.001), a result that was driven by two of the test’s three components: olfactory threshold (OT) (r = 0.385, p = 0.001) and olfactory discrimination (OD) (r = 0.370, p = 0.001) but not olfactory identification (OI) (p > 0.05). Additionally, nasal volume (NV) was associated with composite SS score (r = 0.350, p = 0.002), a finding driven by OT (r = 0.283, p = 0.014). These data suggest that nasal structure affects parameters of olfactory function, likely via alterations in nasal airflow. Thus, anatomic abnormalities and diseases involving airflow (such as OSA) may cause, in part, olfactory dysfunction that is amenable to treatment. We speculate that surgery that alters nasal volume and MCA may improve olfactory performance.
      PubDate: 2015-02-01
  • Does menopause effect nasal mucociliary clearance time'
    • Abstract: Abstract The aim of this study was to investigate the effect of menopause on nasal mucociliary clearance time by comparing the results of premenopausal and postmenopausal women. A total of 60 women met the criteria and were divided into two groups: premenopausal women (n = 30) and postmenopausal women (n = 30). Nasal mucociliary clearance time of these women was measured and compared. Moreover, the correlation between nasal mucociliary clearance time and menopause duration in postmenopausal women was evaluated. Statistical analysis was performed using the SPSS (Statistical Package for the Social Sciences) 13.0 Evaluation for Windows. Normal distribution of continuous variables was tested with Kolmogorov–Smirnov test. Chi square test was used for comparisons between categorical variables. Kruskal–Wallis test and Mann–Whitney U tests were used for continuous variables when comparing the groups. The statistically significant level was accepted as p value <0.05. The mean nasal mucociliary clearance time in premenopausal and postmenopausal women was 11.43 ± 2.81 (7–16) and 16.76 ± 2.73 (12–22), respectively. The mean nasal mucociliary clearance time in postmenopausal women was significantly longer than in premenopausal women (p < 0.0001). Also, there was positive correlation between menopause duration and nasal mucociliary clearance time in postmenopausal women (r = 0.833, p < 0.0001). The clinicians must keep in mind that nasal mucociliary clearance time in postmenopausal women is prolonged and must follow up women in postmenopausal period more closely for respiratory tract diseases, sinonasal and middle ear infections.
      PubDate: 2015-02-01
  • Assessment of quality-of-life outcomes after surgery for nasal polyposis
           with the DyNaChron questionnaire
    • Abstract: Abstract This prospective study assesses outco mes at 6 weeks and 7 months after radical ethmoid surgery in 65 patients with nasal polyposis using a new and detailed instrument, the DyNaChron questionnaire, which was filled in the day prior to surgery and at 6 weeks and 7 months after surgery at follow-up visits. Before surgery, the leading bothersome symptoms were olfactory disturbances (7.74 ± 2.81) and nasal obstruction (6.66 ± 2.28). After surgery (6th week and 7th month), there was a clear improvement of all symptoms including nasal obstruction, olfactory disturbances, anterior rhinorrhea, postnasal discharge, facial pain/headache and cough in comparison to baseline (p < 0.0001). Nasal obstruction was the most improved symptom (effect size of 2.24). At 7th post-operative month, the sense of smell continued to improve slightly. By contrast, the postnasal discharge score that was significantly improved at 6th post-operative week tended to worsen at 7 months (p = 0.0045). Before surgery, strong psychosocial impacts were observed in association with nasal obstruction and anterior rhinorrhea. The physical impacts of each symptom were proportionally correlated to the symptom score before and after surgery. The quality of life (QOL) related to each symptom was clearly better at 6 weeks and remained steady at 7 months after surgery. In conclusion, olfactory disorders and postnasal rhinorrhea were the main remaining symptoms after sinus surgery despite a global improvement of symptoms and quality of life. The earlier time point to stabilize QOL outcomes of endoscopic sinus surgery could be suggested at 6 weeks after surgery.
      PubDate: 2015-02-01
  • Are bovine pericardium underlay xenograft and butterfly inlay autograft
           efficient for transcanal tympanoplasty'
    • Abstract: Abstract To evaluate the success rate and the surgical procedure of two different transcanal myringoplasty techniques using the Tutopatch® (Tutogen Medical, Inc., Alachua, FL, USA), a xenograft produced from bovine pericardium or the butterfly, an inlay tragal cartilage autograft. This is a retrospective study. We studied all cases of transcanal myringoplasty with Tutopatch and butterfly, performed by the same surgeon between April 2005 and May 2013. Perforations were secondary to chronic otitis media without cholesteatoma, perforation post ventilation tube or trauma. They were not exceeding one-third of the tympanic membrane surface for the Tutopatch and one quarter for the butterfly. We evaluated the anatomical success rate, complications and postoperative hearing results in both techniques. A total of 106 myringoplasties were performed: 66 with Tutopatch and 40 with butterfly with a mean follow-up of 16.5 and 5.2 months, respectively. Successful closure rates of Tutopatch and butterfly were 75.8 % (P < 0.0001) and 85.0 % (P < 0.0001), respectively. Myringitis controlled with topical antibiotics treatment occurred in 8 (12.1 %) and 5 (12.5 %) cases. Eighty percent of patients with Tutopatch had a mean residual air-bone gap within 10 dB, compared to 85.0 % in patients with butterfly. When anatomically feasible, a transcanal approach myringoplasty with a Tutopatch® graft or butterfly appears to provide good anatomical and functional results. We show that both techniques provide good anatomical and functional results. The butterfly has the advantage to use an autograft, which is surgically easier because it does not require tympanomeatal flap elevation. We recommend the butterfly technique for non-marginal perforation not exceeding one quarter of the tympanic membrane after excision of the perforation edge and Tutopatch for bigger perforation or when standard autografts are not available. Myringitis is the only described complication without specific incidence.
      PubDate: 2015-02-01
  • The role of lateral pharyngoplasty in obstructive sleep apnea syndrome
    • Abstract: Abstract Recent studies have shown that lateral pharyngoplasty is an effective procedure to correct obstructive sleep apnea. The objective of the paper was to evaluate factors contributing to obstructive sleep apnea syndrome and identify the different severity categories of obstructive sleep apnea that could benefit from lateral pharyngoplasty. We included 60 patients undergoing uvulopalatopharyngoplasty with or without lateral pharyngoplasty from December 1, 2008 to May 31, 2012. Six who did not complete the post-operative survey were excluded. 54 participants were assigned alternatively to either uvulopalatopharyngoplasty alone (control group, n = 29) or to uvulopalatopharyngoplasty with lateral pharyngoplasty (intervention group, n = 25). The reduction of apnea–hypoxia index in the intervention group (49.3 %) was higher than it was in the control group (30.4 %), but the average value was not statistically significant (p = 0.088). Only patients with moderate obstructive sleep apnea in the intervention group achieved a significant reduction of apnea–hypoxia index (30.7 vs. 10.8 %; p = 0.020). Factors such as body mass index, nadir/mean SpO2, snoring index, Epworth sleepiness scale and periodic limb movement index did not change significantly following lateral pharyngoplasty. To evaluate patients’ upper airway anatomy, we employed cephalometry, and found that the retroglossal space played a critical role in severe obstructive sleep apnea. Our study showed that only patients in the moderate category can be benefited from adding lateral pharyngoplasty to uvulopalatopharyngoplasty; however, patients in the mild or severe category did not benefit from adding this procedure. This information is vital when considering surgery for patients with obstructive sleep apnea syndrome. Level of evidence Prospective cohort study, Level II.
      PubDate: 2015-02-01
  • When is reoperative surgery not indicated for recurrent head and neck
           squamous cell carcinoma'
    • PubDate: 2015-02-01
  • Clinicopathological characteristics of carcinoma from unknown primary in
           cervical lymph nodes
    • Abstract: Abstract Carcinoma in cervical lymph nodes of unknown origin represents a rare clinical entity where optimal diagnostic and therapeutic management is still a widely debated issue. Molecular classification of these metastases is thus of utmost importance. We analyzed the expression of eight basic molecular markers in 26 metastases from unknown primaries, 31 metastases from overt primaries and their associated primaries. Medical records of the respective patients were reviewed for main clinicopathological parameters. The expression rates showed no significant differences between the two tumor entities, neither in absolute terms nor in comparison among the parameters. Surprisingly, patients with metastases from unknown primary demonstrated improved progression-free survival (p = 0.046) despite advanced age (p = 0.029), advanced nodal stage (p = 0.006) and higher incidence of extracapsular spread (p = 0.045) compared to patients with metastases from overt primaries. Presence of extracapsular spread was associated with increased expression of epidermal growth factor receptor in metastases from overt primaries (p = 0.035) and reduced expression of matrix metalloproteinase-2 in metastases from unknown primary (p = 0.031). We thus conclude that cervical metastases from unknown and overt primaries show similarities in their molecular profile, but fundamental differences in clinical parameter.
      PubDate: 2015-02-01
  • Medium-term results of combined treatment with transcranial magnetic
           stimulation and antidepressant drug for chronic tinnitus
    • Abstract: Abstract We compared the effects of repetitive transcranial magnetic stimulation (rTMS) and paroxetine [a selective serotonin reuptake inhibitor (SSRI)] on tinnitus in terms of effectiveness and medium-term results. This is a randomised, double-blind, placebo-controlled study. Seventy-five patients with moderate tinnitus were divided into five equal groups. Each group was treated for 1 month as follows: group 1 received rTMS alone at 1 Hz frequency; group 2 received rTMS alone at 10 Hz frequency; group 3 received rTMS at 1 Hz frequency combined with paroxetine; group 4 received paroxetine alone; and group 5 received a placebo (sham rTMS). Participants were tested using the Tinnitus Handicap Inventory (THI), Tinnitus Severity Index (TSI), the Beck Anxiety Scoring (BAS), and Psychiatric Sign Screening (PSS) tests. THI, TSI, BAS, and PSS were measured prior to treatment, and at the first and sixth month post-treatment. The THI and TSI scores improved after treatment in all groups, except the placebo group. The THI scores in groups 1 and 2 showed a statistically significant improvement after the first and sixth month compared to pretreatment scores, whereas a significant improvement in THI scores occurred only after the sixth month in groups 3 and 4. The TSI scores in group 3 showed a significant improvement at the first and sixth month marks after treatment. The rTMS and SSRI play potential roles in the reduction of tinnitus severity, but without cumulative or synergistic effects when a combination of treatment regimens is applied. These positive effects might be due to the relationship between the auditory cortex areas related to emotions and tinnitus.
      PubDate: 2015-02-01
  • Efficacy of sucralfate for the treatment of post-tonsillectomy symptoms
    • Abstract: Abstract Pain after tonsillectomy remains the main issue of postoperative morbidity and the search for an effective post-tonsillectomy analgesic is of increasing relevance. The aim of this study was to evaluate the effectiveness of topical sucralfate during an early post-tonsillectomy period. Fifty patients of both genders from 6 to 58 years submitted to tonsillectomy or adenotonsillectomy were randomly included into either a sucralfate treatment group (N = 25) or into a control group (N = 25). Patients of the sucralfate group received topical sucralfate four times a day for 7 days. No topical treatment was applied to patients of the control group. A systemic analgesic was standardized. Post-tonsillectomy symptoms, including throat pain, odynophagia and otalgia, were evaluated during the period of seven postoperative days. Secondary outcomes were analgesic use, well being in general, return to regular daily activities, secondary hemorrhage and side effects of sucralfate. This study revealed that during the period of the second to seventh postoperative days average throat pain scores of the sucralfate using patients were significantly lower than those of the control group patients (p < 0.05); the same could be applied to odynophagia scores during the period of all seven postoperative days (p < 0.01) and otalgia scores from the 4th postoperative day (p < 0.05). The sucralfate group patients also had a significantly smaller need for analgesics, better scores of well being in general and early return to regular daily activities with no side effects of the treatment. Topical sucralfate could be recommended for the everyday clinical practice as a safe, adjuvant medicine of treatment during the period of the first post-tonsillectomy week.
      PubDate: 2015-02-01
  • The effect of memantine on functional recovery of the facial nerve after
           crush injury
    • Abstract: Abstract The objective of this study is to establish whether memantine is an alternative and effective treatment on facial nerve recovery after crush injury, and also to analyze the effective doses of this promising agent. This is a randomized controlled animal study. 40 rats underwent crush injury to left main trunk of the facial nerve, and divided into 4 groups; (1) control (saline treated), (2) 5-mg/kg memantine, (3) 10-mg/kg memantine, and (4) 20-mg/kg memantine group. Facial nerve functions were evaluated by eye reflex, and whisker movement compared to the unaffected side. They were scored on a 3-point scale. On day 28, the rats were sacrificed, and the facial nerves were dissected. The paraffin sections were studied with caspase-3 immunostaining. According to statistical data, the recovery in Group 4 began significantly earlier than the other groups on the basis of restoring eye blink reflexes and whisker movement. Groups 2 and 3 showed faster recovery than Group 1 on the basis of whisker movement. The caspase-3 positive staining was rarely detected in all groups. The Kruskal–Wallis test revealed that Group 4 showed fewer apoptotic cells than other groups; this was statistically significant. However, the Mann–Whitney U test with the Bonferroni correction did not reveal any significant difference between the groups. In conclusion, this study revealed that memantine acted to restore facial nerve functions, and accelerate recovery after facial nerve injury by inhibiting apoptosis.
      PubDate: 2015-02-01
  • Reliability and validity of the Spanish Glasgow Benefit Inventory after
           cochlear implant surgery in adults
    • Abstract: Abstract In recent years, the outcome assessment of subjects undergoing otorhinolaryngological (ORL) intervention has relied increasingly upon patient-reported questionnaires. The English Glasgow Benefit Inventory (GBI) is a reliable, sensitive and validated post-intervention questionnaire that is used to determine health-related quality-of-life (QoL) in patients following ORL intervention. The GBI has been translated into eight languages including Spanish. The present study aimed to determine the internal consistency and validity of the Spanish version of the GBI in patients with a cochlear implant (CI). 121 adult Spanish speaking patients with a CI were questioned retrospectively using the Spanish GBI. Reliability of the questionnaire was determined using Cronbach’s α coefficient; factor analyses were performed using principal component extraction with orthogonal rotation; and validity was confirmed using Pearson’s correlation coefficient. The mean total score (mean ± standard deviation) of the GBI was 35.1 ± 23.6, 47.6 ± 28.9 for General Health, 17.9 ± 33.2 for Social Benefit and 1.7 ± 27.9 for Physical Health. The reliability was above 0.70 in all test domains. Using factor analyses a 4-factor solution that explained 63.2% of the variance was reached. The objective measures: bisyllables tested without lip-reading and without masking were correlated with the total score and the General Health subscales. The Spanish GBI is a reliable and practicable instrument for the assessment of health-related QoL in Spanish adult CI users.
      PubDate: 2015-02-01
  • Smell and taste in palliative care: a systematic analysis of literature
    • Abstract: Abstract Little is known on the role of the senses smell and taste in end-of-life care. The presented systematic literature analysis investigates the significance of smell and taste in palliative care. The online databases PubMed, CINAHL, MEDLINE, Deutsche Nationalbibliothek and British National Library were searched for English and German literature published between 1970 and April 2013 containing any kind of original data on the impact of smell and taste in patients in a palliative care situation. All retrieved publications were screened for relevance and full text was obtained for all articles identified as relevant. We integrated 13 papers for further analysis (explorative surveys 5, clinical trials 3, case studies 2, qualitative study 1, brief report 1, clinical report 1). Prevalence of smell and taste alterations in palliative care ranges between 60 and 86 %. Existing literature reflects the significance of smells and tastes in palliative care setting in two main streams—smell and taste alterations as symptoms and malodorous wounds. Prevalence of smell and taste alterations in palliative care is high. However, in palliative care literature concepts for the assessment and fostering of subjective significance of smell and taste and the individual impact of significant smells and tastes are predominantly neglected. Available instruments should be characterized, validated and adapted for the use for palliative care patients.
      PubDate: 2015-02-01
  • Epidermal growth factor receptor (EGFR) expression in patients with
           laryngeal squamous cell carcinoma
    • Abstract: Abstract To assess the epidermal growth factor receptor (EGFR) correlation with histopathologic and clinical characteristics of laryngeal squamous cell carcinoma (SCC) and the impact of EGFR overexpression on patient survival. This retrospective study included 185 SCC patients treated at Clinical Department of ENT, Head and Neck Surgery, Split University Hospital Center between January 1, 2000 and December 31, 2009. A statistically significant correlation (p < 0.001) was recorded between the level of EGFR expression and SCC histopathologic grade, stage, metastasizing potential, relapsing potential, and patient survival. Kaplan–Meier survival curve yielded a statistically significant difference (χ 2 = 75.05; p < 0.001) among the four patient groups with different levels of EGFR expression. The higher the level of EGFR expression, the poorer is the patient prognosis and survival. In our study, expression of EGFR as a biomarker showed a potential predictive value in laryngeal SCC.
      PubDate: 2015-02-01
  • Co-existent thyroid disease in patients treated for primary
           hyperparathyroidism: implications for clinical management
    • Abstract: Abstract Treatment for primary hyperparathyroidism necessitates complete excision of involved parathyroid tissue. Simultaneous thyroidectomy may also be required in order to optimise operative access and/or where suspicion of synchronous abnormal thyroid pathology exists. We sought to determine how often simultaneous removal of thyroid tissue was required during parathyroidectomy and the nature of any associated pathology. Radiology reports were also reviewed to determine how often confirmed thyroid pathology from histological specimens, benign or malignant, had been identified pre-operatively. A retrospective chart review of 135 parathyroidectomy procedures performed between 2003 and 2013 was performed. Of 135 parathyroidectomy procedures, 39 patients (29 %) underwent simultaneous partial thyroidectomy of which 36 (27 % of total parathyroidectomies) had dual pathology confirmed. Specifically, malignant lesions were identified in 14 % (n = 5), Graves’ disease 3 % (n = 1), thyroiditis 17 % (n = 6), multinodular goitre 50 % (n = 18), unilateral nodule 6 % (n = 2), hyperplasia 8 % (n = 3) and intra-thyroid adenoma 3 % (n = 1). Reference to these thyroid lesions was made in only 47 % of preoperative radiology reports. In conclusion, synchronous thyroid surgery was required in 29 % of all parathyroidectomy procedures performed for treatment of primary hyperparathyroidism with malignant thyroid lesions incidentally detected in 14 % of cases. Less than half of all confirmed concomitant thyroid pathology had been referred to or recognised on pre-operative radiology studies. These findings highlight the importance of considering the potential need to perform thyroid surgery during parathyroidectomy and obtaining appropriate informed consent.
      PubDate: 2015-02-01
  • Predictors for outcome of paper patch myringoplasty in patients with
           chronic tympanic membrane perforations
    • Abstract: Abstract The purpose of the present study is to evaluate the outcome of paper patch myringoplasty for chronic tympanic membrane (TM) perforations and to explore the predictive factors for a successful closure. A retrospective study was performed in a tertiary referral center. Data of the patients who met the inclusion criteria were analyzed: the treatment outcomes and the potential predictive factors including age, sex, the affected ear, hearing level, duration of perforation, causes, location and size of perforations, relationship between the perforation border and the malleus, status of TM surface, and the number of patch applications. Complete closure was achieved in 27 of the total 43 subjects. Among the 11 clinical and TM factors, only the perforation size remained significant as the predictor after multivariable logistic regression (p = 0.029, OR 4.4). The patients with perforation ≤5 % of the TM showed higher closure rate (78.3 %) than those with perforation >5 % (45.0 %). In conclusion, paper patch myringoplasty showed overall success rate of 62.8 %. In patients with perforations smaller than 5 % of the TM, the closure rate was 78.3 %. The predictor of the treatment outcome was the perforation size. We can try paper patch myringoplasty first in patients who had dry chronic perforations smaller than 5 % of the TM without middle ear disease.
      PubDate: 2015-02-01
  • Reoperation on patients with obstructive sleep apnea–hypopnea
           syndrome after failed uvulopalatopharyngoplasty
    • Abstract: Abstract The goals of this study were to explore the reasons after failed uvulopalatopharyngoplasty (UPPP) in some patients with obstructive sleep apnea–hypopnea syndrome (OSAHS), and to observe the efficacy of the second surgery. Twenty-three OSAHS patients with failed UPPP were included in the study. Routine physical exams, electronic endoscopy, computed tomography scan and polysomnography after nasopharyngeal tube insertion were performed to assess the site of upper airway obstruction, and corresponding appropriate surgical treatment was carried out based on the diagnosis. Comprehensive evaluation of the 23 patients revealed that the sites of obstruction after failed UPPP were as follows: 7 cases predominantly in the oropharyngeal area, 2 cases in the nasal, nasopharyngeal and oropharyngeal area, 5 cases predominantly in the glossopharyngeal area and 9 cases in the oropharyngeal and glossopharyngeal areas. Correspondingly, 7 cases underwent improved UPPP alone, 2 cases underwent adenoidectomy or nasal expansion and improved UPPP, 5 cases underwent glossopharyngeal surgery alone and 9 cases underwent improved UPPP and glossopharyngeal surgery. Follow-up for more than 12 months showed that there were four cured cases, 12 cases with marked improvement, and 7 cases with treatment failure. The success rate was 69.6 %. After undergoing UPPP, OSAHS patients may still have oropharyngeal airway obstruction. By performing a detailed preoperative assessment on the patient’s airway condition and clarifying the site of obstruction, performing the second surgical treatment can still achieve a relatively satisfactory treatment outcome.
      PubDate: 2015-02-01
  • Polyhexanide-containing solution reduces ciliary beat frequency of human
           nasal epithelial cells in vitro
    • Abstract: Abstract In ENT, polyhexanide-containing solutions are used to treat nasal infections caused by multiresistant bacteria like methicillin-resistant Staphylococcus aureus. Many forms of commercial nasal solutions containing polyhexanide exist, such as gels or solutions for topical use. Data regarding the influence of polyhexanide on ciliary beat frequency (CBF) are lacking to date. We tested the CBF of nasal ciliated epithelial cells under the influence of a commercially available polyhexanide-containing solution (Lavasept® Concentrate) in a therapeutic concentration (0.04, 0.02 %). In addition, we tested the concentrations of 0.1 and 0.01 %. Cells were visualized with a phase contrast microscope, and the CBF was measured with the SAVA system’s region of interest method. Ringer’s solution and macrogol served as negative controls. A therapeutic concentration of Lavasept significantly reduced CBF in a time- and concentration-dependent manner. After 1 min, the CBF was reduced from 8.90 ± 1.64 to 5.00 ± 3.72 Hz with a concentration of 0.04 % (p value = 0.001). After 10 min, all cilia stopped beating. After 5 min, a 0.02 % solution of Lavasept concentrate decreased CBF significantly from 8.64 ± 1.71 to 3.30 ± 3.27 Hz (p value < 0.001). In conclusion, CBF of human nasal epithelia is significantly reduced with the use of the polyhexanide-containing solution Lavasept in some therapeutic concentrations. Due to our findings in this study, Lavasept should be used on ciliated mucosa only with caution and in a concentration of 0.02 %.
      PubDate: 2015-02-01
  • Effects of oral contraceptives on selected parameters of the homeostatic
           control system in young women having a sudden disorder of the auditory
           and/or balance system
    • Abstract: Abstract The purpose of the paper was to assess the effects of oral contraceptives on selected parameters of the homeostatic control system in women having a sudden disorder of the auditory and/or balance system. The study included 105 young women divided into two groups: Group I—52 women with the disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 20–49; and Group II—53 women without any disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 18–40. The patients included in the study underwent a full otoneurological evaluation, detailed laryngological diagnostics and an evaluation of selected parameters of the homeostatic control system—fibrinogen level, D-dimer level, evaluation of APTT and PT indicator, plasma estradiol and progesterone with the Roche Cobas analyser by means of chemiluminescence. The vertigo occurring in the study group was most often central (59.6 % of cases), mixed with compensation in 36.6 % of cases, and peripheral only in 3.8 % of cases, indicating labyrinth damage in 40.4 % of cases. An analysis of the progesterone level, considering the menstrual cycle phase in the group, showed that its value was abnormal in 51.0 % of women in the study group and 47.1 % in the control group. In their own studies, the authors observed that the estradiol level in the plasma, considering the menstrual cycle phase in the study group, was abnormal in 41.2 % of women and that the differences in its concentration were statistically significant in the study and control groups (p = 0.005), which may have a negative impact on the possibility of a thromboembolic episode.
      PubDate: 2015-02-01
  • Modified autospreader flap for nasal valve support: utilizing the spring
           effect of the upper lateral cartilage
    • Abstract: Abstract Nasal valve dysfunction has a role in up to 13 % of adults complaining of chronic nasal obstruction yet it is overlooked by many physicians. In rhinoplasty and other nasal surgeries, preserving nasal function is the most significant issue. The autospreader flap has proved to be an effective spreader graft alternative. Adding the spring effect proposed in this study to the autospreader flap increases the width of the internal nasal valve, thus gaining two factors supporting the internal nasal valve. The modified autospreader flap technique is described in detail. Patients in this study were classified into two groups. The first group had no obstructive complaints and the second group had nasal obstructive complaints. Quantitative analysis of NOSE scale scores, endoscopic evaluation, and tomographic evaluation before and after the surgery were performed using statistical analysis. Survey responses were received from 22 patients. Significant improvement in the nasal valve angle width was found in both groups by the endoscopic and tomographic evaluation. Subjective evaluation using NOSE scale scores showed improvement in both groups. The greatest advantage of this technique is that it adds to the autospreader flap a spring action that widens the valve area. We found this technique to be reliable and simple to be performed with fairly good results and patient satisfaction. Level of evidence V Evidence from systematic reviews of descriptive and qualitative studies.
      PubDate: 2015-02-01
  • Learning curve of medialization thyroplasty using a Montgomery™
    • Abstract: Abstract Type I thyroplasty—also called medialization thyroplasty (MT)—is considered as an effective treatment for glottic incompetence in general and for abductor vocal fold palsy in particular. In the past there have been some concerns about the experience a laryngeal framework surgeon should have in order achieve an acceptable voice outcome. To assess the learning curve of MT performed using the Montgomery® hard silicone implant. A retrospective study involving 36 patients divided into three consecutive groups (1, 2, 3) of 12 MT patients or six consecutive groups (1a, 1b, 2a, 2b, 3a, 3b) of six MT patients. Outcome measures: acoustic and aerodynamic outcome improvements (δ) compared to the duration of intervention [operative times (OT)]. Data were analysed by Anova, Kuskal Wallis and χ 2 statistical tests, according to data distributions. OT decreased significantly between groups 1, 2 and 3 with a mean OT of 90.5′, 71.5′ and 56′ (p < 0.001), respectively. Objective δ such as maximum phonation time (MPT) (p 0.376), Estimated Sub-Glottic Pressure (ESPG) (p: 0.675) Shimmer (p: 0.543) and Jitter (p: 0.709) did not show significant improvement. Only the voice handicap index (VHI) δ of group 2 showed significant improvement (p 0.005) compared with the two other groups 1 and 3. Surgeon experience decreases the OT significantly. On the other hand, our study did not show a correlation between surgeon experience and voice outcome measures improvemnts (MPT, ESGP, Shimmer, Jitter).
      PubDate: 2015-02-01
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