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OTORHINOLARYNGOLOGY (80 journals)

Showing 1 - 80 of 80 Journals sorted alphabetically
Acta Oto-Laryngologica     Hybrid Journal   (Followers: 5)
Acta Oto-Laryngologica Case Reports     Open Access   (Followers: 1)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2)
Advanced Arab Academy of Audio-Vestibulogy Journal     Open Access  
American Journal of Audiology     Full-text available via subscription   (Followers: 15)
American Journal of Otolaryngology     Hybrid Journal   (Followers: 25)
Annales d'Otolaryngologie et de Chirurgie Cervico-Faciale     Full-text available via subscription  
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery     Open Access  
Annals of Otolaryngology and Rhinology     Open Access   (Followers: 3)
Annals of Otology and Neurotology     Open Access  
Annals of Otology, Rhinology & Laryngology     Hybrid Journal   (Followers: 15)
Arquivos Internacionais de Otorrinolaringologia     Open Access  
Audiology     Open Access   (Followers: 11)
Audiology and Neurotology     Full-text available via subscription   (Followers: 9)
Audiology and Neurotology Extra     Open Access   (Followers: 1)
Audiology Direct     Full-text available via subscription  
Audiology Research     Open Access   (Followers: 7)
Australian and New Zealand Journal of Audiology     Full-text available via subscription   (Followers: 7)
Bangladesh Journal of Otorhinolaryngology     Open Access   (Followers: 1)
BMC Ear, Nose and Throat Disorders     Open Access   (Followers: 1)
Brazilian Journal of Otorhinolaryngology     Open Access  
Case Reports in Otolaryngology     Open Access   (Followers: 7)
Cephalalgia     Hybrid Journal   (Followers: 7)
Ceylon Journal of Otolaryngology     Open Access   (Followers: 1)
Cleft Palate-Craniofacial Journal     Hybrid Journal   (Followers: 7)
Clinical Medicine Insights : Ear, Nose and Throat     Open Access   (Followers: 1)
Clinical Otolaryngology     Hybrid Journal   (Followers: 17)
Cochlear Implants International     Hybrid Journal   (Followers: 5)
Current Opinion in Otolaryngology & Head & Neck Surgery     Hybrid Journal   (Followers: 12)
Current Otorhinolaryngology Reports     Hybrid Journal  
Ear, Nose & Throat Journal     Full-text available via subscription   (Followers: 1)
Egyptian Journal of Otolaryngology     Open Access   (Followers: 2)
EMC - Cirugía Otorrinolaringológica y Cervicofacial     Full-text available via subscription  
EMC - Otorinolaringoiatria     Full-text available via subscription  
EMC - Otorrinolaringología     Full-text available via subscription  
ENT Updates     Open Access  
ENTtoday     Free   (Followers: 3)
European Annals of Otorhinolaryngology, Head and Neck Diseases     Full-text available via subscription   (Followers: 3)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (Followers: 4)
Head & Neck     Hybrid Journal   (Followers: 11)
HNO     Hybrid Journal   (Followers: 1)
Indian Journal of Otolaryngology and Head & Neck Surgery     Hybrid Journal   (Followers: 1)
International Archives of Otorhinolaryngology     Open Access   (Followers: 2)
International Forum of Allergy & Rhinology     Hybrid Journal   (Followers: 4)
International Journal of Audiology     Hybrid Journal   (Followers: 17)
International Journal of Otolaryngology     Open Access   (Followers: 3)
International Journal of Otolaryngology and Head & Neck Surgery     Open Access   (Followers: 5)
International Journal of Otorhinolaryngology and Head and Neck Surgery     Open Access  
International Journal of Practical Otolaryngology     Open Access  
Iranian Journal of Otorhinolaryngology     Open Access  
JAMA Otolaryngology - Head & Neck Surgery     Full-text available via subscription   (Followers: 31)
Journal of Communication Disorders     Hybrid Journal   (Followers: 16)
Journal of Hearing Sciences and Otolaryngology     Open Access   (Followers: 3)
Journal of Indian Speech Language & Hearing Association     Open Access  
Journal of Laryngology & Otology     Hybrid Journal   (Followers: 21)
Journal of Otolaryngology - Head and Neck Surgery     Open Access   (Followers: 10)
Journal of Otology     Open Access  
Journal of Otology & Rhinology     Hybrid Journal   (Followers: 3)
Journal of the Association for Research in Otolaryngology     Hybrid Journal   (Followers: 1)
Journal of Thoracic Disease     Open Access   (Followers: 1)
Journal of Voice     Hybrid Journal   (Followers: 51)
Laryngoscope     Hybrid Journal   (Followers: 34)
Operative Techniques in Otolaryngology-Head and Neck Surgery     Full-text available via subscription   (Followers: 7)
OTO Open: The Official Open Access Journal of the American Academy of Otolaryngology-Head and Neck Surgery Foundation     Open Access  
Otolaryngologic Clinics of North America     Full-text available via subscription   (Followers: 2)
Otolaryngology - Head and Neck Surgery     Hybrid Journal   (Followers: 19)
Otolaryngology Case Reports     Open Access  
Pan Arab Journal of Rhinology     Open Access  
Polski Przegląd Otorynolaryngologiczny : Polish Journal of Otorhinolaryngology Research     Full-text available via subscription  
Research in Otolaryngology     Open Access   (Followers: 2)
Revista Brasileira de Otorrinolaringologia     Open Access  
Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello     Open Access  
Revista ORL     Open Access  
Rhinology     Full-text available via subscription   (Followers: 12)
Romanian Journal of Rhinology     Open Access  
SIG Perspectives     Full-text available via subscription  
Sinusitis     Open Access  
Trends in Hearing     Open Access   (Followers: 5)
World Journal of Otorhinolaryngology - Head and Neck Surgery     Open Access  
Similar Journals
Journal Cover
European Archives of Oto-Rhino-Laryngology
Journal Prestige (SJR): 0.8
Citation Impact (citeScore): 2
Number of Followers: 4  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1434-4726 - ISSN (Online) 0937-4477
Published by Springer-Verlag Homepage  [2570 journals]
  • Efficacy of prophylactic central neck dissection in hemithyroidectomy for
           papillary thyroid carcinoma
    • Abstract: Purpose To evaluate the efficacy of prophylactic central neck dissection (pCND) in hemithyroidectomy for clinically node-negative papillary thyroid carcinoma (PTC). Methods We retrospectively analyzed 299 patients who underwent thyroid lobectomy with or without pCND for unilateral PTC. Of the 299 patients, 245 (81.9%) underwent unilateral pCND along with lobectomy, and 54 (18.1%) patients underwent lobectomy without pCND. Propensity score matching was performed for five covariates to reduce selection bias. Results In the baseline cohort of 299 patients, mean age, extrathyroidal extension, T classification and stage were higher in the cases undergoing pCND than in those not undergoing pCND. After propensity score matching, the significant differences between the two groups seen in the baseline cohort disappeared. Recurrence rates and recurrence-free survival curves did not differ between the 2 matched groups each of 54 patients. Conclusion The value of pCND in hemithyroidectomy for PTC is limited.
      PubDate: 2019-12-02
       
  • Risk factors of metastasis to the lymph nodes posterior to the right
           recurrent laryngeal nerve in papillary thyroid carcinoma
    • Abstract: Purpose To investigate the risk factors of lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma. Methods Clinicopathologic feature data of 427 patients with right or double lobes who underwent surgery between January 2014 to August 2019 in the Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, were retrospectively analyzed. The risk factors of LN-prRLN metastasis were analyzed by the Chi-squared test and multivariate logistic regression. Results LN-prRLN metastasis was detected in 96 patients. Univariate analysis showed that age, right-side tumor diameter, capsular invasion, comorbid adenoma, and VIa compartment LN metastasis were significantly associated with LN-prRLN metastasis (all P < 0.05). Multivariate logistic regression analysis showed that right-side tumor diameter, capsular invasion, and VIa compartment LN metastasis were independent risk factors of LN-prRLN metastasis (all P ≤ 0.001). The receiver operating characteristic curve showed that the cutoff value of the right tumor diameter for predicting LN-prRLN metastasis was 1.25 cm (sensitivity = 0.5, specificity = 0.819, area under the curve = 0.720, P < 0.001). Conclusion The incidence of LN-prRLN metastasis cannot be ignored, and our findings indicate that prophylactic LN-prRLN dissection should be performed in patients with right-side tumor diameter ≥ 1.25 cm, capsular invasion, and VIa compartment LN metastasis.
      PubDate: 2019-12-02
       
  • Role of endoscopy in lateral skull base approaches to the petrous apex
    • Abstract: Objective The aim of this article is to study the role and advantages of combined microscopic/endoscopic procedures or exclusive endoscopic approaches in the treatment of petrous apex pathologies. Methods The study was designed as a retrospective case series analysis. We included patients affected by pathologies of the petrous apex, who underwent microscopic/endoscopic-assisted or exclusive endoscopic procedures. Patient and pathology characteristics and surgical data (focusing on the involvement of the internal carotid artery (ICA) and facial nerve by the disease) were collected. Residual disease, detected through the endoscopic check, and the feasibility of endoscopic residual tumor removal were also evaluated. Finally, facial nerve and hearing functions were assessed pre- and postoperatively. Results The records of 75 patients undergoing lateral skull base surgery for petrous apex lesions, from May 2009 to March 2019, were collected. In 17 out of 75 patients, an exclusive endoscopic procedure was possible. The remaining 58 patients underwent a combined microscopic/endoscopic approach. In 15 cases, residual disease was found and removed endoscopically at the end of the microscopic procedure; in eight cases, the residual disease was medial and/or inferior to the horizontal segment of the ICA, while in two cases, it was located in the fundus of the internal auditory canal. In five cases, it involved the labyrinthine segment of the facial nerve. Conclusion Petrous apex surgery remains a traditional microscopic-based surgery, but the recent advent of endoscopic surgery has permitted an improvement in radicality minimizing the manipulation of neurovascular structures.
      PubDate: 2019-12-02
       
  • Assessment of the prelacrimal recess in maxillary sinus in different sex
           and age groups using cone beam computed tomography (CBCT)
    • Abstract: Background The intranasal endoscopic prelacrimal recess approach (PLRA) to the maxillary sinus (MS) has been reported to treat many MS and skull base diseases. However, previous studies revealed that the width of the prelacrimal recess (PLR) shows a large individual variation. The purpose of this study was to ascertain the prevalence of the PLR in MS according to gender and age. Methods A series of 701 maxillofacial cone beam computed tomography (CBCT) scans from adult patients were analyzed retrospectively. Patients were divided into five age groups (18–24 years, 25–34 years, 35–44 years, 45–54 years, and ≥ 55 years) and by sex. The frequencies of occurrence of the PLR in the MS were calculated and compared. Results According to the findings obtained from our study, PLR was present in 81.5% of maxillary sinuses. No differences were found when the data distributions of right and left sides were compared. For individuals, the right and left sides were not always symmetrical. The probability of PLR was lesser among women than among men, but this differences was not significant. Another finding of our study was that the percentage of PLR decreased with increasing age among patients aged < 55 years, however, increased again among patients aged ≥ 55 years. Conclusion The anatomy of PLR varies among individuals. Careful analysis of individual anatomical structure characteristic is recommended when considering intranasal endoscopic PLRA to the MS. Besides, the age variation of PLR should be considered in order to avoid complications.
      PubDate: 2019-12-02
       
  • Blocking long noncoding RNA MALAT1 restrained the development of laryngeal
           and hypopharyngeal carcinoma
    • Abstract: Purpose The long non-coding RNA MALAT1 is a predictive marker in several solid tumors with highly conserved sequences. However, the role of non-coding RNA in development of laryngeal or hypopharyngeal cancer remains unclear. Methods Tumor tissues and adjacent non-cancer tissues of 24 patients were collected. We detected the expression of MALAT1 in laryngeal cancer tissues and hypopharyngeal cancer tissues. Moreover, we developed a MALAT1 silencing model in human laryngeal tumor cells by transfecting MALAT1 small interfering RNA into human laryngeal carcinoma cell line Hep-2 and pharyngeal carcinoma cell line FaDu with Lipofectamine 2000 system. Cell cycle analysis, Cell Counting Kit-8 assay, Transwell assay, quantitative reverse transcription PCR, and wound-healing assays were performed to evaluate the impact of MALAT1 depletion on laryngeal or hypopharyngeal cancer cell’s growth, proliferation, apoptosis, invasion and migration. Results MALAT1 was significantly up-regulated in laryngeal and hypopharyngeal carcinoma cells. MALAT1 down-regulation induced the increased apoptosis of both cell lines and suppressed cells’ proliferation. Cells were arrested in G1/G2 phase and cells of S phase were significantly decreased. Down-regulation of MALAT1 expression can also inhibit the migration and invasion of laryngeal squamous cell carcinoma cell (Hep-2) and hypopharyngeal cancer cell (FaDu). Conclusion In summary, our deactivation model of MALAT1 disentangled the active function of it as a regulator of gene expression governing the hallmarks of laryngeal and hypopharyngeal cancer. Blocking this long non-coding RNA may restrain the development of laryngeal cancer.
      PubDate: 2019-12-02
       
  • Correction to: Is there a relation between sudden sensorineural hearing
           loss and white matter lesions'
    • Abstract: In the original publication, fifth author’s surname was incorrectly published as “Diacinto”. The correct surname should read as “Diacinti”.
      PubDate: 2019-12-01
       
  • Aging effect on sleepiness and apneas severity in patients with
           obstructive sleep apnea syndrome
    • PubDate: 2019-12-01
       
  • Regenerating gene 1A single-nucleotide polymorphisms and nasopharyngeal
           carcinoma susceptibility
    • PubDate: 2019-12-01
       
  • Ex-vivo surgical model for “Barbed Snore Surgery”: a
           feasibility study
    • Abstract: Introduction The “Barbed Snore Surgery” is one of the last technical innovations in palatal surgery for Obstructive Sleep Apnea. The availability of a low-cost surgical model able to replicate tissue consistency and main anatomical structures could be fundamental for the spreading of this surgery. The aim of this study was to assess the feasibility of an ex-vivo ovine model in the surgical training of BSS. Methods After adequate preparation of adult lamb heads, a post-graduate student with no surgical expertise was guided by a skilled surgeon in the execution of two BSS procedures: “Barbed Roman Blinds Technique” and “Barbed Anterior Pharyngoplasty”. Anatomical limitations and similarity with the human tissue were assessed and recorded during the simulation. Results All the procedures were successfully completed. Despite proportional differences, the palatal tissue was assessed as similar in consistency and thickness to the human tissue. The simulation was considered satisfactory and suitable for surgical training. Conclusion This ex-vivo ovine surgical model could represent the right tool for BSS training thanks to readily available and inexpensive specimens. Moreover, it appears to present the realistic anatomy and tissue consistence essential for an adequate surgical simulation.
      PubDate: 2019-12-01
       
  • In response to the ‘Letter to the Editor’ on the paper ‘Aging effect
           on sleepiness and apneas severity in patients with obstructive sleep apnea
           syndrome: a meta-analysis study’
    • PubDate: 2019-12-01
       
  • Development of scores assessing the refluxogenic potential of diet of
           patients with laryngopharyngeal reflux
    • Abstract: Objective To develop clinical tools assessing the refluxogenic potential of foods and beverages (F&B) consumed by patients with laryngopharyngeal reflux (LPR). Methods European experts of the LPR Study group of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological societies were invited to identify the components of Western European F&B that would be associated with the development of LPR. Based on the list generated by experts, four authors conducted a systematic review to identify the F&B involved in the development of esophageal sphincter and motility dysfunctions, both mechanisms involved in the development of gastroesophageal reflux disease and LPR. Regarding the F&B components and the characteristics identified as important in the development of reflux, experts developed three rational scores for the assessment of the refluxogenic potential of F&B, a dish, or the overall diet of the patient. Results Twenty-six European experts participated to the study and identified the following components of F&B as important in the development of LPR: pH; lipid, carbohydrate, protein composition; fiber composition of vegetables; alcohol degree; caffeine/theine composition; and high osmolality of beverage. A total of 72 relevant studies have contributed to identifying the Western European F&B that are highly susceptible to be involved in the development of reflux. The F&B characteristics were considered for developing a Refluxogenic Diet Score (REDS), allowing a categorization of F&B into five categories ranging from 1 (low refluxogenic F&B) to 5 (high refluxogenic F&B). From REDS, experts developed the Refluxogenic Score of a Dish (RESDI) and the Global Refluxogenic Diet Score (GRES), which allow the assessment of the refluxogenic potential of dish and the overall diet of the LPR patient, respectively. Conclusion REDS, RESDI and GRES are proposed as objective scores for assessing the refluxogenic potential of F&B composing a dish or the overall diet of LPR patients. Future studies are needed to study the correlation between these scores and the development of LPR according to impedance–pH study.
      PubDate: 2019-12-01
       
  • Effects of pentoxifylline and tocopherol on a rat-irradiated jaw model
           using micro-CT cortical bone analysis
    • Abstract: Purpose A combination of pentoxifylline (PTX) and tocopherol (TP) is believed to reduce chronic fibrosis and induce bone healing in osteoradionecrosis (ORN) of the mandible, but evidence of its therapeutic effectiveness for cortical bone is lacking. This study was designed to determine the effect of combined PTX and TP (PTX + TP) on mandibular cortical bone remodeling in a rat model of ORN, using micro-CT and histological analysis. Methods Forty-eight 8-week-old male Sprague–Dawley rats were randomly divided into irradiated (n = 40) and non-irradiated (n = 8) groups. Animals in the irradiated group were divided into four sub-groups, including PTX, TP, PTX + TP, and normal saline. Three weeks after irradiation, mandibular posterior tooth extraction was performed, and animals were sacrificed 7 weeks after irradiation. The mandibles were analyzed using micro-CT and histological evaluation. Results The alveolar bone height, cortical bone thickness, cortical bone volume, and total cortical bone surface of the PTX + TP group were significantly greater than those of other irradiated groups (p < 0.05). In 3D reconstructed images, the residual volumes of cortical and cancellous bone were inadequate in the irradiated groups. Conclusion We found that a combination of PTX and TP improved quality and quantity of cortical bone in irradiated rat mandibles, thus providing supporting evidence of its utility as a treatment and prophylactic agent in ORN. We observed inadequate volumes of cortical and cancellous bone in ORN mandibles, suggesting that cortical bone could play an important role in further ORN studies.
      PubDate: 2019-12-01
       
  • Outcomes of endoscopic transcanal type 1 cartilage tympanoplasty
    • Abstract: Purpose We aimed to evaluate air–bone GAP (ABG), graft success and hearing gain according to the size and location of perforation in patients who underwent endoscopic transcanal type 1 cartilage tympanoplasty due to the tympanic membrane perforation and chronic otitis media. Methods The 104 patients (52 male and 52 female) who underwent endoscopic transcanal type 1 cartilage tympanoplasty, were evaluated retrospectively. Tragal cartilage grafts were utilized in all patients. Perforation size/location, duration of surgery, pre-operative and post-operative (6th month) average ABG, and pure-tone audiometric results (at 500–1000–2000–4000 Hz) as well as overall graft success were evaluated. Results The mean duration of surgery was 45.60 ± 17.39 min. Perforations were most frequently located in anterior quadrant with moderate sized. The post-operative air-conduction results were significantly improved at 500–1000–2000–4000 Hz frequencies. Similarly, pre-operative air-conduction pure-tone average (PTA) (35.36 ± 11.9 dB) was significantly decreased (22.34 ± 7.9 dB) after postoperative 6 months (p ≤ 0.001). The overall graft success rate was 93.2%. Moreover, pre-operative mean ABG (19.82 ± 7.4 dB) was significantly decreased (9.05 ± 4.3 dB) after postoperative 6 months (p ≤ 0.001). Conclusions Endoscopic transcanal type 1 cartilage tympanoplasty achieved a high graft success rate, and improved hearing results, regardless of the perforations' location and size. Endoscopic tympanoplasty provides high patient safety and comfort in middle-ear surgery by wide visualization, easy applicability, short-operation duration, low complication risk, and less invasive approach.
      PubDate: 2019-12-01
       
  • Prospective evaluation of oral corticosteroid as a predictor of
           postoperative olfactory recovery after functional endoscopic surgery for
           nasal polyposis
    • Abstract: Purpose Anticipating the possibility of olfactory recovery after functional endoscopic surgery (FES) in nasal polyposis (NP) is difficult. The main objective of this study was to assess the predictive factors of recovering the sense of smell after radical bilateral ethmoidectomy. Secondary objectives were to identify other predictors of olfactory recovery. Methods Open prospective study was conducted at the Nantes University Hospital including all patients with NP operated on in the Ear, Nose, and Throat Department between January 2011 and September 2017. These patients underwent functional endoscopic surgery (radical ethmoidectomy) after medical treatment failure. Olfaction was quantified prospectively and systematically during the preoperative consultation using a visual analog scale. Multivariate analysis evaluated the presence of predictive factors of postoperative olfactory recovery. Results One hundred nineteen patients were included in the study. Overall, olfaction was partially improved after surgery. For patients who presented greater than 50% recovery of olfaction after systemic corticosteroid therapy before surgery, we observed a predictive better rate of olfactory recovery after surgery (p < 0.001). Age over 65 years, a history of sinonasal surgery, associated asthma, and bacterial colonization were not associated with less postoperative olfactory recovery. Conclusion This study identified an objective factor that may influence olfactory recovery after FES using a therapeutic trial for olfactory recovery after oral corticosteroid treatment taken before surgery.
      PubDate: 2019-12-01
       
  • Transoral robotic tongue base reduction and supraglottoplasty combined
           with maxillomandibular advancement: a new option for selected sleep apnea
           patients' Preliminary report
    • Abstract: Purpose Transoral robotic surgery (TORS) and maxillo-mandibular advancement (MMA) are effective options for obstructive sleep apnea patients. Identification of the correct candidate is by far the most important item in achieving a succesful outcome. As a consequence, not all patients can be managed successfully via one or the other procedure. To overcome the limits of any single procedure we have combined, in a very selected population of patients, TORS tongue base reduction and MMA. Preliminary data are encouraging, in terms of both AHI and ESS. Methods A retrospective cohort study was conducted on five patients treated with combined TORS-MMA surgery. Demographic and clinical data, pre-operative and post-operative PSG and ESS were collected. Results Three of five patients were recruited. All patients presented severe OSAHS. Mean AHI and ESS went respectively from 48 and 12 pre-operatively to 19 and 4 post-operatively. Minor bleeding occurred in two patients. No significant sequelae have been reported. Conclusions Combined TORS and MMA is feasible and safe. Our very preliminary data are encouraging, in terms of both AHI and ESS. Long-term follow-up and a larger amount of subjects are needed to confirm this surgical approach as a valuable option for selected OSAHS patient.
      PubDate: 2019-12-01
       
  • The significance of vascular loops in the internal auditory meatus: a true
           incidental imaging finding'
    • Abstract: Purpose To determine the clinical significance of vascular loops (VL) in the internal auditory meatus (IAM) and cerebellopontine angle (CPA). Methods We carried out a retrospective case series in a tertiary referral centre. Out of 6978 patients undergoing magnetic resonance imaging (MRI) of the IAM for unilateral cochleovestibular symptoms we identified the ones with VLs and reviewed their medical notes. We performed a statistical correlation between the laterality of the VL in the IAM/ CPA as graded according to the Chavda classification (type 1 in the CPA, type 2 extending in the IAM, type 3 extending to the distal IAM end), the laterality of symptoms and the patient’s age. Results A total of 77 VL were identified in 64 patients (0.9%); 39 patients had the VL on the same side of the main symptom, while 25 patients had the VL on the contralateral side. There were 37 Type 1 loops, 29 Type 2 loops and 11 Type 3 loops. The comparison between the grading of the VL and the laterality of symptoms did not reach the level of significance (p = 0.321). There was also no association between the presence of the loop and the patients’ age (p = 0.5). All patients were reassured and discharged without any representation in three years follow-up. Conclusions We did not identify any significant correlation between the laterality of VLs and the laterality of symptoms, irrespective of the grading of the loop or the patients’ age. Such VLs should be considered an incidental rather than causal findings.
      PubDate: 2019-12-01
       
  • The effect of structured self-assessment in virtual reality simulation
           training of mastoidectomy
    • Abstract: Purpose Virtual reality (VR) simulation surgical skills training is well established, but self-directed practice is often associated with a learning curve plateau. In this study, we investigate the effects of structured self-assessment as a means to improve performance in mastoidectomy training. Methods The study was a prospective, educational study. Two cohorts of novices (medical students) were recruited for practice of anatomical mastoidectomy in a training program with five distributed training blocks. Fifteen participants performed structured self-assessment after each procedure (intervention cohort). A reference cohort of another 14 participants served as controls. Performances were assessed by two blinded raters using a modified Welling Scale and simulator-recorded metrics. Results The self-assessment cohort performed superiorly to the reference cohort (mean difference of final product score 0.87 points, p = 0.001) and substantially reduced the number of repetitions needed. The self-assessment cohort also had more passing performances for the combined metrics-based score reflecting increased efficiency. Finally, the self-assessment cohort made fewer collisions compared with the reference cohort especially with the chorda tympani, the facial nerve, the incus, and the malleus. Conclusions VR simulation training of surgical skills benefits from having learners perform structured self-assessment following each procedure as this increases performance, accelerates the learning curve thereby reducing time needed for training, and induces a safer performance with fewer collisions with critical structures. Structured self-assessment was in itself not sufficient to counter the learning curve plateau and for continued skills development additional supports for deliberate practice are needed.
      PubDate: 2019-12-01
       
  • Clinical significance of cervical and ocular vestibular evoked myogenic
           potentials in benign paroxysmal positional vertigo: a meta-analysis
    • Abstract: Purpose As the pathological cause of benign paroxysmal positional vertigo (BPPV), the dislocation or degeneration of otoconia in the utricle and saccule is suggested. Vestibular evoked myogenic potential (VEMP) could reflect otolithic dysfunction due to these etiologies of BPPV. The aim of this study was to validate the clinical significance of cervical (c) and ocular (o) VEMP in BPPV by a meta-analysis of previous articles. Methods Articles related to BPPV with data on cVEMP and oVEMP were collected. The following keywords were used to search PubMed and Scopus for English language articles: benign paroxysmal positional vertigo or BPPV and vestibular evoked myogenic potential or VEMP. Results The p13 latency in cVEMP and n1 latency in oVEMP were slightly but significantly prolonged in BPPV patients compared to control patients. AR in oVEMP of BPPV patients also showed higher value than that of control patients. However, the n23 latency and AR in cVEMP and p1 latency in oVEMP showed no significant difference between BPPV and control patients. Furthermore, latencies in VEMPs also showed no significant difference between an affected and a non-affected ear in BPPV patients. Conclusions Our results indicated that otolith dysfunction of BPPVs was detected by latencies in VEMPs, and AR in oVEMP more sensitively reflects the difference between affected and non-affected ears in BPPV patients. The otolith dysfunction of BPPV might be induced by the systemic condition. However, the differences of latencies between BPPV patients and control patients were too small to use VEMPs as a prognostic predictor.
      PubDate: 2019-12-01
       
  • Anterolateral thigh free flap in reconstruction of lateral skull base
           defects after oncological resection
    • Abstract: Purpose Evaluation of the utility of the free anterolateral thigh flap reconstruction of the defects resulting from radical temporal bone resection in the management of lateral skull base malignancies in a single institution. Methods An analysis of 17 en bloc subtotal petrosectomies for removal of malignant tumours was performed. There were 12 squamous cell carcinomas, 4 basal cell carcinomas and 1 adenoid cystic carcinoma. The tumours were staged with the University of Pittsburgh TNM system. In all patients, the lateral temporal bone with the preservation of the petrous apex and carotid artery was performed. All patients had parotid gland resection. The post-resection defect was reconstructed with an ALT free flap. Results Tumour radical resection and defect reconstruction with an ALT flap was achieved in all patients without intraoperative complications. The transplants were harvested as fasciocutaneous flaps, 11 perfused by musculocutaneous and 6 by septocutaneous perforators. The ALT flaps had a mean pedicle length of 8 cm (6–12 cm), and the flap size ranged between 6 × 15 cm and 15 × 30 cm. The flaps were supplied by nine facial, five occipital and three maxillary arteries. Recipient-site veins included eight internal jugular, seven facial, one retromandibular and one external jugular vein. All arterial pedicles were anastomosed in an end-to-end manner. The veins were anastomosed with interrupted sutures and in 11 cases with Synovis-Coupler® devices. All the flap transfers were performed successfully. Three patients experienced postoperative complications. Conclusions The ALT flap proved to be effective for covering large temporal skull base defects resulting from the radical removal of temporal bone malignancies. The functional and cosmetic results were acceptable with a low complication rate.
      PubDate: 2019-12-01
       
  • Topical Collection: Sleep apnea syndrome: from the pathogenesis to the
           last therapies
    • PubDate: 2019-11-13
       
 
 
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