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Journal Cover   Journal of Otolaryngology - Head and Neck Surgery
  [SJR: 0.571]   [H-I: 31]   [7 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1916-0216
   Published by Biomed Central Ltd. Homepage  [270 journals]
  • Unilateral isolated sphenoid sinusitis with contralateral abducens nerve
           palsy - A rare complication treated in a low-resource setting

    • Authors: Jennifer Siu, Sudhir Sharma, Leigh Sowerby
      First page: 9
      Abstract: Background: Unilateral isolated sphenoid sinus disease (ISSD) is a rare diagnosis of the paranasal sinuses that can be associated with complications involving vascular, neurologic, and optic structures in close proximity.Case presentationA 62 year old female presented to a hospital in Georgetown, Guyana with right lateral rectus palsy, diplopia, and a severe progressively worsening headache. CT scan revealed an opaque left sphenoid sinus consistent with unilateral ISSD. A transnasal sphenoidotomy was performed under local anesthetic in the absence of endoscopic guidance. There were no perioperative complications and headache resolved immediately after the surgery while the diplopia and lateral rectus palsy resolved completely after 6 weeks. Conclusion: We present a rare complication of ISSD, and highlight challenges associated with diagnosis and management of ISSD in a resource-limited setting. This is the second reported case of unilateral ISSD with contralateral lateral rectus palsy in the literature.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:9
      PubDate: 2015-03-01T12:00:00Z
      DOI: 10.1186/s40463-015-0053-y
      Issue No: Vol. ${item.volume} (2015)
  • Olfactory testing in children using objective tools: comparison of
           Sniffin¿ Sticks and University of Pennsylvania Smell Identification
           Test (UPSIT)

    • Authors: Sarah Hugh, Jennifer Siu, Thomas Hummel, Vito Forte, Paolo Campisi, Blake Papsin, Evan Propst
      First page: 10
      Abstract: Background: Detection of olfactory dysfunction is important for fire and food safety. Clinical tests of olfaction have been developed for adults but their use in children has been limited because they were felt to be unreliable in children under six years of age. We therefore administered two olfactory tests to children and compared results across tests. Methods: Two olfactory tests (Sniffin’ Sticks and University of Pennsylvania Smell Identification Test (UPSIT) were administered to 78 healthy children ages 3 to 12 years. Children were randomized to one of two groups: Group 1 performed the UPSIT first and Sniffin’ Sticks second, and Group 2 performed Sniffin’ Sticks first and UPSIT second. Results: All children were able to complete both olfactory tests. Performance on both tests was similar for children 5 and 6 years of age. There was an age-dependent increase in score on both tests (p 
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:10
      PubDate: 2015-03-01T12:00:00Z
      DOI: 10.1186/s40463-015-0061-y
      Issue No: Vol. ${item.volume} (2015)
  • Chronic rhinosinusitis: an under-researched epidemic

    • Authors: Luke Rudmik
      First page: 11
      Abstract: Background: Chronic rhinosinusitis (CRS) is a highly prevalent inflammatory disease with significant impacts on patient quality of life and daily productivity. Evaluating the volume of research on CRS, relative to similar chronic diseases, may provide insight into current disparities in research prioritization. Methods: A systematic review was performed using Ovid MEDLINE (R) (1970 – December 31st, 2014) to define the volume of research publications for CRS, asthma, and diabetes mellitus (DM). Primary outcomes were overall volume of research publications and volume of publications per year. A subgroup analysis was performed using chi-square (χ2) omnibus test with 2×3 contingency tables to identify significant differences in the proportion of total randomized controlled trials, systematic reviews, meta-analyses, and economic evaluation publications between CRS, asthma, and DM groups. Results: There were substantial disparities in the volume of research published over the last 45 years for CRS (n = 7,962), asthma (n = 136,652), and DM (n = 337,411). Although the volume of research for CRS in increasing, the disparities in the annual publication volumes between CRS, asthma, and DM appeared consistent over the last 45 years. Conclusions: Outcomes from this review have demonstrated a large disparity in the volume of published research for CRS compared to asthma and DM. Given the similarities in prevalence rates, impact on quality of life and economic burden, the relative under supply of CRS research should prompt efforts to increase research prioritization for this chronic disease.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:11
      PubDate: 2015-03-05T00:00:00Z
      DOI: 10.1186/s40463-015-0064-8
      Issue No: Vol. ${item.volume} (2015)
  • Thyroid Fine-needle aspiration biopsy: an evaluation of its utility in a
           community setting

    • Authors: Andre Le, Greg Thompson, Benjamin Hoyt
      First page: 12
      Abstract: Background: Thyroid cancer rates are on the rise worldwide with over 5000 new cases estimated in Canada in 2012. The American Thyroid Association recommends the use of fine-needle aspiration biopsy (FNA) in the workup of thyroid nodules. Studies show that thyroid FNA accuracy may vary based on interpretation by cytopathologists in academic versus community centres. To date, there has been no literature published addressing the accuracy or utility of preoperative FNA in a Canadian community center. Our goals were to demonstrate the accuracy of thyroid FNA at our centre, and to compare our results to those published in the literature. Methods: Medical records for patients who underwent thyroidectomy performed by two otolaryngologists in Fredericton, NB, between September 2008 and February 2013 were reviewed. 125 patients with 197 FNAs were analyzed. Fisher’s Exact test was used to compare the malignancy rates in each FNA category, and Chi-Square test was used for FNA distribution comparison. Results: The distribution of all FNA diagnoses at our centre was as follows: 38 (19%) benign, 100 (51%) inconclusive, 8 (4%) suspicious for malignancy, 2 (1%) malignant, and 49 (25%) unsatisfactory. FNA distribution was significantly different between our centre and comparison centres (Chi-Square p 
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:12
      PubDate: 2015-03-12T12:00:00Z
      DOI: 10.1186/s40463-015-0063-9
      Issue No: Vol. ${item.volume} (2015)
  • Postoperative abnormal response of C-reactive protein as an indicator for
           infectious complications after oral oncologic surgery with primary

    • Authors: Masaya Akashi, Shungo Furudoi, Kazunobu Hashikawa, Akiko Sakakibara, Takumi Hasegawa, Takashi Shigeta, Tsutomu Minamikawa, Takahide Komori
      First page: 13
      Abstract: Background: C-reactive protein (CRP) screening has been reported to be reliable for detection of infectious complications. Postoperative abnormal response of CRP can predict wound infection in colorectal surgery. This study aimed to determine the efficacy of CRP monitoring to detect infectious complications in oral oncologic surgery. Methods: One hundred patients who underwent oral cancer resection with primary reconstruction were enrolled. Postoperative kinetics of CRP were classified into a normal or abnormal response. Results: A normal CRP response after surgery was observed in 61 patients and an abnormal response was observed in 39. There were postoperative infectious complications in 21 patients, with surgical site infections in 13 patients (early onset in six and late onset in seven). Non-wound infections were found in nine patients. Sensitivity, specificity, the positive predictive value, and the negative predictive value for abnormal CRP response as a predictor for early infectious complications were 100%, 70.1%, 35.9%, and 100%, respectively. Conclusion: Postoperative serial CRP screening is a useful test as an indicator of infectious complications in oral oncologic surgery. Normal CRP responses can rule out almost all early infectious complications.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:13
      PubDate: 2015-04-02T12:00:00Z
      DOI: 10.1186/s40463-015-0066-6
      Issue No: Vol. ${item.volume} (2015)
  • A new diagnostic vestibular evoked response

    • Authors: Zeinab Dastgheib, Brian Lithgow, Brian Blakley, Zahra Moussavi
      First page: 14
      Abstract: ObjectiveTo describe the development of a new clinically applicable method for assessing vestibular function in humans with particular application in Meniere’s disease.Study designSophisticated signal-processing techniques were applied to data from human subject undergoing tilts stimulating the otolith organs and semicircular canals. The most sensitive representatives of vestibular function were extracted as “features”. Methods: After careful consideration of expected response features, Electrovestibulography, a modified electrocochleography, recordings were performed on fourteen Meniere’s patients and sixteen healthy controls undergoing controlled tilts. The data were subjected to multiple signal processing techniques to determine which “features” were most predictive of vestibular responses. Results: Linear discriminant analysis and fractal dimension may allow data from a single tilt to be used to adequately characterize the vestibular system. Conclusion: Objective, physiologic assessment of vestibular function may become realistic with application of modern signal processing techniques.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:14
      PubDate: 2015-04-11T00:00:00Z
      DOI: 10.1186/s40463-015-0065-7
      Issue No: Vol. ${item.volume} (2015)
  • Assessment of the current Canadian rhinology workforce

    • Authors: Kristine Smith, Doron Sommer, Sean Grondin, Brian Rotenberg, Marc Tewfik, Shaun Kilty, Erin Wright, Arif Janjua, John Lee, Chris Diamond, Luke Rudmik
      First page: 15
      Abstract: Background: The Canadian Rhinologic workforce and future needs are not well defined. The objective of this study was to define the current demographics and practice patterns of the Canadian Rhinologic workforce. Outcomes from this study can be used to perform rhinologic workforce needs assessments. Methods: A national survey was administered to all Canadian otolaryngologists who were identified to have a clinical practice composed of >50% rhinology. Results: 42 surgeons participated in the survey (65% response rate). The mean age was 46 (SD 10.1) years and the average age of planned retirement was 66 (SD 4.0). Eighty three percent of respondents had completed a rhinology fellowship and 17% practiced exclusively rhinology. Thirty three percent hold advanced degrees. Forty two percent of surgeons felt their access to operative time was insufficient. Six percent of surgeons reported not having access to image guided surgery. Fourteen percent felt that there were too many practicing rhinologists in Canada while 17% believed there were too few practicing rhinologists. Seventeen percent have advised their residents to pursue other fields due to a perceived lack of future jobs. Overall, 66% of respondents were satisfied with their income, and 83% were satisfied with their careers. Conclusions: This study has demonstrated that there is a perceived mismatch between the current supply of Rhinology labor and the capacity to treat patients in a timely manner. Outcomes from this study will begin to improve Rhinologic workforce planning in Canada and reduce the gap between patient demand and access to high quality care.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:15
      PubDate: 2015-05-09T00:00:00Z
      DOI: 10.1186/s40463-015-0070-x
      Issue No: Vol. ${item.volume} (2015)
  • Warthin’s tumor of the larynx: a very rare case and systematic
           review of the literature

    • Authors: Lluís Nisa, Basile Landis, Cinzia Salmina, Angeliki Ailianou, Eva Karamitopoulou, Roland Giger
      First page: 16
      Abstract: Background: Warthin’s tumor or cystadenolymphoma (CAL) is a benign salivary gland tumor occurring almost exclusively in the parotid gland. CALs of other locations are rare.Case presentationWe report a laryngeal CAL detected in a positron emission tomography/computed tomography (PET/CT) performed for breast cancer follow-up. The tumor was successfully treated by transoral surgery.DiscussionOnly 14 cases of laryngeal CAL are reported worldwide. These cases confirmed our experience of an uncomplicated and mostly successful transoral resection. Conclusion: CALs of the larynx are very rare. They are characterized by hypermetabolism in PET/CT. The increasing use of PET/CT investigations in cancer patients could give rise to more incidental findings of CALs at unusual locations such as the larynx.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:16
      PubDate: 2015-05-12T00:00:00Z
      DOI: 10.1186/s40463-015-0067-5
      Issue No: Vol. ${item.volume} (2015)
  • Prospective functional outcomes in sequential population based cohorts of
           stage III/ IV oropharyngeal carcinoma patients treated with 3D conformal
           vs. intensity modulated radiotherapy

    • Authors: Paul Kerr, Candace Myers, James Butler, Mohamed Alessa, Pascal Lambert, Andrew Cooke
      First page: 17
      Abstract: Background and purposeTo compare early (3 and 6 month) and later (12 and 24 month) functional outcomes of stage III and IV (M0) oropharyngeal squamous cancer patients treated in sequential cohorts with 3D conformal (3DCRT) or intensity modulated radiotherapy (IMRT).Patients and methods200 patients in sequential population based cohorts of 83 and 117 patients treated at a single institution with 3DCRT and then IMRT respectively were prospectively assessed at pre-treatment and 3, 6, 12 and 24 months post treatment. A standard functional outcomes protocol including performance status (KPS, ECOG), 3 Performance Status scales for Head and Neck (PSS-HN), the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), Voice Handicap Index-10 (VHI-10) and self-rated xerostomia were applied. Results: Mean age at diagnosis was 59 years. The primary site was base of tongue in 77 and tonsil or soft palate in 123 patients. Median follow up was 2.5 years for the second cohort. Concomitant therapy was used in 159 (79.5%). Overall survival at 3 years was 75.6% and 71.5% for IMRT and 3DCRT cohorts respectively (not significant). A multiple imputation technique was used to estimate missing values in order to avoid a healthy patient bias. KPS and ECOG reached nadirs at 3 to 6 months but approached baseline values at 12 to 24 months and did not differ by treatment. The 3 PSS-HN scales, Eating in Public (p 
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:17
      PubDate: 2015-05-13T00:00:00Z
      DOI: 10.1186/s40463-015-0068-4
      Issue No: Vol. ${item.volume} (2015)
  • Selectively false-positive radionuclide scan in a patient with sarcoidosis
           and papillary thyroid cancer: a case report and review of the literature

    • Authors: Nicole Lebo, Francois Raymond, Michael Odell
      First page: 18
      Abstract: Background: Radioiodine and Tc-99 m pertechnetate scans are routinely relied upon to detect metastasis in papillary thyroid cancer; false-positive scans are relatively rare. To our knowledge, no published reports exist of sarcoidosis causing such selectively false-positive scans. Methods: We present a case of a 41-year-old woman with known metastatic papillary thyroid cancer (T1bN1aMx) in whom sarcoidosis-affected cervical and mediastinal lymph nodes demonstrated uptake of thyroid-targeting radionuclides. Only the minority of these nodes demonstrated radionuclide uptake, raising the suspicion of adjacent or coexisting sarcoid and metastatic involvement. Selective uptake of thyroid-targeted radionuclides by isolated sarcoidosis is, to our knowledge, a previously undocumented occurrence. Results: Biopsies of uptake-negative mediastinal nodes revealed sarcoidosis. Pathology from a subsequent neck dissection excising uptake-positive cervical nodes also showed sarcoidosis, with no coinciding malignancy. Conclusions: We document a case of sarcoidosis causing a selectively false-positive thyroid scintigraphy scan. It is useful for clinicians to be aware of potential false-positives and deceptive patterns on radionuclide scans when managing patients with both well-differentiated thyroid cancer and a co-existing disease affecting the nodal basins draining the thyroid gland.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:18
      PubDate: 2015-05-15T12:00:00Z
      DOI: 10.1186/s40463-015-0069-3
      Issue No: Vol. ${item.volume} (2015)
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