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  Journal of Otolaryngology - Head and Neck Surgery
  [SJR: 0.564]   [H-I: 11]   [9 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1916-0216
   Published by Biomed Central Ltd. Homepage  [274 journals]
  • Anatomical examination of the fibula: digital imaging study for
           osseointegrated implant installation

    • Authors: Yoshiaki Ide, Satoru Matsunaga, Jeffrey Harris, Daniel Connell, Hadi Seikaly, Johan Wolfaardt
      First page: 1
      Abstract: Background: Free vascularized fibular flaps are commonly used in jaw reconstruction. CT scan images of the fibula are used in digital planning of jaw reconstruction. In order to fully describe the anatomy of the fibula, an imaging study of the fibula was undertaken. The purpose of the present study was to examine the anatomical structure of the fibula using patient CT images. Methods: The CT scan images of fibulae of 20 patients were used for the study. The results of the analysis showed that, of the widths, the anterior border of the fibula to the posterior surface was the largest dimension. The shape type analysis showed that the triangular type was most prominent near the head of the fibula, and the irregular type was most prominent towards the lateral malleolus. Results: The results of height and width related to the long axis of implant installation showed that the width of the central section was the largest. With respect to the length of available bone volume, the length near the lateral malleolus was larger than that near the head of the fibula. The results showed that there were significant differences in size between male and female fibulae. Conclusion: The present study provides a CT scan based analysis of the anatomy of the fibula. Important information for the optimal site of installation of osseointegrated implants in fibular free flap reconstructions is also provided.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:1
      PubDate: 2015-02-03T12:00:00Z
      DOI: 10.1186/s40463-015-0055-9
      Issue No: Vol. ${item.volume} (2015)
       
  • The Mcgill thyroid nodule score ¿ does it help with indeterminate
           thyroid nodules'

    • Authors: Rickul Varshney, Veronique-Isabelle Forest, Marco Mascarella, Faisal Zawawi, Louise Rochon, Michael Hier, Alex Mlynarek, Michael Tamilia, Richard Payne
      First page: 2
      Abstract: Background: Ultrasound guided fine-needle aspiration (USFNA) biopsy of thyroid nodules often gives a result of indeterminate pathology, placing thyroid specialists in difficult management situations. The aim of this study is to evaluate the incidence of malignancy in patients undergoing surgery and to correlate these results with the McGill Thyroid Nodule Score (MTNS). Methods: We performed a retrospective study comparing USFNA results, MTNS and histopathology of patients undergoing thyroid surgery between 2010 and 2012. Pre-operative USFNA results were divided into three subgroups: benign, indeterminate and suspicious for/malignant. The indeterminate USFNA subgroup comprised of Bethesda type III (atypia of undetermined significance) and Bethesda type IV (follicular neoplasms, including Hurthle cell neoplasms) lesions. Post-operative histopathology was divided into benign or malignant groups. Results: Of the 437 patient charts reviewed, 57.0% had an indeterminate USFNA biopsy. Within the indeterminate group, the malignancy rate was 39.8%. For indeterminate USFNA, the median MTNS was 7 (32% risk of malignancy) for benign nodules and 9 (63% risk of malignancy) for malignant nodules on post-operative histopathology (p'
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:2
      PubDate: 2015-02-03T12:00:00Z
      DOI: 10.1186/s40463-015-0058-6
      Issue No: Vol. ${item.volume} (2015)
       
  • Surgical exploration and discovery program: inaugural involvement of
           otolaryngology ¿ head and neck surgery

    • Authors: Brittany Greene, Linden Head, Nada Gawad, Stanley Hamstra, Laurie McLean
      First page: 3
      Abstract: Background: There is significant variability in undergraduate Otolaryngology ' Head and Neck Surgery (OTOHNS) curricula across Canadian medical schools. As part of an extracurricular program delivered jointly with other surgical specialties, the Surgical Exploration and Discovery (SEAD) program presents an opportunity for medical students to experience OTOHNS. The purpose of this study is to review the participation and outcome of OTOHNS in the SEAD program. Methods: The SEAD program is a two-week, 80-hour, structured curriculum that exposes first-year medical students to nine surgical specialties across three domains: (1) operating room observerships, (2) career discussions with surgeons, and (3) simulation workshops. During observerships students watched or assisted in surgical cases over a 4-hour period. The one-hour career discussion provided a specialty overview and time for students' questions. The simulation included four stations, each run by a surgeon or resident; students rotated in small groups to each station: epistaxis, peritonsillar abscess, tracheostomy, and ear examination. Participants completed questionnaires before and after the program to evaluate changes in career interests; self-assessment of knowledge and skills was also completed following each simulation. Baseline and final evaluations were compared using the Wilcoxon Signed-Rank test. Results: SEAD participants showed significant improvement in knowledge and confidence in surgical skills specific to OTOHNS. The greatest knowledge gain was in ear examination, and greatest gain in confidence was in draining peritonsillar abscesses. The OTOHNS session received a mean rating of 4.8 on a 5-point scale and was the most popular surgical specialty participating in the program. Eight of the 18 participants were interested in OTOHNS as a career at baseline; over the course of the program, two students gained interest and two lost interest in OTOHNS as a potential career path, demonstrating the potential for helping students refine their career choice. Conclusions: Participants were able to develop OTOHNS knowledge and surgical skills as well as refine their perspective on OTOHNS as a potential career option. These findings demonstrate the potential benefits of OTOHNS departments/divisions implementing observerships, simulations, and career information sessions in pre-clerkship medical education, either in the context of SEAD or as an independent initiative.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:3
      PubDate: 2015-02-03T12:00:00Z
      DOI: 10.1186/s40463-015-0059-5
      Issue No: Vol. ${item.volume} (2015)
       
  • Survival outcomes of First Nations patients with oral cavity squamous cell
           carcinoma (Poliquin 2014)

    • Authors: Bree Erickson, Vincent Biron, Han Zhang, Hadi Seikaly, David Côté
      First page: 4
      Abstract: Background: Oral cavity squamous cell carcinoma (OCSCC) is the most common head and neck cancer, affecting approximately 2000 Canadians yearly. Analysis of Canadian Cancer Registry data has shown that the incidence of oral cavity cancer is decreasing and survival outcomes are improving.There are significant health disparities in First Nations (FN) people in Canada. The incidence of cancer in FN groups is significantly lower when compared to the general population, but the cancer-related morbidity and mortality is significantly higher. There is no Canadian literature currently for OCSCC, or any other head and neck cancer, that compares survival outcomes of FN to the overall population. Therefore, the objective of this study is to determine whether there is a difference in epidemiology and survival outcomes between FN and non-FN patients with OCSCC. Methods: This is a retrospective study of a population-based, prospectively-collected database from Alberta Cancer Registry (ACR). Patients with OCSCC, diagnosed and treated in Alberta between 1998 and 2009 were included. ACR data collected included patient gender, age at diagnosis, tobacco and alcohol use, FN status, TNM staging, performance status, date of death, cause of death, and follow-up. FN status was identified through the Alberta Health and Wellness registry and through postal code correlation for those who live on reserves. Results: A total of 583 patients with OCSCC were included in this study. Of these, 19 were identified as being FN, leaving 564 non-FN patients. When comparing the FN and non-FN groups, there is no significant difference in baseline demographics. Estimated yearly incidences for OCSCC in the Alberta population (all ages) and FN patients are 1.74/100,000 and 1.32/100,000 respectively (p'='0.23). Significant differences are seen in overall survival (OS) (5-year OS 58.1% for non-FN and 33.7% for FN) and for disease-specific survival (DSS) (5-year DSS 67.8% for non-FN and 44.5% for FN). Multivariate analysis confirmed FN patients have a significant increase risk of death in OS and DSS, with hazard ratios of 4.20 (p'='0.01) and 4.57 (p'='0.02), respectively. Conclusions: The overall survival and disease specific survival are significantly lower in FN patients compared to non-FN patients with OCSCC.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:4
      PubDate: 2015-02-03T12:00:00Z
      DOI: 10.1186/s40463-015-0056-8
      Issue No: Vol. ${item.volume} (2015)
       
  • A survey on pulmonary screening practices among otolaryngology-head &
           neck surgeons across Canada in the post treatment surveillance of head and
           neck squamous cell carcinoma

    • Authors: J Madana, Gregoire Morand, Luz Barona-Lleo, Martin Black, Alex Mlynarek, Michael Hier
      First page: 5
      Abstract: Background: Post treatment lung screening for head and neck cancer patients primarily focuses on the distant metastasis and a high rate of second primary can also be expected. The best screening tool and timing for this purpose is controversial. We sought out to assess the current practice and beliefs among Canadian Head and Neck Surgeons. Methods: After Ethical Board approval, a nationwide survey was conducted through the Canadian Society of Otolaryngology (CSO) among head and neck surgeons regarding their practices for pulmonary screening in HNSCC patients. Results: Our CSO survey among Otolaryngology-head and neck surgeons showed that 26 out of 32 respondents perform routine lung screen, out of which 23 (88%) feel that chest radiography should be preferred. The majority of respondents felt that lung screening could impact beneficially on mortality. For symptomatic patients, low-dose spiral CT was the preferred modality (48%), followed by PET/CT scan (14%) and sputum cytology (14%). In high-risk asymptomatic patients (current smoker, radiation exposure, family history and advanced HNSCC), 31% of respondents performed a CXR. The same percentage performed a low dose CT, while 19% relied on PET scan. A further 19% of respondents did not perform any screening in high-risk patients. Most respondents (77%) had more than 10'years practice since graduation from medical school and came from the provinces of Quebec, Ontario and Alberta. Conclusion: Chest radiography remains the preferred modality for lung screening and was believed to be impacting beneficially on lung mortality. The recent literature does not seem to be in agreement with those beliefs. Further studies to establish which modality is best and concurrent nation-wide education are warranted.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:5
      PubDate: 2015-02-04T12:00:00Z
      DOI: 10.1186/s40463-015-0057-7
      Issue No: Vol. ${item.volume} (2015)
       
  • Reviewer acknowledgement 2014

    • Authors: Hadi Seikaly, Erin Wright
      First page: 6
      Abstract: Contributing reviewersThe Editors of Journal of Otolaryngology - Head & Neck Surgery would like to thank all our reviewers who have contributed to the journal in Volume 43 (2014).
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:6
      PubDate: 2015-02-11T12:00:00Z
      DOI: 10.1186/s40463-015-0054-x
      Issue No: Vol. ${item.volume} (2015)
       
  • Face and content validity of a novel, web-based otoscopy simulator for
           medical education

    • Authors: Brandon Wickens, Jordan Lewis, David Morris, Murad Husein, Hanif Ladak, Sumit Agrawal
      First page: 7
      Abstract: Background: Despite the fact that otoscopy is a widely used and taught diagnostic tool during medical training, errors in diagnosis are common. Physical otoscopy simulators have high fidelity, but they can be expensive and only a limited number of students can use them at a given time.Objectives1) To develop a purely web-based otoscopy simulator that can easily be distributed to students over the internet. 2) To assess face and content validity of the simulator by surveying experts in otoscopy. Methods: An otoscopy simulator, OtoTrain™, was developed at Western University using web-based programming and Unity 3D. Eleven experts from academic institutions in North America were recruited to test the simulator and respond to an online questionnaire. A 7-point Likert scale was used to answer questions related to face validity (realism of the simulator), content validity (expert evaluation of subject matter and test items), and applicability to medical training. Results: The mean responses for the face validity, content validity, and applicability to medical training portions of the questionnaire were all ≤3, falling between the “Agree”, “Mostly Agree”, and “Strongly Agree” categories. The responses suggest good face and content validity of the simulator. Open-ended questions revealed that the primary drawbacks of the simulator were the lack of a haptic arm for force feedback, a need for increased focus on pneumatic otoscopy, and few rare disorders shown on otoscopy. Conclusion: OtoTrain™ is a novel, web-based otoscopy simulator that can be easily distributed and used by students on a variety of platforms. Initial face and content validity was encouraging, and a skills transference study is planned following further modifications and improvements to the simulator.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:7
      PubDate: 2015-02-24T00:00:00Z
      DOI: 10.1186/s40463-015-0060-z
      Issue No: Vol. ${item.volume} (2015)
       
  • Oncolytic activity of reovirus in HPV positive and negative head and neck
           squamous cell carcinoma

    • Authors: Timothy Cooper, Vincent Biron, David Fast, Raymond Tam, Thomas Carey, Maya Shmulevitz, Hadi Seikaly
      First page: 8
      Abstract: Background: The management of patients with advanced stages of head and neck cancer requires a multidisciplinary and multimodality treatment approach which includes a combination of surgery, radiation, and chemotherapy. These toxic treatment protocols have significantly improved survival outcomes in a distinct population of human papillomavirus (HPV) associated oropharyngeal cancer. HPV negative head and neck squamous cell carcinoma (HNSCC) remains a challenge to treat because there is only a modest improvement in survival with the present treatment regimens, requiring innovative and new treatment approaches. Oncolytic viruses used as low toxicity adjunct cancer therapies are novel, potentially effective treatments for HNSCC. One such oncolytic virus is Respiratory Orphan Enteric virus or reovirus. Susceptibility of HNSCC cells towards reovirus infection and reovirus-induced cell death has been previously demonstrated but has not been compared in HPV positive and negative HNSCC cell lines.ObjectivesTo compare the infectivity and oncolytic activity of reovirus in HPV positive and negative HNSCC cell lines. Methods: Seven HNSCC cell lines were infected with serial dilutions of reovirus. Two cell lines (UM-SCC-47 and UM-SCC-104) were positive for type 16 HPV. Infectivity was measured using a cell-based ELISA assay 18 h after infection. Oncolytic activity was determined using an alamar blue viability assay 96 h after infection. Non-linear regression models were used to calculate the amounts of virus required to infect and to cause cell death in 50% of a given cell line (EC50). EC50 values were compared. Results: HPV negative cells were more susceptible to viral infection and oncolysis compared to HPV positive cell lines. EC50 for infectivity at 18 h ranged from multiplicity of infection (MOI) values (PFU/cell) of 18.6 (SCC-9) to 3133 (UM-SCC 104). EC50 for cell death at 96 h ranged from a MOI (PFU/cell) of 1.02x102 (UM-SCC-14A) to 3.19x108 (UM-SCC-47). There was a 3x106 fold difference between the least susceptible cell line (UM-SCC-47) and the most susceptible line (UM-SCC 14A) EC50 for cell death at 96 h. Conclusions: HPV negative HNSCC cell lines appear to demonstrate greater reovirus infectivity and virus-mediated oncolysis compared to HPV positive HNSCC. Reovirus shows promise as a novel therapy in HNSCC, and may be of particular benefit in HPV negative patients.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2015, null:8
      PubDate: 2015-02-24T12:00:00Z
      DOI: 10.1186/s40463-015-0062-x
      Issue No: Vol. ${item.volume} (2015)
       
  • 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)
       
 
 
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