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Otolaryngology—Head and Neck Surgery

Daniel P Ballard, Jason Abramowitz, Daniel C Sukato, Boris Bentsianov, Richard Rosenfeld
Objective To assist otolaryngologists in counseling patients with hoarseness who would benefit from injection laryngoplasty on whether or not to perform the procedure in the office vs the operating room. Data Sources Cochrane library, CINAHL, PubMed, and EMBASE. Review Methods Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting standards of English-language articles that compared voice outcomes for in-office and in the operating room injection laryngoplasty...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Lukas Anschuetz, Matteo Alicandri-Ciufelli, Marco Bonali, Matteo Fermi, Marco Caversaccio, Livio Presutti, Daniele Marchioni
Objective The aim of this study is to describe the endoscopic anatomy of the subtympanic sinus (STS), establish a classification according to its extension regarding the level of the facial nerve (FN), and assess the feasibility of the transcanal endoscopic approach to the STS. Study Design Experimental anatomic research. Setting Temporal bone laboratory. Methods We performed endoscopic dissection of 34 human whole head and ear block specimens. Of those, 29 underwent high-resolution computed tomography. The STS was classified according to its extension regarding the level of the FN: type A, no extension medial to the FN; type B, extension to the medial limit of the FN; type C, extension of the sinus medially and posteriorly from the FN into the mastoid cavity...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Rosh K V Sethi, Nicholas B Abt, Aaron Remenschneider, Yingbing Wang, Kevin S Emerick
Objective Preoperative single-photon emission computed tomography/computed tomography (SPECT/CT) imaging may aid in the localization of sentinel lymph nodes (SLNs) in cutaneous head and neck malignancy and has been rigorously evaluated for deep cervical lymph nodes. The purpose of this study was to assess the sensitivity, specificity, and positive predictive value (PPV) of SPECT/CT for preoperative localization of nodal basins superficial to the sternocleidomastoid muscle, with comparison to deep nodal basins of the neck...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Alia Mowery, Tyler Light, Daniel Clayburgh
Objective The aim of the present study is to address the paucity of data on long-term trends in postoperative complication rates in head and neck surgery. Specifically, this study assesses trends in morbidity and mortality following head and neck surgery over a 20-year period from 1995 to 2015 and identifies risk factors for the development of complications. Study Design Retrospective cross-sectional analysis of Veterans Affairs Surgical Quality Improvement Program database from 1995 to 2015. Setting Veterans Affairs medical centers across the United States...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Tiffany P Baugh, C W David Chang
Objectives The purpose of this study is to describe the demographics of children undergoing inpatient management of epistaxis and recognize the clinical circumstances that may necessitate embolization or ligation for epistaxis management. Study Design and Setting Cross-sectional analysis of a national database. Subjects and Methods A review of data reported by hospitals in the United States to the Healthcare Cost and Utilization Project Kids' Inpatient Database with a diagnosis of epistaxis was conducted ( International Classification of Diseases, Ninth Revision [ ICD-9] code 784...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Yuvatiya Plodpai
Objective Although overlay grafting for complicated tympanic perforations offers a high success rate, potential complications may outweigh its advantages. This study aimed to assess endoscopic overlay tympanoplasty (EOT), compared with microscopic overlay tympanoplasty (MOT), to optimize outcomes while minimizing complications associated with large tympanic perforations. Study Design Nonmasked, randomized. Setting Tertiary care university hospital. Subjects and Methods Altogether, 70 patients with large tympanic perforations were randomized to undergo overlay tympanoplasty between June 2014 and July 2016...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Harry H Ching, Jacob B Kahane, Nathaniel H Reeve, Robert C Wang
Endoscopic stapler approaches to Zenker's diverticulum often yield a persistent diverticulum and recurrent dysphagia up to 20%. A novel technique to reduce the postoperative diverticulum is described. Eight consecutive patients with Zenker's diverticulum who underwent endoscopic stapler diverticulotomy had adjunctive endoscopic plication of the diverticulum wall to functionally reduce the residual diverticulum size. On postoperative esophagram, there was no visible diverticulum in 4 of 7 patients (57%). The remaining 3 patients had a reduction in common wall of 76%, 50%, and 40% with a mean postoperative size of 1...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Miguel Goncalves, Konstantinos Mantsopoulos, Mirco Schapher, Heinrich Iro, Michael Koch
Objective To assess the value of ultrasound, if indicated, supplemented by sialendoscopy, in the diagnosis of sialolithiasis. Study Design Retrospective study. Setting Referring center for salivary gland diseases. Subjects and Methods All patients who presented with a suspected diagnosis of obstructive sialopathy between January 2011 and April 2017 and had not undergone any treatment were retrospectively evaluated. A total of 2052 patients and 2277 glands were included in the study. Ultrasound examinations were carried out initially and followed by sialendoscopy in all cases...
June 1, 2018: Otolaryngology—Head and Neck Surgery
K J Lee, Keyu Liu
Many patients are not satisfied with their doctor's answer when they complain about tinnitus. The proposed classification can be used to communicate with patients as well as guide future research. Type A itemizes the treatable causes of tinnitus. Type B itemizes tinnitus with a lack of medical explanation. Type C tinnitus is caused by diagnosable and treatable conditions, as listed in tinnitus type A, but the tinnitus persists after the successful treatment of the other symptoms.
June 1, 2018: Otolaryngology—Head and Neck Surgery
Esther X Vivas, Nicholas J Panella, Kristen L Baugnon
Objectives To describe patient characteristics, audiometric outcomes, and magnetic resonance imaging (MRI) signal patterns in patients with suspected labyrinthine hemorrhage. Study Design Retrospective review. Setting Tertiary medical center. Subjects and Methods Radiology database was queried for terms related to labyrinth hemorrhage or labyrinthitis and then selected for patients in which labyrinthine hemorrhage was suspected in the report. Eleven patients were identified and all treated at our institution...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Samuel J Rubin, Ellen B Gurary, Muhammad M Qureshi, Andrew R Salama, Waleed H Ezzat, Scharukh Jalisi, Minh Tam Truong
Objective To determine if adjuvant radiation therapy for patients with pT2N0 oral cavity tongue cancer affects overall survival. Study Design Retrospective cohort study. Setting National Cancer Database. Subjects and Methods Cases diagnosed between 2004 and 2013 with pathologic stage pT2N0 oral cavity tongue cancer with negative surgical margins were extracted from the National Cancer Database. Data were stratified by treatment received, including surgery only and surgery + postoperative radiation therapy. Univariate analysis was performed with a 2-sample t test, chi-square test, or Fisher exact test and log-rank test, while multivariate analysis was performed with Cox regression models adjusted for individual variables as well as a propensity score...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Yong Gi Jung, Gi Cheol Park
The inferior turbinate is an important structure for maintenance of adequate physiologic function within the nasal cavity. However, it hampers access to lesions involving maxillary sinus areas, including postoperative mucocele or benign tumor, and acts as an inferior limit to widening the natural ostium of a maxillary sinus. Here, we introduce a novel technique, interior turbinate swing, to facilitate entry to the inferior meatus or maxillary sinus while maintaining integrity of the inferior turbinate. In this technique, the anterior part of inferior turbinate is cut with sharp scissors, rotated posteriorly, and held in the nasopharynx...
June 1, 2018: Otolaryngology—Head and Neck Surgery
John D Cramer, Jonas T Johnson, Marci L Nilsen
Objectives Pain is common among patients with cancer, stemming from both malignancy and side effects of treatment. The extent to which pain persists after treatment has received little attention. We examined the prevalence, predictors, and impact on quality of life (QOL) caused by pain among survivors of head and neck cancer. Study Design Cohort study. Setting Tertiary head and neck cancer survivorship clinic. Subjects and Methods We identified survivors of head and neck cancer ≥1 year after diagnosis and examined the prevalence and risk factors for development of pain...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Johanna Jokela, Laura Tapiovaara, Marie Lundberg, Aaro Haapaniemi, Leif Bäck, Riitta Saarinen
Objectives To evaluate the incidence and nature of complications associated with diagnostic and interventional sialendoscopies and to report intervention failures in a prospective setup. Study Design Prospective observational study. Setting Academic tertiary care university hospital. Subjects and Methods Patients who underwent diagnostic or interventional sialendoscopy between October 2015 and December 2016 were prospectively enrolled. Patient data, operation-related factors, treatment failures, and complications were recorded into a database and analyzed...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Daniel C O'Brien, Michele M Carr
Objectives To determine if and how resident emotional health is monitored among otolaryngology training programs and to determine what wellness resources are available to otolaryngology residents. Study Design Survey. Setting Tertiary academic medical centers. Subjects and Methods An anonymous 50-item survey sent via REDCap to the 107 allopathic American otolaryngology program directors (PDs). Results The response rate was 44%, of whom 47.7% regularly surveyed emotional health among their residents. A total of 33...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Erika M Zettner, Malcolm A Gleser
Objective Hearing loss is a significant and growing problem as patients with cystic fibrosis (CF) live longer and experience frequent courses of intravenous aminoglycoside antibiotics (hereafter, "IVs"). This study seeks to document that risk in a large adult population with CF, accounting for age and aminoglycoside exposure. Study Design Retrospective case review of patients with CF who had multiple audiograms over years. Setting Tertiary care cystic fibrosis setting. Subject and Methods The first and last audiograms recorded over a 10-year period were compared for 165 adult patients with CF...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Reuven Ishai, Renata M Knoll, Jenny X Chen, Kevin Wong, Katherine L Reinshagen, Joseph B Nadol, Aaron K Remenschneider, David H Jung, Elliott D Kozin
Objective Hearing loss following temporal bone (TB) fracture may result from direct transection of the middle and inner ear. The pathophysiology of hearing loss due to head injury without TB fracture, however, is not well understood. Few reports describe otopathologic findings. Herein, we investigate the pathologic findings of patients who sustained a head injury without evidence of a TB fracture. Study Design Otopathology study. Setting Otopathology laboratory. Subjects Subjects with a history of head injury without TB fracture...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Marius Lebret, Nathalie Arnol, Jean-Benoît Martinot, Renaud Tamisier, Chrystèle Deschaux, Jean-Louis Pépin, Jean-Christian Borel
Nasal obstruction is frequently reported by patients with sleep apnea and complicates the choice of a nasal or oronasal mask for continuous positive airway pressure (CPAP) therapy. However, the type of interface used for the delivery of CPAP is crucial to ensure tolerance and compliance. The aim of this prospective pilot study was to identify whether the validated Nasal Obstruction Symptom Evaluation (NOSE) score rated at CPAP initiation was associated with the type of mask used after 4 months of treatment...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Elliot Morse, Rance J T Fujiwara, Saral Mehra
Objectives To examine the association of industry payments for brand-name intranasal corticosteroids with prescribing patterns. Study Design Cross-sectional retrospective analysis. Setting Nationwide. Subjects and Methods We identified physicians prescribing intranasal corticosteroids to Medicare beneficiaries 2014-2015 and physicians receiving payment for the brand-name intranasal corticosteroids Dymista and Nasonex. Prescription and payment data were linked by physician, and we compared the proportion of prescriptions written for brand-name intranasal corticosteroids in industry-compensated vs non-industry-compensated physicians...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Max Hennessy, Johnathan McGinn, Bartholomew White, Sakeena Payne, Joshua I Warrick, Henry Crist
Objective Identify methods to improve the frozen-section diagnosis of acute invasive fungal rhinosinusitis. Study Design Biopsies with frozen section for suspected acute invasive fungal rhinosinusitis were reviewed to identify causes for missed diagnoses and evaluate methods for potential improvement. Setting All aspects of the study were performed at the Penn State Milton S. Hershey Medical Center. Subjects and Methods All frozen sections performed for suspected acute invasive fungal rhinosinusitis between 2006 through 2017 were reviewed with their diagnoses compared to the final diagnoses...
May 1, 2018: Otolaryngology—Head and Neck Surgery
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