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Otolaryngology—Head and Neck Surgery

Grace X Tan, Emily F Boss, Daniel S Rhee
Objectives (1) Describe outcomes of bronchoscopy with foreign body removal among children on the basis of a large standardized multi-institutional data set. (2) Identify factors associated with 30-day adverse events. Study Design Cross-sectional analysis of a US national database. Setting Public data set from the ACS NSQIP-P (American College of Surgeons National Surgical Quality Improvement Program-Pediatric) from 2012 to 2015. Subjects and Methods Children <18 years old who underwent bronchoscopy with removal of foreign body were identified...
September 18, 2018: Otolaryngology—Head and Neck Surgery
Stephanie Johnson-Obaseki, Lisa Caulley, Martin Corsten, Geoffrey Liu, Jim Dimitroulakos, David Goldstein, Jonathan Irish, Jennifer Rider
Objective Evaluate serum C-reactive protein (CRP) in human papillomavirus (HPV)-positive oropharynx cancer as compared with HPV-negative oropharynx cancer and determine if CRP levels were associated with overall survival and/or recurrence-free survival. Study Design Prospective cohort study. Setting Tertiary care academic cancer center between 2007 and 2010. Subjects and Methods Among patients with oropharynx cancer and confirmed HPV status, plasma CRP levels were measured with a high-sensitivity ELISA kit...
September 18, 2018: Otolaryngology—Head and Neck Surgery
Li-Ang Lee, Chao-Jan Wang, Yu-Lun Lo, Chung-Guei Huang, I-Chun Kuo, Wan-Ni Lin, Li-Jen Hsin, Tuan-Jen Fang, Hsueh-Yu Li
Objective A surgical response to upper airway (UA) surgery for obstructive sleep apnea (OSA) depends on adequate correction of collapsible sites in the UA. This pilot study aimed to examine the surgical response to UA surgery directed by drug-induced sleep computed tomography (DI-SCT) for OSA. Study Design Prospective case series. Setting Tertiary referral center. Subjects and Methods This study recruited 29 OSA patients (median age, 41 years; median body mass index, 26.9 kg/m2 ) who underwent single-stage DI-SCT-directed UA surgery between October 2012 and September 2014...
September 18, 2018: Otolaryngology—Head and Neck Surgery
Shekhar K Gadkaree, Alexander Gelbard, Simon R Best, Lee M Akst, Martin Brodsky, Alexander T Hillel
Objective To test the hypothesis that the etiologies of bilateral vocal fold mobility impairment (BLVFI), bilateral vocal fold paralysis (BVFP), and posterior glottis stenosis (PGS) have distinct clinical outcomes. To identify patient-specific and procedural factors that influence tracheostomy-free survival. Study Design Retrospective cohort study. Setting Johns Hopkins Medical Center from 2004 to 2015. Subjects and Methods Case series with chart review of 68 patients with PGS and 17 patients with BVFP. Multiple logistic regression analysis determined factors associated with airway prosthesis dependence at last follow-up and the procedural burden (defined as number of operative procedures per year)...
September 18, 2018: Otolaryngology—Head and Neck Surgery
Raj C Dedhia, Amit J Shah, Donald L Bliwise, Arshed A Quyyumi, Patrick J Strollo, Qiao Li, Giulia Da Poian, Gari D Clifford
Objective Hypoglossal nerve stimulation represents a novel therapy for the treatment of moderate-severe obstructive sleep apnea; nonetheless, its cardiovascular effects are not known. We examine the effects of hypoglossal nerve stimulation on heart rate variability, a measure of autonomic function. Study Design Substudy of the STAR trial (Stimulation Therapy for Apnea Reduction): a multicenter prospective single-group cohort. Setting Academic and private practice centers in the United States and Europe. Subjects and Methods A subset of responder participants (n = 46) from the STAR trial was randomized to therapy withdrawal or therapy maintenance 12 months after surgery...
September 18, 2018: Otolaryngology—Head and Neck Surgery
Diana Khalil, Martin J Corsten, Margaret Holland, Adele Balram, James Ted McDonald, Stephanie Johnson-Obaseki
Objective Diagnosis of laryngeal cancer is dependent on awareness that persistent hoarseness needs to be investigated as well as access to an otolaryngologist. This study aimed to better classify and understand 3 factors that may lead to variability in stage at presentation of laryngeal cancer: (1) socioeconomic status (SES), (2) differences in access to health care by location of residence (rural vs urban or by province), and (3) access to an otolaryngologist (by otolaryngologists per capita). Study Design Registry-based multicenter cohort analysis...
September 11, 2018: Otolaryngology—Head and Neck Surgery
Yuan-Pin Hsu, Chin-Wang Hsu, Chyi-Huey Bai, Sheng-Wei Cheng, Chiehfeng Chen
Objectives The aim of this study (PROSPERO ID: CRD42017081952) was to evaluate medical treatment for epistaxis from hereditary hemorrhagic telangiectasia (HHT). Data Sources PubMed, Embase, Scopus, and Cochrane Library databases were interrogated from their inceptions to November 2017. Review Methods Randomized clinical trials comparing medical treatment with placebo for epistaxis of HHT were included. We used a random-effects model to synthesize overall effects. Heterogeneity was evaluated with the I2  statistic...
September 11, 2018: Otolaryngology—Head and Neck Surgery
Samuel R Barber, Saurabh Jain, Young-Jun Son, Eugene H Chang
The surgeon's knowledge of a patient's individual anatomy is critical in skull base surgery. Trainees and experienced surgeons can benefit from surgical simulation; however, current models are expensive and impractical for widespread use. In this study, we report a next-generation mixed-reality surgical simulator. We segmented critical anatomic structures for 3-dimensional (3D) models to develop a modular teaching tool. We then developed a navigation tracking system utilizing a 3D-printed endoscope as a trackable virtual-reality (VR) controller and validated the accuracy on VR and 3D-printed skull models within 1 cm...
September 11, 2018: Otolaryngology—Head and Neck Surgery
Diana Bigler, Kristen Burke, Nicholas Laureano, Kristan Alfonso, Julie Jacobs, Matthew L Bush
Objective There is evidence that children who are deaf and hard of hearing (DHH) have a higher incidence of behavioral disorders. Assessment of behavioral health in this population is often complicated by language developmental delays, which may result in unrecognized and untreated behavioral problems. The purpose of this study is to assess the association of behavioral disorders among children who are DHH and to explore behavioral interventions for children in this population. Data Sources PubMed, CINALH, PsychINFO, and Web of Science...
September 11, 2018: Otolaryngology—Head and Neck Surgery
Douglas C von Allmen, Lauren J Francey, Garrett M Rogers, Marc D Ruben, Aliza P Cohen, Gang Wu, Robert E Schmidt, Stacey L Ishman, Raouf S Amin, John B Hogenesch, David F Smith
Objective To review the effects of the circadian clock on homeostasis, the functional interaction between the circadian clock and hypoxia-inducible factors, and the role of circadian dysregulation in the progression of cardiopulmonary disease in obstructive sleep apnea (OSA). Data Sources The MEDLINE database was accessed through PubMed. Review Methods A general review is presented on molecular pathways disrupted in OSA, circadian rhythms and the role of the circadian clock, hypoxia signaling, crosstalk between the circadian and hypoxia systems, the role of the circadian clock in cardiovascular disease, and implications for practice...
September 11, 2018: Otolaryngology—Head and Neck Surgery
Habib Rizk, Yuri Agrawal, Susan Barthel, Marc L Bennett, Joni K Doherty, Patricia Gerend, Daniel R Gold, David Morrill, John G Oas, J Kirk Roberts, Erika Woodson, David A Zapala, Amy Bennett, Anant M Shenoy
No abstract text is available yet for this article.
August 31, 2018: Otolaryngology—Head and Neck Surgery
A Eliot Shearer, Kathy Frees, Diana L Kolbe, Richard J H Smith
Comprehensive genetic testing has become integral in the evaluation of children with deafness, but the amount of blood required to obtain DNA can be prohibitive in newborns. Dried blood spots (DBSs) are routinely collected and would provide an alternative source of DNA. Our objective was to evaluate the use of DBSs for comprehensive genetic testing for deafness. DNA derived from fresh and archived DBS samples was compared with DNA from whole blood. We performed next-generation sequencing of all known deafness genes in 4 DBS samples: 2 positive controls, an unknown sample, and a negative control...
August 28, 2018: Otolaryngology—Head and Neck Surgery
Bahir H Chamseddin, Romaine F Johnson, Ron B Mitchell
Objectives To evaluate demographic, clinical, and polysomnographic features of children with Down syndrome suspected of having obstructive sleep apnea. To identify factors that predict severe obstructive sleep apnea among children with Down syndrome. Study Design Case series with chart review. Setting Children's Medical Center Dallas / University of Texas Southwestern Medical Center. Subject and Methods Demographic, clinical, and polysomnographic data were collected for children with Down syndrome aged 2 to 18 years...
August 28, 2018: Otolaryngology—Head and Neck Surgery
Jin Pyeong Kim, Dong Kun Lee, Jeong Hwan Moon, Jung Je Park, Seung Hoon Woo
Objective Transoral surgery is becoming a preferred technique because it does not leave any scar after surgery. However, transoral surgery for a dermoid cyst of the oral cavity is not standardized yet, due to the anatomic complexity of this region. The aim of this study was to evaluate the safety and efficacy of a transoral dermoid cyst excision. Study Design Multicenter prospective observational study. Setting University hospital. Subjects and Methods This study was designed as a 4-year prospective multicenter evaluation of dermoid cyst excisions within the floor of mouth...
August 28, 2018: Otolaryngology—Head and Neck Surgery
Peter Hibbert, Jacqueline H Stephens, Carl de Wet, Helena Williams, Andrew Hallahan, Gavin R Wheaton, Chris Dalton, Hsuen P Ting, Gaston Arnolda, Jeffrey Braithwaite
Objective The aims of this study were twofold: (1) to design and validate a set of clinical indicators of appropriate care for tonsillitis and (2) to measure the level of tonsillitis care that is in line with guideline recommendations in a sample of Australian children. Study Design A set of tonsillitis care indicators was developed from available national and international guidelines and validated in 4 stages. This research used the same design as the CareTrack Kids study, which was described in detail elsewhere...
August 28, 2018: Otolaryngology—Head and Neck Surgery
Bharat Panuganti, Yuqi Qiu, Barbara Messing, Gregory Lee, Carole Fakhry, Raymond Blanco, Patrick Ha, Karen Messer, Joseph A Califano
Objectives We aimed to demonstrate the efficacy of a multifaceted performance improvement regimen to reduce the incidence of adverse events following a spectrum of head and neck surgical procedures. Methods We conducted a chart review of patients who underwent a head and neck procedure between January 1, 2013, and October 30, 2015, at our institution, including 392 patients (450 procedures) before the quality improvement regimen was implemented (October 1, 2013) and 942 patients (1136 procedures) after implementation...
August 28, 2018: Otolaryngology—Head and Neck Surgery
Vijay A Patel, Jad Ramadan, Michele M Carr
Objectives To identify risk factors and determine the perioperative morbidity of infants undergoing congenital choanal atresia (CCA) repair. Study Design Retrospective analysis of the ACS-NSQIP-P database (American College of Surgeons National Surgical Quality Improvement-Pediatric). Setting Tertiary medical center. Subjects and Methods Patients who underwent CCA repair at age ≤365 days at the time of surgery were queried via the ACS-NSQIP-P database (2013-2016) via Current Procedural Terminology code 30540...
August 28, 2018: Otolaryngology—Head and Neck Surgery
Patricia L Purcell, Todd C Edwards, Meghan Wisneski, Dylan K Chan, Henry Ou, David L Horn, Jonathan R Skirko, Kathleen C Y Sie
Objective This study interviewed youth with unilateral hearing, utilizing their responses to generate candidate items for a condition-specific patient-reported instrument. Study Design Mixed methods, cross-sectional. Setting Tertiary care children's hospital. Participants and Methods Youth with unilateral hearing loss and normal hearing in the contralateral ear were identified and recruited for participation through query of an audiometric database and through hearing loss clinics. Interviews with the youth were qualitatively analyzed to identify common themes and generate items related to functional impact...
August 28, 2018: Otolaryngology—Head and Neck Surgery
James A Burns, Stephen D Adlard, James B Kobler, Monica A Tynan, Robert H Petrillo, Lauren F Tracy
Objectives To compare the physical characteristics of 3 laser-protected endotracheal tubes (LPETs) commonly used in endoscopic laser surgery. To report potential intraoperative problems related to LPET use and suggest practical solutions. Study Design Comparative analysis. Setting Academic laboratory. Subjects and Methods Physical characteristics of the Mallinckrodt Laser-Flex (MTL), Medtronic Laser-Shield II (ML-II), and Rusch LaserTubus (RL) were compared. The effect of bending LPETs on airflow resistance was estimated with a pressure transducer...
August 21, 2018: Otolaryngology—Head and Neck Surgery
Michael Li, Yin Yiu, Tyler Merrill, Vedat Yildiz, Brad deSilva, Laura Matrka
Objective To determine the incidence of posttracheostomy tracheal stenosis and to investigate variables related to the patient, hospitalization, or operation that may affect stenosis rates. Study Design A combined retrospective cohort and case-control study. Setting Tertiary care academic medical center. Subjects and Methods A total of 1656 patients who underwent tracheostomy at a tertiary care medical center from January 2011 to November 2016 were reviewed for evidence of subsequent tracheal stenosis on airway endoscopy or computed tomography...
August 21, 2018: Otolaryngology—Head and Neck Surgery
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