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Clinical Otolaryngology

Chih-Ming Chang, Yi-Ho Young, Po-Wen Cheng
Various vestibular stimuli, including air-conducted sound (ACS), bone-conducted vibration (BCV), and galvanic vestibular stimulation (GVS), can be used to elicit vestibular-evoked myogenic potential (VEMP). VEMP obtained from the sternocleidomastoid (SCM) muscle is called cervical VEMP (cVEMP), while that recorded at extraocular muscles is termed ocular VEMP (oVEMP). cVEMP was first recognized as fundamental in determining the sacculo-collic reflex (SCR) pathway in the mid-1990s. In the mid-2000s, oVEMP was successfully recorded and emerged as the basis for a promising examination for evaluating the integrity of the vestibulo-ocular reflex (VOR) pathway...
November 12, 2018: Clinical Otolaryngology
Chantelle Rizan, Prodip Das, Rob Low, Saskia Harden, Nick Groves, Breda Flaherty, Trevor Welland, Mahmood Bhutta
OBJECTIVES: Unilateral tinnitus must be investigated with an IAM MRI to rule out a rare but important finding of a cerebello-pontine angle lesion. A streamlined pathway was designed to uniquely enable GPs to make direct and concurrent referrals for an IAM MRI alongside an audiology-led one-stop tinnitus clinic. The primary aim was evaluating the efficacy of the streamlined pathway. The secondary aim was to identify defect measures and associated costs. Design A prospective, experimental non-randomised control study with retrospective controls was used...
November 12, 2018: Clinical Otolaryngology
Gangcai Zhu, Ou Peng, Shaohong Li, Ganghua Zhu, Shuhui Wang, Jiajia Liu, Danhui Yin, Xia Peng, Tao Yang, Qinglai Tang, Xinming Yang
The postcricoid space and pyriform sinus are difficult to completely display under routine laryngoscopy examination. We present the results obtained from 50 patients who were randomly recruited to receive a laryngoscopy examination via a routine, Valsalva manoeuvre combined with anterior cervical skin traction (V-ACST), followed by a Valsalva manoeuvre combined with the modified Killian method (V-MK). The routine method is not suitable for displaying the postcricoid space. In general, both the V-ACST and V-MK displayed the postcricoid space and pyriform sinus very well...
November 9, 2018: Clinical Otolaryngology
Stefan J Janik, István Paraszti, Lena Hirtler, Rudolf Seemann, Hannes Traxler, Wolfgang Weninger, Boban M Erovic
OBJECTIVES: The main purpose of this study was to evaluate flap size and flap design of skin islands in myocutaneous serratus anterior free flaps (SAFFs) in fresh cadavers and to further investigate whether myocutaneous SAFFs are suitable flaps for pharyngeal reconstruction after laryngopharyngectomy. METHODS: Dissection and injection of methylene blue was performed in 20 hemithoraces of 13 fresh cadavers to evaluate flap size and location of skin islands. Based on these preclinical data, we performed pharyngeal reconstruction with myocutaneous SAFF in 5 patients after laryngopharyngectomy...
November 9, 2018: Clinical Otolaryngology
Mohd Normani Zakaria, Rosdan Salim, Adnan Tahir, Zuraida Zainun, Nurul Syarida Mohd Sakeri
OBJECTIVES: Subjective visual vertical (SVV) is a simple, quick and reliable test for measuring utricular function. The literature on the effects of fundamental demographic variables such as age and gender on SVV is inconclusive and should be supported by research with larger samples. The aim of the present study was to determine the influences of age, gender and geometric pattern of visual image on SVV among healthy adults. STUDY DESIGN: This study employed a repeated measures design...
November 8, 2018: Clinical Otolaryngology
S Shahsavari, D T Walker, C Patel, K Kapoor, C R Davies-Husband
Direct visualisation of the upper aerodigestive tract is a fundamental skill for ENT surgeons. Rigid endoscopes themselves have seen little transformation since they were first developed for gastroscopy by Kussmaul in 18681 . In an era of ultra high definition and 3D technology, a straight, rigid metal tube with adjoining light source carrier to inspect mucosal surfaces up to 40cm from the surgeon's eye could benefit from updating. In our department, we favour the use of the video-laryngoscope, specifically the C-MAC system from Karl Storz...
November 8, 2018: Clinical Otolaryngology
Maria Heikkinen, Svantte Halttunen, Markku Terävä, Jussi M Kärkkäinen, Heikki Löppönen, Elina Penttilä
Between January 2006 and December 2015, 320 patients with vocal fold paralysis (VFP) were identified in Kuopio University Hospital, Finland. The overall annual incidence rate of VFP was 11.4 per 100 000 inhabitants (95% confidence interval 10.1-12.8). The most common etiologies of VFP were iatrogenic (50.6%), idiopathic (21.6%), and neoplasm (14.7%). The incidence of VFP during surgical procedures was 5.2% in thyroid surgery, 4.3% in parathyroid surgery, 16.6% in esophageal surgery, 5.6% in mediastinoscopy, 4% in non-cardiac surgery through sternotomy, 3...
October 28, 2018: Clinical Otolaryngology
L Maupeu, T Raguin, M Hengen, P Diemunsch, P Schultz
In suspension microlaryngoscopy, the endotracheal tube, which hampers the vision of the subglottic plane, may disturb the surgery. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) provides effective aventilatory mass flow under deep sedation and seems an interesting approach to operate without endotracheal tube. The objective is to evaluate the indications, the technique and the failures of THRIVE in laryngeal surgery. This prospective study included 19 patients over the age of 18, that overwent laryngeal surgery under laryngosuspension...
October 28, 2018: Clinical Otolaryngology
Shabana Habib, Kate Solan, Prodip Das
Adenoidectomy is a commonly performed paediatric ear nose and throat operation. It is indicated in children for the treatment of nasal obstruction, recurrent otitis media with effusion, and sleep-disordered breathing. Conventionally the procedure was performed by cold curettage, with a higher rate of persistent postoperative bleeding. Monopolar suction diathermy adenoidectomy shows improved haemostasis with reduced intraoperative blood loss and postoperative bleeding. This article is protected by copyright...
October 26, 2018: Clinical Otolaryngology
Deepika Narayanan, Hung Doan, Rebecca Simonette, Peter L Rady, Stephen K Tyring
We read with interest the recent article titled 'Expression of 15-lipoxygenase-1 in Merkel cell carcinoma is linked to advanced disease'. Frochman-Frana and colleagues concluded that ALOX15 expression is seen in primary MCC tumor samples as well as lymph node metastasis samples. Primary tumors of metastatic MCC had a higher expression rate of ALOX15 compared to samples without metastatic disease, providing evidence in support of ALOX15's association with cancer development. This article is protected by copyright...
October 26, 2018: Clinical Otolaryngology
Christine A den Besten, Peter Monksfield, Arjan Bosman, Piotr H Skarzynski, Kevin Green, Christina Runge, Stina Wigren, Johan I Blechert, Mark C Flynn, Emmanuel Am Mylanus, Myrthe Ks Hol
OBJECTIVES: To compare the hearing performance of patients with conductive and mild mixed hearing loss and single-sided sensorineural deafness provided with a new transcutaneous bone conduction hearing implant (the Baha Attract System) with unaided hearing as well as aided with a sound processor on a softband. Furthermore, to evaluate safety and subjective benefit before and after implantation of the test device. PARTICIPANTS: Fifty-four adult patients in five participating centres were enrolled in this prospective study...
October 25, 2018: Clinical Otolaryngology
Loraine Vatin, Joanna Vitte, Thomas Radulesco, Jean-Baptiste Morvan, Jean Del Grande, Arthur Varoquaux, Stéphane Ranque, Jean Gaudart, Patrick Dessi, Carole Cassagne, Justin Michel
Definitive diagnosis of allergic fungal sinusitis is confirmed by pathologists postoperatively. We aimed at identifying preoperative predictive factors for allergic fungal sinusitis (AFS) diagnosis in order to support the surgical strategy that requires a complete surgical debridement of the fungal material, thus differing from classical endoscopic surgery for chronic rhinosinusitis (CRS). The confirmation of systemic corticotherapy indication and its rapid postoperative introduction reduces the risk of relapse...
October 24, 2018: Clinical Otolaryngology
Ángel Ramos Macías, Silvia A Borkoski-Barreiro, Juan C Falcón González, Isabel de Miguel Martínez, Ángel Ramos de Miguel
BACKGROUND: While CI provision is a well-established and beneficial therapy in an increasing number of countries for adults with acquired SSD, there is less experience with this therapeutic option in children OBJECTIVE OF REVIEW: determine the audiological and clinical results of cochlear implantation in children below the age of 12 years old with congenital and acquired single-sided deafness. EVALUATION METHOD: Observational, descriptive, transversal study, in children <12 implanted for congenital or acquired SSD...
October 24, 2018: Clinical Otolaryngology
F Ampil, G Caldito, C A Nathan, M Vora, T Richards
Approximately 9% to 42% of people with head and neck cancer (HNC) belong to the intermediate-risk (IR) class. The benefit of postoperative radiotherapy (PORT) may not be uniform across various patient subgroups of IR-HNC. Our 134-patient experience retrospectively explores the issue of which IR-HNC patient subset (T3-T4 or nodal metastases without extracapsular spread/ECS) may benefit from PORT. Particular attention should be paid to a more intensive adjuvant regimen of chemoradiotherapy for the nodal metastases ECS-free patient cohort because of the poorer disease-free survival after PORT alone that was observed in the present study...
October 24, 2018: Clinical Otolaryngology
Ewelina M Sielska-Badurek, Katarzyna Jędra, Maria Sobol, Ewa Osuch-Wójcikiewicz, Kazimierz Niemczyk
OBJECTIVE: To provide the normative values for laryngeal stroboscopy (LS) concerning amplitude, open quotient, asymmetry and phase difference in healthy, young subjects. STUDY DESIGN: Prospective case-control study. SETTING: Patients treated at a single institute. METHODS: 68 healthy subjects were included in the study (35 women, 33 men), aged 18-35 years. After obtaining LS recordings image processing was performed to attain parameters of vocal fold vibration...
October 24, 2018: Clinical Otolaryngology
A Coudert, S Vigier, A Scalabre, R Hermann, S Ayari-Khalfallah, E Truy
Inner ear malformations were significantly associated with a facial nerve anomaly in 11% of cases. The most frequent malformations associated with facial nerve anomalies are common cavity and cochlear hypoplasia. Middle ear malformations, especially the hypoplastic stapes, were frequently associated with an inner ear malformation. Although essential, pre-operative imaging does not allow detection of all facial nerve anomalies. During cochlear implantation in malformed cochlea, we recommend the use of facial nerve monitoring when accessing the round window niche...
October 24, 2018: Clinical Otolaryngology
Victoria V Wilmot, Jeremy P Davis, Sean Carrie
Workforce planning is essential to ensure enough doctors, with the necessary skills and training, are available to meet the demands on the health service. This task is challenging within the NHS due to the time period over which forecasts are made and the complexity of healthcare delivery.The aim of this study was to identify the number of Ear, Nose and Throat (ENT) consultants, trainees, non-consultant-grade doctors and vacancies across England, Scotland and Wales and compare with previous data from England recorded in 2014 and 2010...
October 16, 2018: Clinical Otolaryngology
Jan Wedman, Jan Pruim, Lisa van der Putten, Otto S Hoekstra, Remco de Bree, Boukje A C van Dijk, Bernard F A M van der Laan
18F FDG PET is superior to other imaging techniques in revealing residual laryngeal cancer after radiotherapy. Unfortunately, its specificity is low, due to FDG uptake in inflammation and in anaerobic conditions. PET imaging with the amino acid-based radiopharmaceutical C11-methionine (MET) should be less influenced by post-radiation conditions. The aim of this study was to investigate the potential of MET in diagnosing recurrent laryngeal cancer after radiotherapy as compared to 18F-FDG. METHODS: Forty-eight patients with a clinical suspicion of local residual disease at least three months after completion of radiotherapy or chemoradiotherapy for a T2-4 laryngeal carcinoma, along with an indication for direct laryngoscopy, were included...
October 12, 2018: Clinical Otolaryngology
Chien-Yu Huang, Yaoh-Shiang Lin, Bor-Hwang Kang, Kuo-Ping Chang, Chao-Chuan Chi, Ming-Yee Lin, Hsing-Hao Su, Ting-Shou Chang, Huai-Pao Lee, Ching-Chih Lee
OBJECTIVE: We examined whether dynamic margin criteria margin-to-thickness (MTR) ratio has superior predictive value compared with the resection margin or tumour thickness alone in the survival outcome in oral squamous cell carcinoma (OSCC). DESIGN: This is a retrospective cohort study. SETTING: Oral squamous cell carcinoma patients treated in Kaohsiung Veterans General Hospital Cancer Center between January 2006 and December 2013. PARTICIPANTS: A cohort of 302 patients with OSCC who had undergone surgical management...
October 8, 2018: Clinical Otolaryngology
Jasper Vonk, Kim A Smit, Jan L N Roodenburg, Bert van der Vegt, Gyorgy B Halmos, Johanna G M Vemer-van den Hoek, Pieter U Dijkstra, Max J H Witjes
OBJECTIVES OF THE REVIEW: The decision whether to include postoperative radiotherapy on patients with oral squamous cell carcinoma depends on the risk of local recurrence. The objectives of this study were to systematically review literature on whether perineural invasion in oral squamous cell carcinoma patients is associated with higher local recurrence rates and whether local recurrence is influenced by the administration of postoperative radiotherapy in patients presenting with perineural invasion...
October 8, 2018: Clinical Otolaryngology
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