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Journal of Otolaryngology—Head & Neck Surgery

Justin T Lui, Evan D Compton, Won Hyung A Ryu, Monica Y Hoy
BACKGROUND: Given mounting pressure of work hour restrictions, resource constraints, and variability of clinical exposure, Otolaryngology-Head & Neck Surgery (OHNS) residency training has shifted away from the apprenticeship model to embrace the Royal College of Physicians and Surgeons of Canada's "Competence by Design" initiative. As a result, appraising both current and potential educational adjuncts has become increasingly important. In this investigation, a national needs assessment survey was performed to identify strengths, weaknesses, and future opportunities of the current training landscape...
October 1, 2018: Journal of Otolaryngology—Head & Neck Surgery
Vincent L Biron, Ashlee Matkin, Morris Kostiuk, Jordana Williams, David W Cote, Jeffrey Harris, Hadi Seikaly, Daniel A O'Connell
BACKGROUND: Recent guidelines for the management of thyroid nodules incorporate mutation testing as an adjunct for surgical decision-making, however current tests are costly with limited accuracy. Droplet digital PCR (ddPCR) is an ultrasensitive method of nucleic acid detection that is particularly useful for identifying gene mutations. This study aimed to assess the analytic and clinical validity of RAS and BRAF ddPCR mutational testing as a diagnostic tool for thyroid fine needle aspirate biopsy (FNAB)...
September 24, 2018: Journal of Otolaryngology—Head & Neck Surgery
Changxing Liu, Daljit Mann, Uttam K Sinha, Niels C Kokot
Head and neck carcinomas (HNCs) collectively are the sixth most common cancer with an annual incidence of about 400,000 cases in the US. The most well-established risk factors for HNCs are tobacco and alcohol abuse. With the increasing public awareness, the incidence of HNCs is decreasing. But there is an increasing incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been observed during the last decade. This phenomena is associated with persistent infection with high-risk HPV. HPV associated OPSCC patients tend to be younger males of high socioeconomic status...
September 21, 2018: Journal of Otolaryngology—Head & Neck Surgery
Hani Z Marzouki, Vincent L Biron, Peter T Dziegielewski, Andrew Ma, Jason Vaz, Gabriela Constantinescu, Jeffrey Harris, Daniel O'Connell, Hadi Seikaly
BACKGROUND: To determine the impact of Human Papillomavirus (HPV) status on speech, swallowing, and quality of life (QOL) outcomes after surgical treatment of oropharyngeal cancer (OPSCC). METHODS: A retrospective review of a prospectively collected database of all patients with OPSCC diagnosed and treated from 1998 to 2009. Speech, swallowing, and quality of life data were gathered at 3 different evaluation points. HPV status was determined using p16 positivity as a surrogate marker...
September 19, 2018: Journal of Otolaryngology—Head & Neck Surgery
Lisa Jin, Paula Téllez, Ruth Chia, Daphne Lu, Neil K Chadha, Julie Pauwels, Simon Dobson, Hazim Al Eid, Frederick K Kozak
BACKGROUND: An Infectious Disease vaccine specialist joined our institution's Cochlear Implant Team in 2010 in order to address the high percentage of non-compliance to immunization prior to surgery identified previously from an internal review. The purpose of this study was to (1) review the immunization status of cochlear implant recipients in 2010-2014, (2) assess if introducing a vaccine specialist made a significant change in vaccination compliance and (3) elucidate any barriers to vaccination compliance...
September 17, 2018: Journal of Otolaryngology—Head & Neck Surgery
Sena Turkdogan, Véronique-Isabelle Forest, Michael P Hier, Michael Tamilia, Anca Florea, Richard J Payne
BACKGROUND: Medullary thyroid cancer (MTC) cells are capable of secreting various tumor markers including calcitonin and carcinoembyronic antigen (CEA). The purpose of this study is to determine whether abnormal CEA levels may be used as a tumor marker to predict the severity of disease in MTC. METHODS: A retrospective analysis was completed for 33 patients with MTC who had preoperative serum CEA levels. Univariate and multivariate analyses were used to quantify the relationship between serum CEA levels and tumor stage and prognosis...
September 17, 2018: Journal of Otolaryngology—Head & Neck Surgery
Oleksandr Butskiy, Brent A Chang, Kimberly Luu, Robert M McKenzie, Donald W Anderson
BACKGROUND: To describe and evaluate a four step systematic approach to dissecting the recurrent laryngeal nerve (RLN) starting at the cricothyroid junction during thyroid surgery (subsequently referred to as the retrograde medial approach). METHODS: All thyroidectomies completed by the senior author between August 2014 and January 2016 were retrospectively reviewed. Patients were excluded if concurrent lateral or central neck dissection was performed. A follow up period of 1 year was included...
September 17, 2018: Journal of Otolaryngology—Head & Neck Surgery
Alexandra E Quimby, Edmund S H Kwok, Daniel Lelli, Peter Johns, Darren Tse
BACKGROUND: Dizziness is a common presenting symptom in the emergency department (ED). The HINTS exam, a battery of bedside clinical tests, has been shown to have greater sensitivity than neuroimaging in ruling out stroke in patients presenting with acute vertigo. The present study sought to assess practice patterns in the assessment of patients in the ED with peripherally-originating vertigo with respect to utilization of HINTS and neuroimaging. METHODS: A retrospective cohort study was performed using data pertaining to 500 randomly selected ED visits at a tertiary care centre with a final diagnostic code related to peripherally-originating vertigo between January 1, 2010 - December 31, 2014...
September 10, 2018: Journal of Otolaryngology—Head & Neck Surgery
Michaela Plath, Martina A Broglie, Diana Förbs, Sandro J Stoeckli, Wolfram Jochum
BACKGROUND: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has an improved outcome and may allow for treatment de-escalation. High-risk HPV (HR-HPV) infection is associated with deregulated expression of the cell cycle-associated proteins p16INK4 , pRB, cyclin D1 and p53. The objective of this study was to assess cell cycle proteins as potential surrogate markers for HR-HPV DNA testing to identify OPSCC with favorable prognosis after resection. METHODS: Tissue microarray cores of 313 surgically treated OPSCC were stained for p16INK4a , pRB, cyclin D1 and p53 using immunohistochemistry...
September 6, 2018: Journal of Otolaryngology—Head & Neck Surgery
M Elise Graham, Brian D Westerberg, Jane Lea, Paul Hong, Simon Walling, David P Morris, Andrea L O Hebb, Rochelle Galleto, Emily Papsin, Maeve Mulroy, Hannah Foggin, Manohar Bance
BACKGROUND: Patients with vestibular schwannomas (VS) are faced with complex management decisions. Watchful waiting, surgical resection, and radiation are all viable options with associated risks and benefits. We sought to determine if patients with VS experience decisional conflict when deciding between surgery or non-surgical management, and factors influencing the degree of decisional conflict. METHODS: A prospective cohort study in two tertiary ambulatory skull-base clinics was performed...
September 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
D S Chan, K Gong, M G Roskies, V I Forest, M P Hier, R J Payne
BACKGROUND: The American Thyroid Association published revised guidelines in 2015 on the management of differentiated thyroid cancer in adults. One of the key changes introduced in the revision proposes that diagnostic biopsy be based on ultrasound findings (i.e. size and nodule characteristics). The overall effect of these changes results in fewer nodules requiring biopsy. This study was conducted to determine if the changes to the guidelines will result in overlooked thyroid cancers, specifically malignancies with aggressive characteristics measuring between 1 and 1...
September 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
Vinay Fernandes, Yiqiao Wang, Robert Yeung, Sean Symons, Vincent Lin
BACKGROUND: Cochlear implant (CI) insertion depth can affect residual hearing preservation, tonotopic range coverage, and Mapping. Therefore, determining insertion depth has the potential to maximize CI performance. A post-op skull X-RAY is commonly used to assess insertion depth, however its effectiveness has not been well established. Our primary objective was to assess the accuracy of post-op skull X-RAYs to determine insertion depth, compared to CT as the gold standard. Secondary objectives were to compare experience level of raters and different skull X-RAY views...
September 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
Jason K Wasserman, Ryan Rourke, Bibianna Purgina, Lisa Caulley, Jim Dimitroulakos, Martin Corsten, Stephanie Johnson-Obaseki
Following publication of the original article [1], the authors reported an error in one of the author names. In this Correction the incorrect and correct author names are listed.
August 2, 2018: Journal of Otolaryngology—Head & Neck Surgery
Clifford Scott Brown, Ralph Abi-Hachem, David Woojin Jang
BACKGROUND: Patients with a ventricular assist device (VAD) are at risk for epistaxis due to the need for anticoagulation. Additionally, these patients develop acquired von Willebrand syndrome (AvWS) due to these devices. Management is complicated by the risk of thrombosis if anticoagulation is reversed. This study sought to characterize the clinical features and management of epistaxis in this high-risk population. METHODS: Retrospective review of adults with VAD and epistaxis necessitating inpatient consultation with the otolaryngology service were included...
August 2, 2018: Journal of Otolaryngology—Head & Neck Surgery
Antoine Eskander, Paolo Campisi, Ian J Witterick, David D Pothier
BACKGROUND: An analysis of the scope of practice of recent Otolaryngology - Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates. METHODS: Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012...
July 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
Jill Querney, Jean-Luc Ethier
BACKGROUND: Pediatric tracheostomies occur for various reasons, including prologned intubation, and require a multidisciplinary approach with routine follow-up. CASE PRESENTATION: This report reviews the history and clinical outcome of a 29 year old female patient who was lost to follow-up for nearly two decades after a pediatric tracheostomy. When she presented to the Otolaryngology service as an adult the original indication for tracheostomy had resolved and decannulation was initiated, but a profound psychological dependence had developed...
July 13, 2018: Journal of Otolaryngology—Head & Neck Surgery
James P Bonaparte, Ross Campbell
BACKGROUND: A nasal septal deviation can have a significant detrimental effect on a patient's quality of life. Nasal valve collapse (NVC) often co-exists with a septal deviation. The Cottle maneuver is one of the most common methods to diagnose NVC; however, no study has assessed the efficacy of this physical exam finding. This study tests the hypothesis that patients with nasal obstruction due to a septal deviation with a negative pre-operative Cottle maneuver will demonstrate a greater improvement in their Nasal Obstruction Symptom Evaluation (NOSE) score, compared to patients who demonstrate a positive pre-operative Cottle maneuver, when assessed at 12 months following a septoplasty with turbinate diathermy...
July 11, 2018: Journal of Otolaryngology—Head & Neck Surgery
Ying-Chieh Hsu, Chin-Lung Kuo, Tzu-Chin Huang
BACKGROUND: This study compares endoscopic and microscopic tympanoplasty for the treatment of chronic otitis media (COM) without cholesteatoma. METHODS: This retrospective study included 153 ears (139 patients) treated surgically (endoscopic or microscopic tympanoplasty) for COM in the absence of cholesteatoma at our hospital between January 2008 and October 2015. The adoption of transcanal endoscopic ear surgery (TEES) or microscopic ear surgery (MES) was divided temporally (before and since 2014)...
July 4, 2018: Journal of Otolaryngology—Head & Neck Surgery
Justin M Pyne, Tarek Ibrahim Lawen, Duncan D Floyd, Manohar Bance
BACKGROUND: The accurate diagnosis of Eustachian tube (ET) dysfunction can be very difficult. Our aim is to determine whether a 678 Hz probe tone is a more accurate indicator of Patulous ET (PET) than the 226 Hz probe tone when used in compliance over time (COT) testing. METHODS: Twenty subjects (11 normal ET ears and 7 PET ears) were individually seated in an examination room and connected to a GSI TympStar Middle Ear Analyzer. The order of probe tone frequency (678 or 226 Hz) was randomized...
July 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
Philipp Opitz, Olf Herbarth
BACKGROUND: Different organisms such as bacteria, molds and humans produce and release a relative unknown class of metabolites which are responsible for the individual olfactory pattern. These volatile organic metabolites (VOM) represent a kind of biosignature that reflects the sum of all multifactorial influences, including genetics, environmental factors, nutritional and disease status. As a result of pathological processes the individual body odor can be influenced by newly produced or altered compositions of the VOM...
July 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
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