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Journal of Otolaryngology—Head & Neck Surgery

Kimberly Luu, Amirreza Pakdel, Edward Wang, Eitan Prisman
BACKGROUND: 3-Dimensional (3D) printing can be applied to virtual planning and creation of surgical guides for mandibular reconstruction. Such systems are becoming increasingly prevalent in head and neck reconstruction. However, third party access to this technology is costly and removes the opportunity to design, create, and modify the bony reconstructions, as third party technology is a black box. This series is a pilot study to document the feasibility of an in-house software tool...
December 12, 2018: Journal of Otolaryngology—Head & Neck Surgery
Alexandra E Quimby, Nicole L Lebo, Rebecca Griffiths, Stephen Hall, Jim Dimitroulakos, Stephanie Johnson-Obaseki
BACKGROUND: We sought to expand upon preliminary data suggesting that metformin confers a survival benefit to patients with head and neck squamous cell carcinoma (HNSCC). METHODS: A large-scale retrospective cohort study of all patients in Ontario diagnosed with squamous cancer of the larynx, hypopharynx, and nasopharynx between Dec 1st 2007 to Dec 1st 2012 was undertaken. The Institute for Clinical and Evaluative Sciences was accessed to obtain patient demographic, treatment and outcome information...
December 4, 2018: Journal of Otolaryngology—Head & Neck Surgery
Michael Xie, Michael K Gupta, Stuart D Archibald, B Stanley Jackson, James Edward Massey Young, Han Zhang
BACKGROUND: Marijuana is the most widely used illicit substance in Canada. To date, no conclusive study has looked at the epidemiologic basis of marijuana use and head and neck cancer (HNC). Due to the imminent recreational legalization of marijuana in Canada, the epidemiologic relationship between marijuana use and HNC is becoming increasingly important. OBJECTIVE: To examine the epidemiologic characteristics of HNC patients who are recreational marijuana users...
November 22, 2018: Journal of Otolaryngology—Head & Neck Surgery
Yaeesh Sardiwalla, Nicholas Jufas, David P Morris
OBJECTIVE: Minimally Invasive Ponto Surgery (MIPS) was recently described to facilitate the placement of percutaneous bone anchored hearing devices. As early adopters of this new procedure, we sought to perform a quality assurance project using our own small prospective cohort to justify this change in practice. We chose to examine device stability and to gauge our patients' perspective of the surgery and their overall satisfaction with the process. METHODS: A total of 12 adult patients who underwent MIPS between 2016 and 2017 with a minimum post-operative follow-up of 12 months were included in this study...
November 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
Josie Xu, Paolo Campisi, Vito Forte, Brian Carrillo, Allan Vescan, Ryan Brydges
BACKGROUND: Portable educational technologies, like simulators, afford students the opportunity to learn independently. A key question in education, is how to pair self-regulated learning (SRL) with direct instruction. A cloud-based portable otoscopy simulator was employed to compare two curricula involving SRL. Pre-clerkship medical students used a prototype smartphone application, a 3D ear attachment and an otoscope to complete either otoscopy curriculum. METHODS: Pre-clerkship medical students were recruited and randomized to two curriculum designs...
November 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
Peng You, Sandra Katsiris, Julie E Strychowsky
BACKGROUND: Foreign body ingestion is common, especially in the pediatric population. Plans for retrieval should be tailored to the specific esophageal foreign bodies. CASE PRESENTATION: We present a difficult to retrieve esophageal foreign body in a 3-year-old girl who ingested a 2 cm glass pebble. Intraoperatively, attempts using conventional optical forceps and retrieval baskets were unsuccessful due to the size and smooth texture of the object. A novel strategy using double Fogarty embolectomy balloon catheters for retrieval of blunt esophageal foreign bodies was devised and described...
November 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
David Forner, Martin Bullock, Daniel Manders, Timothy Wallace, Christopher J Chin, Liane B Johnson, Matthew H Rigby, Jonathan R Trites, Mark S Taylor, Robert D Hart
BACKGROUND: Secretory Carcinoma (SC) is a recently described malignancy affecting salivary glands of the head and neck, with a paucity of evidence regarding the natural history, morbidity, and mortality. This study aimed to investigate the current treatment options utilized for SC, as well as its presentation and outcomes. METHODS: This study is a retrospective case series and includes patients diagnosed with SC at four Maritime Canadian institutions. Literature review of patient outcomes following treatment of SC is also included...
November 16, 2018: Journal of Otolaryngology—Head & Neck Surgery
Eunkyu Lee, Song I Park, Donghyeok Kim, Hokyung Jin, Han-Sin Jeong
BACKGROUND: Skin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft. To improve the success rate of oral skin graft, we proposed a novel and simple dressing technique for intraoral skin graft to control saliva accumulation, in comparison with the conventional bolster dressing. METHODS: We retrospectively reviewed 31 patients reconstructed with skin graft in their intraoral defect...
November 14, 2018: Journal of Otolaryngology—Head & Neck Surgery
Marc-Antoine Hudon, Erin D Wright, Etienne Fortin-Pellerin, Marie Bussieres
BACKGROUND: Chronic rhinosinusitis (CRS) affects up to 16% of the population. When medical treatment fails, endoscopic sinus surgery (ESS) is considered. The value of resecting the middle turbinate to optimize surgical outcomes has been hypothesized but remains controversial and unproven. Whether the middle turbinate should be left in place or resected is controversial. Our objective is to determine if middle turbinectomy improves objective surgical outcomes after ESS. METHODS: Sixteen patients (15 men, 15 primary surgery) undergoing bilateral complete ESS for CRS with nasal polyposis were recruited...
November 8, 2018: Journal of Otolaryngology—Head & Neck Surgery
Chang-Hee Kim, Jung Eun Shin
BACKGROUND: Hemotympanum refers to both the presence of blood in the middle ear cavity and to ecchymosis of the tympanic membrane (TM), and a systematic study of intra-TM (iTM) hemorrhage without bleeding in the middle ear cavity has not been conducted. The goals of our study were to analyze the causes of iTM hemorrhage without TM perforation or bleeding in the middle ear cavity, and to demonstrate the clinical characteristics of the disease. METHODS: This Case series study included five patients with iTM hemorrhage between August 2014 and August 2017...
November 6, 2018: Journal of Otolaryngology—Head & Neck Surgery
Rachelle A LeBlanc, Andre Isaac, Jonathan Abele, Vincent L Biron, David W J Côté, Matthew Hearn, Daniel A O'Connell, Hadi Seikaly, Jeffrey R Harris
BACKGROUND: Accurate localization of parathyroid adenomas is of critical importance in surgical planning for minimally invasive parathyroidectomy. SPECT/CT is considered the investigation of choice but has limitations regarding localization of superior versus inferior adenomas. We proposed a novel method for localization using SPECT/CT by determining the anterior-posterior relationship of the adenoma to a horizontal line in the coronal plane through the tracheoesophageal groove. Our objective was to determine the accuracy, validity, and inter-rater reliability of this method...
October 26, 2018: Journal of Otolaryngology—Head & Neck Surgery
M Gazzaz, J Saini, S Pagliardini, B Tsui, C Jeffery, H El-Hakim
BACKGROUND: Propofol and remifentanil intravenous combination is one popular form of total intravenous anesthesia (TIVA) in mainstream clinical practice, but it has rarely been applied to a rat model for laryngoscopy and laryngeal electromyography (LEMG). Our objective was to establish a safe and reproducible general anesthetic protocol for laryngoscopy and endoscopic LEMG in a rat model. Our hypothesis is that TIVA allows a minimally morbid, and feasible laryngoscopy and LEMG. METHODS: Sprague Dawley rats were subjected to either inhalational anesthesia (IA) (isoflurane) or TIVA (propofol and remifentanil) and underwent laryngoscopy and LEMG...
October 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
Laurent Fradet, Rabia Temmar, Frédéric Couture, Mathieu Belzile, Pierre-Hugues Fortier, Robert Day
BACKGROUND: To date, no single molecular marker has been demonstrated as clinically useful in differentiating malignant from benign thyroid nodules when a fine needle aspiration falls in the "unknown significance" categories of the Bethesda Classification. PACE4, a member of the proprotein convertase family of enzymes, has been shown to play a major role in the pathogenesis of prostate cancer, through the formation of an oncogenic isoform named PACE4-altCT. PACE4 isoforms have also been suggested to play a role in other cancers, including thyroid cancer, but have never been investigated in a detailed manner...
October 19, 2018: Journal of Otolaryngology—Head & Neck Surgery
Pichit Sittitrai, Donyarat Reunmarkkaew, Saisaward Chaiyasate
BACKGROUND: The purpose of this study was to evaluate the benefit of induction chemotherapy followed by surgery in locally advanced unresectable stage IVb laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC). METHODS: Data of patients with stage IVb LHSCC who received induction chemotherapy for the purpose of tumor resection between January 2007 and January 2016 were retrospectively collected. Definitive surgery with postoperative adjuvant therapy was performed in patients whose tumors became resectable (resectable group)...
October 16, 2018: 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
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