Response to Comments on "Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy"
(Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Damar, M. Tags: Letters to the Editor Source Type: research

"Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy"
(Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Bakshi, S. S. Tags: Letters to the Editor Source Type: research

Expansion Pharyngoplasty by New Simple Suspension Sutures without Tonsillectomy
In conclusion, the described new sutures could significantly correct OSA in patients with retropalatal obstruction and lateral pharyngeal walls collapse with easy applicability and no reported complication. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: El-Ahl, M. A. S., El-Anwar, M. W. Tags: Clinical Techniques and Technology Source Type: research

Auricular Split-Thickness Skin Graft for Ear Canal Coverage
Split-thickness skin graft (STSG) continues to be the preferred means of external auditory canal (EAC) reconstruction. We thus sought to describe our experience using skin from the posterior aspect of the auricle (SPAA) as a donor site in EAC reconstruction. Grafts were, on average, 5 x 10 mm in size and obtained with a No. 10 blade after tumescence injection. The cases of 39 patients who underwent 41 procedures were retrospectively reviewed. Of the 38 patients with both 3- and 6-month follow-ups, no postoperative stenosis or bony exposure occurred. STSG from the SPAA can be a good option in EAC reconstruction. Total EAC/t...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Haidar, Y. M., Walia, S., Sahyouni, R., Ghavami, Y., Lin, H. W., Djalilian, H. R. Tags: Clinical Techniques and Technology Source Type: research

Laryngeal, Retropharyngeal, and Cervical Glomangiopericytomas: A Case Report
(Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Fox, D. P., Helekar, B. S., Gallagher, K. K. Tags: Case Report Source Type: research

Uvulopalatopharyngoplasty: Does Multilevel Surgery Increase Risk?
Objectives (1) Determine the rate of postoperative complications, reoperation, readmission, and death after uvulopalatopharyngoplasty (UPPP) for sleep apnea through multi-institutional clinical data. (2) Compare outcomes of UPPP between multilevel and single-level procedures for the treatment of sleep apnea. Study Design Retrospective database analysis. Methods The American College of Surgeons National Surgical Quality Improvement Program—a nationally validated, prospective, multi-institutional database from 2005 to 2013—was analyzed for patients who underwent UPPP, per corresponding Current Procedural Termin...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Baker, A. B., Xiao, C. C., OConnell, B. P., Cline, J. M., Gillespie, M. B. Tags: Sleep Medicine and Surgery Source Type: research

The Impact of Angiotensin-Modulating Antihypertensives on Time Interval to Revision Surgery for Nasal Polyps
Conclusion Use of ACEIs and ARBs is associated with an increased time to revision sinus surgery among patients with concurrent nasal polyps and asthma. A possible mechanism of this observed effect is suppression of periostin expression through inhibition of the angiotensin pathway. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Brook, C. D., Maxfield, A. Z., Stankovic, K., Metson, R. B. Tags: Sinonasal Disorders Source Type: research

Structured Preoperative Phone Counseling by Junior Medical Staff for Improving the Consent Process for Tonsillectomy
Conclusion Preoperative phone counseling by junior medical staff closer to the time of surgery reinforces and clarifies the information previously provided by senior consultants at the time of initial consent for tonsillectomy. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Kam, J., Harrop, E., Parmar, P., Kim, R., Leith, N., Gunawardena, I. Tags: Pediatric Otolaryngology Source Type: research

Perceptual Assessment of Velopharyngeal Dysfunction by Otolaryngology Residents
Conclusion Perceptual training of otolaryngology residents has the potential to improve their ratings of hypernasal speech. Length of time in residency may not be best predictor of perceptual skill. Training modalities incorporating practice with hypernasal speech samples could improve rater skills and should be studied more extensively. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Butts, S. C., Truong, A., Forde, C., Stefanov, D. G., Marrinan, E. Tags: Pediatric Otolaryngology Source Type: research

Bimodal Stimulation in Prelingually Deaf Children: Lessons from a Cross-sectional Survey
Objective (1) To survey the use of bimodal stimulation by prelingually deaf children receiving unilateral cochlear implantation and (2) to investigate demographic and audiologic factors explaining the use of bimodal stimulation. Study Design Cross-sectional survey. Setting Tertiary care institution. Subjects and Methods The study included 44 unilaterally implanted prelingually deaf children from a single institution, with a minimum follow-up of 1 year. During routine follow-up visits, an examiner interviewed parents on their children’s use of bimodal stimulation. At the same time, residual hearing and hearing aid ...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Scorpecci, A., Giannantonio, S., Pacifico, C., Marsella, P. Tags: Pediatric Otolaryngology Source Type: research

Prevalence and Surgical Implications of Dural Enhancement at the Porus Acusticus in Vestibular Schwannomas
Conclusion Dural enhancement is present in approximately 10% of extracanalicular VS. Dural enhancement at the porus acusticus may represent hypervascularity, dural reaction, or infiltration, and portends increased tumor adherence and greater likelihood of subtotal resection to preserve facial nerve function. To our knowledge, this is the first series that reports the prevalence of this phenomenon in VS and the potential surgical implications. Recognition preoperatively may be valuable toward patient counseling. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Patel, N. S., Van Abel, K. M., Link, M. J., Driscoll, C. L. W., Van Gompel, J. J., Neff, B. A., Lane, J. I., Carlson, M. L. Tags: Otology and Neurotology Source Type: research

Dual pH with Multichannel Intraluminal Impedance Testing in the Evaluation of Subjective Laryngopharyngeal Reflux Symptoms
Conclusions Dual pH-MII analysis is a useful supplementary tool to provide objective evidence of pharyngeal reflux exposure in patients with suspected LPR. RSI scores appear to correlate with objective evidence of acid exposure in the pharynx, while RFS scores do not. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Cumpston, E. C., Blumin, J. H., Bock, J. M. Tags: Laryngology and Neurolaryngology Source Type: research

Laryngology in Art: The Portrait of Dr Wilhelm Mayer-Hermann
This article examines the portrait and attempts to shed light on the life and career of the Dr Wilhelm Mayer-Hermann. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Patel, A. A. Tags: History of Otolaryngology Source Type: research

Drainage Patterns to Nontraditional Nodal Regions and Level IIB in Cutaneous Head and Neck Malignancy
Conclusions Nontraditional SLN locations, such as EJ, perifacial, suboccipital, postauricular, and parotid, as well as level IIB, are important sites of drainage for head and neck cutaneous malignancy. Prediction of at-risk lymph node regions is important to help guide SLNBs, elective and completion neck lymphadenectomy and radiation, and long-term observation. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Creighton, F., Bergmark, R., Emerick, K. Tags: Head and Neck Surgery Source Type: research

Discharge Destination after Head and Neck Surgery: Predictors of Discharge to Postacute Care
Conclusion Our study indicates that patients undergoing major or moderate head and neck surgery, patients with reduced functional status, and patients with advanced comorbidities are at substantial risk of discharge to postacute care. The possibility of discharge to postacute care should be discussed with high-risk patients. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Cramer, J. D., Patel, U. A., Samant, S., Shintani Smith, S. Tags: Head and Neck Surgery Source Type: research

Pretreatment Neutrophil-Lymphocyte Ratio in Salivary Gland Tumors Is Associated with Malignancy
This study was performed on 182 patients with SGTs (age range: 16-87 years; 93 male and 89 female) who were treated between January 2010 and May 2015. Pretreatment counts and percentages of leukocytes and NLR were measured preoperatively in benign and malignant tumors. Results Mean neutrophil percentage (63.50% ± 12.11% vs 58.76% ± 8.20%, P = .008) and NLR (3.29 ± 3.13 vs 2.13 ± 1.26, P = .008) were significantly higher in patients with malignant SGTs than in patients with benign SGTs. Mean lymphocyte count (2.42 ± 0.72 103/mm3 vs 1.97 ± 0.87 103/mm3, P
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Damar, M., Dinc, A. E., Erdem, D., Aydil, U., Kizil, Y., Eravcı, F. C., Biskin, S., Sevik Elicora, S., Isik, H. Tags: Head and Neck Surgery Source Type: research

Radiation Dose Reduction in Paranasal Sinus CT: With Feasibility of Iterative Reconstruction Technique
Conclusions With low-dose CT, the radiation dose can be decreased to 22% of that of standard-dose CT without affecting the image quality. Low-dose CT can be considered the minimum optimal radiation for patients who need surgery. Iterative model reconstruction is not useful for assessing the anatomic details of the paranasal sinus on CT. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Bang, M., Choi, S. H., Park, J., Kang, B. S., Kwon, W. J., Lee, T. H., Nam, J. G. Tags: General Otolaryngology Source Type: research

Clinicopathology of Immunoglobulin G4-Related Chronic Sclerosing Sialadenitis: A Single-Center Study
Objectives To investigate the clinicopathologic characteristics of patients with immunoglobulin G4–related chronic sclerosing sialadenitis (IgG4-RCSS), a recently recognized disease. Study Design Case series with chart review and pathology study. Settings Tertiary care hospital. Subjects and Methods We evaluated chronic sialadenitis specimens obtained over 11 years using pathologic examination and IgG4 immunohistochemistry staining. The specimens were assigned a revised diagnosis of IgG4-RCSS or chronic sialadenitis not otherwise specified, and clinicopathologic data from each group were compared. Results Of the ...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Chang, D.-H., Wu, P.-S., Wang, Y.-C., Lin, C.-H., Li, W.-Y., Ma, H., Perng, C.-K. Tags: General Otolaryngology Source Type: research

Health Literacy Assessment in an Otolaryngology Clinic Population
Conclusion Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Megwalu, U. C., Lee, J. Y. Tags: General Otolaryngology Source Type: research

Nonthyroid Metastasis to the Thyroid Gland: Case Series and Review with Observations by Primary Pathology
Objective Nonthyroid metastases to the thyroid gland can cause morbidity, including dysphagia, dysphonia, and airway compromise. Because metastatic malignancies portend a poor prognosis, obtaining equipoise between treatment morbidity and local disease progression is paramount. We reviewed cases of nonthyroid metastases to determine treatment and prognostic recommendations. Study Design Case series with chart review. Setting Tertiary care hospital. Subjects and Methods We searched PubMed for reported cases between 1994 and September 2013 using search terms as follows: any combination of primary tumor locations and thyro...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Russell, J. O., Yan, K., Burkey, B., Scharpf, J. Tags: Endocrine Surgery Source Type: research

Parathyroid 4D-CT: Multi-institutional International Survey of Use and Trends
Four-dimensional computed tomography (4D-CT) is a new modality for preoperative localization of parathyroid adenomas. We performed a survey study to describe the role and trends in the utilization of 4D-CT. Of 361 radiologists, 200 (55%) reported that 4D-CT was used in their practices. Nineteen (10%) used 4D-CT as the first-line imaging study; 155 (76%) reported that 4D-CT played a secondary role; and 26 (13%) reported that it is performed routinely in combination with ultrasound and scintigraphy. Early adopters of 4D-CT (use for>3 years) were 3 times more likely to use 4D-CT in a first-line role (18%) when compared wit...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Hoang, J. K., Williams, K., Gaillard, F., Dixon, A., Sosa, J. A. Tags: Endocrine Surgery Source Type: research

Does the Preoperative Administration of Steroids Reduce Intraoperative Bleeding during Endoscopic Surgery of Nasal Polyps?
Conclusion This study demonstrated that the preoperative administration of steroids in patients with nasal polyps could effectively reduce intraoperative bleeding. However, the duration of treatment and dosing standard require further investigation, and more trials need to be included. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Hwang, S. H., Seo, J. H., Joo, Y. H., Kang, J. M. Tags: Review Articles Source Type: research

Olfactory Outcomes after Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Meta-analysis
Objective To use combined pre- and postsurgical olfactory outcomes to assess the impact of endoscopic sinus surgery on chronic rhinosinusitis–related olfactory impairment. Data Sources CINAHL, Cochrane, OVID, EMBASE, PubMed, and SCOPUS. Each database was searched from inception up to October 2015. Review Methods Studies were included that reported subjective or objective olfactory data in chronic rhinosinusitis patients before and after endoscopic sinus surgery. Results Thirty-one studies were used in the meta-analysis. Weighted mean differences of olfactory measures demonstrated significant improvement in mixed C...
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Kohli, P., Naik, A. N., Farhood, Z., Ong, A. A., Nguyen, S. A., Soler, Z. M., Schlosser, R. J. Tags: Review Articles Source Type: research

Patient-Reported Outcome Measures Related to Laryngopharyngeal Reflux: A Systematic Review of Instrument Development and Validation
Conclusion Laryngopharyngeal reflux is often diagnosed according to symptoms. Currently available LPR-related PRO measures used to symptomatically identify suspected LPR patients have disparate developmental rigor and important methodological deficiencies. Care should be exercised to understand the measurement characteristics and contextual relevance before applying these PRO measures for clinical, research, or quality initiatives. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Francis, D. O., Patel, D. A., Sharda, R., Hovis, K., Sathe, N., Penson, D. F., Feurer, I. D., McPheeters, M. L., Vaezi, M. F. Tags: Review Articles Source Type: research

Therapeutic Mastoidectomy in the Management of Noncholesteatomatous Chronic Otitis Media: Literature Review and Cost Analysis
Conclusions Examination of the available literature supports the notion that therapeutic mastoidectomy does not lend any additional benefit to the management of noncholesteatomatous chronic otitis media. This has implications for patient care, both clinically and financially. Further research, ideally in the form of a prospective, multi-institutional, geographically wide, ethnically diverse, randomized controlled trial, is needed to further support this notion. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Trinidade, A., Page, J. C., Dornhoffer, J. L. Tags: Review Articles Source Type: research

Predicting Outcomes after Uvulopalatopharyngoplasty for Adult Obstructive Sleep Apnea: A Meta-analysis
Conclusion Friedman stage and hyoid position are important predictors for UPPP. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Choi, J. H., Cho, S. H., Kim, S.-N., Suh, J. D., Cho, J. H. Tags: Review Articles Source Type: research

Gabapentin for Perioperative Analgesia in Otorhinolaryngology-Head and Neck Surgery: Systematic Review
Conclusion Overall, gabapentin appears to have a significant beneficial effect on perioperative pain relief and analgesic consumption in otorhinolaryngology–head and neck surgery procedures within the first 24 hours. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Sanders, J. G., Dawes, P. J. D. Tags: Review Articles Source Type: research

Highlights from the Current Issue: December 2016
(Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - November 30, 2016 Category: ENT & OMF Authors: Krouse, J. H. Tags: Highlights Source Type: research

Rhinocerebral Mucormycosis of the Optic Nerve
(Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Mattingly, J. K., Ramakrishnan, V. R. Tags: Clinical Photograph Source Type: research

Cricohyoidoepiglottopexy in Laryngeal Trauma
(Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Ferreira, E., Nabuco Araujo, C., Agostinho, S., Santos, A. R. Tags: Case Report Source Type: research

Successful Implementation of a Clinical Care Pathway for Management of Epistaxis at a Tertiary Care Center
Objective We compare the management of patients with severe epistaxis before and after the implementation a clinical care pathway (CCP) to standardize care, minimize hospital stay, and decrease cost. Study Design Single prospective analysis with historical control. Setting Tertiary academic hospital. Subjects and Methods Patients treated for epistaxis between October 2012 to December 2013 were compared with a prospective analysis of patients treated for severe epistaxis after implementation of a CCP from June 2014 to February 2015. Severe epistaxis was defined as nasal bleeding not able to be controlled with local press...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Vosler, P. S., Kass, J. I., Wang, E. W., Snyderman, C. H. Tags: Sinonasal Disorders Source Type: research

Effects of Covering Surgical Wounds with Polyglycolic Acid Sheets for Posttonsillectomy Pain
Postoperative pain is a remaining issue in tonsillectomy. Polyglycolic acid (PGA) is a biocompatible material used for absorbent suture reinforcement, and its sheet has been applied for covering defects after resection of oral carcinoma. The aim of this study is to examine whether the attachment of a PGA sheet to surgical wounds would reduce posttonsillectomy pain. In this prospective single-blind study, 17 consecutive adult patients were recruited who needed to undergo tonsillectomy, mainly due to habitual tonsillitis. Following bilateral tonsillectomies, a PGA sheet was attached with fibrin glue to only 1 side, without n...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Miyaguchi, S.-i., Horii, A., Kambara, R., Takemoto, N., Akazawa, H., Takahashi, N., Baba, H., Inohara, H. Tags: Pediatric Otolaryngology Source Type: research

Primary Caregiver Perception of Pain Control following Pediatric Adenotonsillectomy: A Cross-Sectional Survey
Objectives To (1) review pain medications prescribed following pediatric adenotonsillectomy (T&A), (2) identify pain medications reported to be helpful, and (3) compare parent-reported outcomes among various combinations of pain medications. Study Design Case series with planned data collection. Setting Multihospital network. Subjects and Methods The primary caregivers of children aged 1 to 18 years who underwent isolated T&A from June to December 2014 were contacted 14 to 21 days after surgery. Data collected included pain medications prescribed, medications most helpful in controlling pain, and duration that p...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Sowder, J. C., Gale, C. M., Henrichsen, J. L., Veale, K., Liljestrand, K. B., Ostlund, B. C., Sherwood, A., Smith, A., Olsen, G. H., Ott, M., Meier, J. D. Tags: Pediatric Otolaryngology Source Type: research

Decisional Conflict and Regret in Parents Whose Children Undergo Tonsillectomy
Objective To determine if decisional regret (DR) in parents following tonsillectomy/adenotonsillectomy (TA) in their children is related to preoperative decisional conflict, perceived outcome of surgery, complications of surgery, or other factors. Study Design Observational analytic cohort study. Setting Tertiary care children’s hospital. Subjects and Methods Preoperative decisional conflict (DC) and SURE tests were administered to a parent of a child scheduled for TA between July 2014 and July 2015. The DR tests were given 1 to 3 months postoperatively. Data were collected on patient age, sex, perceived outcome o...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Carr, M. M., Derr, J. B., Karikari, K. Tags: Pediatric Otolaryngology Source Type: research

Geniculate Ganglion Tumors: Clinical Presentation and Surgical Results
This study aims to compare those tumors limited to the geniculate ganglion in terms of clinical features and postoperative outcomes. Study Design Case series with chart review. Settings University tertiary reference center. Subjects and Methods Medical charts were reviewed for 17 patients who had surgery for geniculate ganglion tumor removal (10 hemangiomas, 6 schwannomas, 1 meningioma). Hemangiomas and schwannomas were compared for preoperative facial nerve function, hearing, tumor size, and postoperative outcomes. Results Facial palsy was observed in all cases. Regarding the preoperative facial nerve function, severe...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Lahlou, G., Nguyen, Y., Russo, F. Y., Ferrary, E., Sterkers, O., Bernardeschi, D. Tags: Otology and Neurotology Source Type: research

Electrophysiologic Evaluation of the Facial Nerve and Blink Reflex Pathways in Asymptomatic Cochlear Implant Users
Conclusion During functioning of the CI system, excitability of the facial circuit may increase either through the facial motor nucleus or through removal of the inhibitory effect of the descending pathway. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Edizer, D. T., Adatepe, T., Uzun, N., Yigit, O., Gunduz, A., Yildiz, M., Celebi, O. O. Tags: Otology and Neurotology Source Type: research

Muscle Tension Dysphagia: Symptomology and Theoretical Framework
Conclusion The study results suggest that laryngeal muscle tension may be a factor in the underlying etiology in patients with idiopathic functional dysphagia. We propose the diagnostic term muscle tension dysphagia to describe a subset of patients with functional dysphagia. Further prospective studies are needed to better evaluate potential gastroesophageal confounders in this group of patients and to identify an effective paradigm for treatment. In our limited series, speech-language pathology intervention directed toward unloading muscle tension appears effective. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Kang, C. H., Hentz, J. G., Lott, D. G. Tags: Laryngology and Neurolaryngology Source Type: research

Collagen Content Limits Optical Coherence Tomography Image Depth in Porcine Vocal Fold Tissue
Objective Vocal fold scarring, a condition defined by increased collagen content, is challenging to treat without a method of noninvasively assessing vocal fold structure in vivo. The goal of this study was to observe the effects of vocal fold collagen content on optical coherence tomography imaging to develop a quantifiable marker of disease. Study Design Excised specimen study. Setting Massachusetts Eye and Ear Infirmary. Subjects and Methods Porcine vocal folds were injected with collagenase to remove collagen from the lamina propria. Optical coherence tomography imaging was performed preinjection and at 0, 45, 90, a...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Garcia, J. A., Benboujja, F., Beaudette, K., Rogers, D., Maurer, R., Boudoux, C., Hartnick, C. J. Tags: Laryngology and Neurolaryngology Source Type: research

Voice Outcomes following a Single Office-Based Steroid Injection for Vocal Fold Scar
This study was based on pre- and postoperative analysis of patient-reported, perceptual, acoustic, aerodynamic, and videostroboscopic parameters. The sample comprised 25 patients undergoing office-based dexamethasone injection into the superficial lamina propria for mild/moderate vocal fold scar. Average follow-up was 13.7 ± 4.4 weeks; patients completed 3.5 ± 2.3 sessions of voice therapy between assessments. Complete data sets were not available for each parameter; sample size is noted with results. Results Voice handicap index (n = 24; P
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Young, W. G., Hoffman, M. R., Koszewski, I. J., Whited, C. W., Ruel, B. N., Dailey, S. H. Tags: Laryngology and Neurolaryngology Source Type: research

The History and Evolution of Surgery on the Vestibular Labyrinth
The history of surgery on the vestibular labyrinth is rich but sparsely documented in the literature. The story begins over a century ago with the labyrinthectomy in an era that consisted exclusively of ablative surgery for infection or vertigo. Improved understanding of vestibular physiology and pathology produced an era of selective ablation and hearing preservation that includes semicircular canal occlusion for benign paroxysmal positional vertigo. An era of restoration began with a discovery of superior semicircular canal dehiscence and its repair. The final era of vestibular replacement is upon us as the possibility o...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Naples, J. G., Eisen, M. D. Tags: History of Otolaryngology Source Type: research

Gene Methylation Profiling in Sinonasal Adenocarcinoma and Squamous Cell Carcinoma
Conclusion ITAC carries a higher number and a different profile of gene methylations as compared with SNSCC. Gene methylation plays a greater role in papillary and colonic ITAC subtypes, which may indicate a different tumorigenic pathway for these ITAC subtypes. These findings could be used as prognosticators and may have implications for future individualized therapies based on epigenetic changes. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Costales, M., Lopez-Hernandez, A., Garcia-Inclan, C., Vivanco, B., Lopez, F., Llorente, J. L., Hermsen, M. A. Tags: Head and Neck Surgery Source Type: research

Tumor Debulking in the Management of Laryngeal Cancer Airway Obstruction
We present a case series with chart review to communicate our institutional experience with this technique. T3/4 glottic and supraglottic cancers treated between 2004 and 2014 underwent review, and 14 patients were identified for this study. Of these, 5 (35.7%) required subsequent tracheotomy, and 9 (64.3%) did not. Patients requiring subsequent tracheotomy had a delay in initiating definitive treatment when compared with those who did not (83.3 vs 31.3 days, P = .0025). No patient required a tracheotomy after initiation of definitive treatment. Our experience suggests that tumor debulking may be a viable option in select ...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Du, E., Smith, R. V., Ow, T. J., Tassler, A. B., Schiff, B. A. Tags: Head and Neck Surgery Source Type: research

Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival
Conclusions LND was the only independent prognostic predictor of OS and DFS in patients with pN+ laryngeal SCC. Moreover, patients with LND ≥0.09 were significantly associated with high risk of regional recurrence. Thus, patients with LND ≥0.09 are at high risk of regional recurrence and death and may be considered for adjuvant chemoradiation. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Imre, A., Pinar, E., Dincer, E., Ozkul, Y., Aslan, H., Songu, M., Tatar, B., Onur, I., Ozturkcan, S., Aladag, I. Tags: Head and Neck Surgery Source Type: research

Presentation to Emergency Departments for Acute Rhinosinusitis: Disparities in Symptoms by Race and Insurance Status
Conclusion Symptomatology does not explain disproportionate ED use for ARS by Medicaid patients, while higher self-reported pain levels may explain self-pay patients’ disproportionate ED utilization. Likewise, ED presentation for ARS among Hispanic patients may be related to symptomatology that is less specific for ARS, such as headache and facial pain. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Bergmark, R. W., Sedaghat, A. R. Tags: General Otolaryngology Source Type: research

Surgery in MEN 2A Patients Older Than 5 Years with Micro-MTC: Outcome at Long-term Follow-up
In multiple endocrine neoplasia syndrome type 2A (MEN 2A), early total thyroidectomy (TT; performed before the age of 5 years) is the best option to prevent medullary thyroid carcinoma (MTC) development, but the management of MEN 2A patients diagnosed after childhood is still under debate. Seventeen consecutive patients diagnosed with MEN 2A after the age of 5 years (mean age, 23.3 years) with a pathologic diagnosis of micro-MTC without nodal involvement were enrolled. All patients underwent TT with thymectomy and central compartment lymph node dissection. During surgery, parathyroid tissue removal occurred in 14 patients....
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Tonelli, F., Giudici, F., Marcucci, T., Cavalli, T., Spini, S., Gheri, R. G., Brandi, M. L. Tags: Endocrine Surgery Source Type: research

Intraoperative Frozen Section in "Suspicious for Papillary Thyroid Carcinoma" after Adoption of the Bethesda System
Conclusions With no significant preoperative clinical or sonographic predictors for thyroid malignancy and given the high specificity of iFSE, our results support the use of iFSE for patients with preoperative FNA cytology of SFM–Bethesda V who are undergoing thyroid surgery, to determine the extent of required surgery. (Source: Otolaryngology - Head and Neck Surgery)
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Abu-Ghanem, S., Cohen, O., Raz Yarkoni, T., Fliss, D. M., Yehuda, M. Tags: Endocrine Surgery Source Type: research

Head and Neck Manifestations of Eosinophilic Granulomatosis with Polyangiitis: A Systematic Review
Conclusion Otolaryngologists are in a unique position for the early diagnosis and prevention of late complications of eosinophilic granulomatosis with polyangiitis. The American College of Rheumatology criteria should be relied on in the diagnostic workup. Close surveillance of these patients in a multidisciplinary fashion and with baseline complete blood counts, chest radiographs, and autoimmune laboratory tests is often necessary. Such patients with head and neck manifestations of the disease are nearly always responsive to steroids and often require additional immunosuppressive therapy or surgical intervention in cases ...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Goldfarb, J. M., Rabinowitz, M. R., Basnyat, S., Nyquist, G. G., Rosen, M. R. Tags: Review Articles Source Type: research

Stapedotomy vs Cochlear Implantation for Advanced Otosclerosis: Systematic Review and Meta-analysis
Objectives To compare the hearing outcomes of stapedotomy vs cochlear implantation in patients with advanced otosclerosis. Data Sources PubMed, EMBASE, and The Cochrane Library were searched for the terms otosclerosis, stapedotomy, and cochlear implantation and their synonyms with no language restrictions up to March 10, 2015. Methods Studies comparing the hearing outcomes of stapedotomy with cochlear implantation and studies comparing the hearing outcomes of primary cochlear implantation with salvage cochlear implantation after an unsuccessful stapedotomy in patients with advanced otosclerosis were included. Postoperati...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Abdurehim, Y., Lehmann, A., Zeitouni, A. G. Tags: Review Articles Source Type: research

Are Online Zenkers Diverticulum Materials Readable and Understandable?
The objectives of this study were to assess the readability and understandability of online materials on ZD, evaluate them against the existing criteria, and investigate the relationship between readability and understandability. Methods The first 50 webpages from an online search for ZD were analyzed. Twenty-one webpages had materials intended for patients and were included in the study. The patient education materials (PEMs) were analyzed using 6 readability tools. Four individuals used the Patient Education Materials Evaluation Tool (PEMAT) to assess the understandability. Fleiss interrater reliability analysis determi...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Balakrishnan, V., Chandy, Z., Verma, S. P. Tags: Special Focus Section: Patient Safety/Quality Improvement Source Type: research

Medical Information Exchange: Pattern of Global Mobile Messenger Usage among Otolaryngologists
We examined the experience and practices governing the usage of a global mobile messenger application (WhatsApp) for mobile health purposes in a national cohort of practicing otolaryngologists in Israel, a known early adaptor information technology society. Methods Cross-sectional data were collected from practicing otolaryngologists and otolaryngology residents via self-administered questionnaire. The questionnaire was composed of a demographic section, a section surveying the practices of mobile application use, mobile health application use, and knowledge regarding institutional policies governing the transmission of m...
Source: Otolaryngology - Head and Neck Surgery - October 31, 2016 Category: ENT & OMF Authors: Siegal, G., Dagan, E., Wolf, M., Duvdevani, S., Alon, E. E. Tags: Special Focus Section: Patient Safety/Quality Improvement Source Type: research