Otolaryngology Commons^™

Nasal Chondromesenchymal Hamartoma: A Case Report And Review Of The Literature, Jana Ghulmiyyah

Research Days

Background: Nasal chondromesenchymal hamartoma (NCMH) is a rare benign tumor of the sinonasal cavity. It commonly presents in infancy, however there are reported cases of adult tumors. As of August 2021, there have been 56 reported cases in the literature. This is the first description of a solely endoscopically resected NCMH in a neonate in addition to a review of the literature.

Case Presentation: A 5-day old male patient born at term presented to our institution for stridor and cyanosis since birth. The patient was reported to have desaturations while feeding at the outside hospital. On bedside examination, the patient ...

Use Of Mandibular Distraction Osteogenesis To Correct Micrognathia And Airway Obstruction In Newborn Female With Pierre Robin Sequence And Neonatal Abstinence Syndrome In Rural Appalachia, Seneca Williams, Adam Van Horn Md

Marshall Journal of Medicine

We present a case of Pierre Robin sequence and Neonatal Abstinence Syndrome (NAS) in a newborn female patient to highlight the surgical technique of mandibular distraction osteogenesis to correct airway obstruction due to micrognathia. The patient presented as a transport after delivery due to respiratory distress. She was noted to have a cleft palate and micrognathia. The absence of other dysmorphic features diagnosed her with non-syndromic Pierre Robin sequence. To solve her upper airway obstruction, mandibular distraction osteogenesis was performed. This procedure allowed the patient to be weaned from all respiratory support and nasogastric tube feeds by the end of ...

Otolaryngology Subspecialty Surgical Rescheduling Rates During The Covid-19 Pandemic, Emily S Sagalow, Alexander Duffy, Priyanga Selvakumar, David Cognetti

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Objective: In the beginning of the COVID-19 pandemic in spring 2020, elective and oncologic surgical cases were cancelled. After adequate safety protocols were established, each subspecialty within otolaryngology faced unique challenges in reengaging patients for surgical scheduling.

Study design: Retrospective review from March to May 2020.

Setting: Single academic institution.

Methods: Patients whose otolaryngology surgery was cancelled due to COVID-19 hospital precautions were identified. Rescheduling rates were analyzed by subspecialty. Case completion was determined as the percentage of initially cancelled cases that were completed within 6 months of their original planned dates.

Results: Of 833 otolaryngology cases scheduled between March ...

A Unique Case Of Metastatic Prostate Carcinoma To The Subglottis, Samuel Bosco, Kristen Prijs, Jordan Licata, Sandra A Schwartz, Raymond Lesser

Otolaryngology (ENT) Resident Research

An 85-year-old male presented to an otolaryngology office with hoarseness, stridor, and shortness of breath. He had been evaluated by 2 outside otolaryngologists for a 4-year history of hoarseness. He was referred for consideration for speech therapy regarding hoarseness, vocal fold edema, and a questionable right vocal fold polyp. The patient reported that his symptoms had worsened progressively over the prior 6-12 months. He had no history of head and neck cancer, recent intubation, autoimmune conditions, head and neck trauma, or smoking. The patient had a history of prostate carcinoma treated with radical prostatectomy, radiation therapy, and hormone therapy 18 ...

Functional Nasal Breathing Rehabilitation: Effectiveness And Feasibility Of An Online Integrative Breathing Therapy Protocol, Rosalba Courtney, Roger Engel, Sandra Grace, Anna Potts, Brooke Riordan, Kaitlyn Ireland, Courtney Osbourne, Avinash Sukhtankar

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Nasal disuse and mouth breathing are associated with negative structural, functional, postural, occlusal, and behavioural changes. While there is some research to suggest that nasal breathing exercises can reduce mouth breathing, clinical protocols have not been extensively investigated. The purpose of this research was to determine the feasibility and effectiveness of a nasal breathing rehabilitation protocol based on Integrative Breathing Therapy principles called Functional Nasal Breathing Rehabilitation (FNBR).

Methods: Twenty-three participants with symptoms of nasal obstruction and self-reported mouth breathing completed the 4-week online FNBR training. Outcome measures included the Nasal Obstruction Symptom Evaluation (NOSE) scale, a numeric rating ...

Deep Neck Abscess After Intubation Trauma: A Case Report., Kashyap Kaul, Chetan S Nayak, Jessica Jacoby, Kenneth D Katz

Department of Emergency Medicine

Significant injuries from endotracheal intubation are exceedingly rare but can lead to life-threatening complications, such as pharyngeal perforation. This type of perforation can result in abscess formation and airway compromise. Risks for this complication include operator skill and intubation in emergent situations. This case report details a 59-year-old male who underwent elective septoplasty with bilateral nasal turbinate reduction. The procedure required general anesthesia induction and endotracheal intubation. He developed a gradually enlarging right-sided neck mass with associated fevers, neck pain, odynophagia, and dysphonia. He presented to the emergency department on postoperative day 5 and was diagnosed with a right-sided, prevertebral ...

Tadalafil Enhances Immune Signatures In Response To Neoadjuvant Nivolumab In Resectable Head And Neck Squamous Cell Carcinoma, Adam J. Luginbuhl, Jennifer Johnson, Larry Harshyne,, Alban J Linnenbach, Sanket Kumar Shukla, Angela Alnemri, Gaurav Kumar, David Cognetti, Joseph Curry, Nikita Kotlov, Zoya Antysheva, Sandrine Degryse, Kyle Mannion, Michael K Gibson, James Netterville, Brandee Brown, Rita S. Axelrod, Ralph G. Zinner, Madalina Tuluc, Stacey Gargano, Benjamin E Leiby, Ayako Shimada, M G Mahoney, Ubaldo E. Martinez-Outshoorn, Ulrich Rodeck, Young J Kim, Andrew P. South, Athanassios Argiris

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Purpose: We hypothesize that the addition of the phosphodiesterase-5 inhibitor tadalafil to the PD-1 inhibitor nivolumab, is safe and will augment immune-mediated antitumor responses in previously untreated squamous cell carcinoma of the head and neck (HNSCC).

Patients and methods: We conducted a two-arm multi-institutional neoadjuvant randomized trial in any-stage resectable HNSCC (NCT03238365). Patients were stratified at randomization by human papillomavirus (HPV) status. Patients in both arms received nivolumab 240 mg intravenously on days 1 and 15 followed by surgery on day 28. Those in the combination therapy arm also received tadalafil 10 mg orally once daily for 4 weeks. Imaging ...

Clinical Symptoms Contributing To Zenker's Diverticulum Repair: A Retrospective Review, Jhon F. Martinez Paredes, Razan Al Fakir, Amy L. Rutt

School of Medicine Publications and Presentations

Objective: Zenker's diverticulum (ZD) is usually associated with dysphagia and other symptoms due to the interrelated functions of several systems. Surgical management of ZD is effective for all sizes of diverticula, but not all patients decide to undergo surgery. The purpose of this study was to determine the relationship between clinical presentation and patients' decision to undergo surgical repair.

Subjects and methods: This is a retrospective study including 165 patients with ZD treated over the last 11 years. Data collection includes patients' chief complaints and symptoms, medical history, findings on radiologic swallow evaluations, and patients' decision to undergo surgery ...

Mental Practice Of Lingual Resistance And Cortical Plasticity In Older Adults: An Exploratory Fnirs Study, Erin Kamarunas, Sarah Szynkiewicz, Lindsay Griffin, Teresa Drulia, Kelsey Murray

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Mental practice using motor imagery (MP) improves motor strength and coordination in the upper and lower extremities in clinical patient populations. Its effectiveness as a rehabilitation tool for patients with lingual weakness is not yet well understood, nor are the underlying mechanisms within the context of swallow or lingual MP. Using previously published data on a lingual and MP exercise program, the objective of this study was to explore how MP of lingual exercise affects cortical activation in healthy older adults over time and how neural changes correlate with functional oral pressure outcomes.

Method: A prospective randomized controlled study ...

A Rare Case Of A Middle Ear Glomangioma., Margaret E. Wieser, David R. Gilley, Jason G. May, Arnaldo L. Rivera

Manuscripts, Articles, Book Chapters and Other Papers

Glomus tumors are benign hyperplasia of glomus bodies, and they are rarely found in the head and neck. The middle ear is an exceptionally rare site for a true glomus tumor, and there are only three previously reported cases in this location. Glomus tumors are etiologically different than glomus tympanicum, which are paragangliomas of the middle ear that are often mistakenly referred to as "glomus tumors." This is a common misconception due to the "glomus" misnomer. We report a case of a patient diagnosed with a middle ear glomangioma after initially presenting to our clinic with tinnitus and hearing loss ...

Otitis Media Practice During The Covid-19 Pandemic., Tal Marom, Jacob Pitaro, Udayan Shah, Sara Torretta, Paola Marchisio, Ayan Kumar, Patrick Barth, Sharon Ovnat Tamir

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome ...

Eagle Syndrome: Efficacies Of Medical And Surgical Treatments, Kirklin Mitchell

Capstone Showcase

Eagle Syndrome is a rare syndrome caused by elongation of the styloid process of the temporal bone or calcification of the stylohyoid ligament occurring in a very small percentage of the population that can cause a wide range of common symptoms, leading to it being often misdiagnosed. While there are no set standards for treating Eagle Syndrome, both pharmaceutical and surgical options exist. Pharmaceutical options are often ineffective in long term treatment so surgery is usually required for full symptom resolution. Transoral and Transcervical surgeries have similar efficacies but each come with important drawbacks when considering which type of surgery ...

Typical Sounding Atypical Diagnostic Conundrum -- A Rare Case Of Mycobacterium Avium Complex (Mac) Presenting With Multiple Cranial Nerve Involvement, Ashwini Kini, Karl Echiverri, Edward J. Escott, Padmaja Sudhakar

Neurology Faculty Publications

Background

MAC infections rarely cause symptomatic systemic infection in immunocompetent healthy individuals. This case brings to light a rare such presentation that gives us a learning point about keeping a strong pre-clinical suspicion for this condition in patients whom lung imaging reveals suspicious cavitary lesions. Starting empiric therapy while awaiting culture results may be considered after weighing risks and benefits in order to achieve the morbidity and mortality associated with the disease.

Case report

A 54 year-old white male presented for evaluation of progressively worsening vertigo, imbalance, vertical diplopia, facial diplegia, bilateral hyperacusis followed by hearing loss, dysphagia, and dysarthria ...

Defining Disparities In Cochlear Implantation Through The Social Determinants Of Health, Marissa Schuh, Matthew L. Bush

Otolaryngology--Head & Neck Surgery Faculty Publications

Hearing loss is a global public health problem with high prevalence and profound impacts on health. Cochlear implantation (CI) is a well-established evidence-based treatment for hearing loss; however, there are significant disparities in utilization, access, and clinical outcomes among different populations. While variations in CI outcomes are influenced by innate biological differences, a wide array of social, environmental, and economic factors significantly impact optimal outcomes. These differences in hearing health are rooted in inequities of health-related socioeconomic resources. To define disparities and advance equity in CI, there is a pressing need to understand and target these social factors that influence ...

Combined Amplification And Sound Therapy For Individuals With Tinnitus And Coexisting Hearing Loss: A Retrospective Cohort Study, Purushothaman Ganesan, Hansapani Rodrigo, Jason Schmiedge, Rob Reiter, Simham Swapna, Vinaya Manchaiah

Mathematical and Statistical Sciences Faculty Publications and Presentations

BACKGROUND: The heterogeneity of tinnitus perception and its impact necessitates a tailor-made management approach in everyone. The current study examined the effects of residual inhibition in combined amplification and sound therapy in individuals with tinnitus and coexisting hearing loss.

METHODS: A retrospective analysis was performed on patients with tinnitus and coexisting hearing loss between 2016 and 2019. A total of 72 patients provided with combined amplification and sound therapy were divided into 3 groups based on residual inhibition: (i) complete residual inhibition, (ii) partial residual inhibition, and (iii) negative residual inhibition. Tinnitus severity was measured using the Tinnitus Functional Index ...

Multi-Institutional Study Validates Safety Of Intraoperative Cesium-131 Brachytherapy For Treatment Of Recurrent Head And Neck Cancer, Adam J. Luginbuhl, Alyssa Calder, David Kutler, Chad Zender, Trisha Wise-Draper, Jena Patel, Michael Cheng, Vidhya Karivedu, Tingting Zhan, Bhupesh Parashar, Shuchi Gulati, Min Yao, Pierre Lavertu, Vinita Takiar, Alice Tang, Jennifer Johnson, William M. Keane, Joseph Curry, David Cognetti, Voichita Bar-Ad

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Introduction: Surgery is the primary treatment for resectable, non-metastatic recurrent head and neck squamous cell carcinoma (HNSCC). We explore the safety and oncologic benefit of intraoperative Cesium-131 (Cs-131) brachytherapy combined with salvage local and/or regional surgical resection.

Methods and materials: Findings were reported from a single arm multi-institutional prospective phase 1/2 trial involving surgery plus Cs-131 (surgery + Cs-131) treatment. The results of two retrospective cohorts-surgery alone and surgery plus intensity modulated radiation therapy (surgery + ReIMRT)-were also described. Included patients had recurrent HNSCC and radiation history. Safety, tumor re-occurrence, and survival were evaluated.

Results: Forty-nine patients were enrolled ...

Sars-Cov-2: A Potential Trigger Of Dermato-Neuro Syndrome In A Patient With Scleromyxedema, Mike Fritz, Daniel Tinker, Alex W. Wessel, Gabriela M. Morris, Linda Goldenberg, Mark Fesler, Lokesh Rukmangadachar, M. Yadira Hurley

Otolaryngology--Head & Neck Surgery Faculty Publications

No abstract provided.

Unilateral Vocal Fold Paralysis In Adults: Etiological Factors In Yemen, Ali Obaid Muthanna

Hadhramout University Journal of Natural & Applied Sciences

Unilateral vocal fold paralysis is a common finding in otolaryngology practice. Various etiologies is known to cause this condition are neck surgery, cancer, neck trauma, neurological disorders and idiopathic The aim of this study was to determine the possible etiologies of unilateral vocal fold paralysis among adult patients. A prospective hospital based study was conducted at OtoLaryngology Department, at Al-Thawra Teaching Hospital, Sana'a, Yemen, during the period January 2015-June 2018.Patients have unilateral vocal fold paralysis were enrolling in this study. All patients underwent to history, clinical examination, laboratory investigations, and radiological studies. A total of 80 patients with ...

Development Of A Concept For A Mobile Application To Support Orofacial Myofunctional Therapy, Christina Osen, Nicola Litke, Michel Wensing, Aline Weis

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: This study aimed to develop a concept for a mobile health application, an app-based exercise tool, to support the treatment of orofacial myofunctional disorders by speech-language therapists (SLTs).

Method: A sequential mixed research design combining qualitative research and user-centered software development was applied. Qualitative interviews and focus groups were conducted with eight SLTs, one patient and three relatives to gather ideas for an app to support orofacial myofunctional therapy. On the basis of the findings, a paper-based prototype was developed, which was then evaluated by seven end users, to refine the concept of the app.

Results: Qualitative data on ...

Iaom President's Greeting 2021: 50th Anniversary Celebration, Amanda Moore Chastain

International Journal of Orofacial Myology and Myofunctional Therapy

The 50^th Anniversary Address delivered by the President of the International Association of Orofacial Myology at the Annual IAOM Convention held online October 22-24, 2021.