Otolaryngology Commons^™

A Near-Infrared Probe For Non-Invasively Monitoring Cerebrospinal Fluid Flow By F-18-Positron Emitting Tomography And Fluorescence, H. Guo, H. Kommidi, C. C. Lekaye, J. Koutcher, M. S. Judenhofer, S. R. Cherry, A. P. Wu, O. Akin, M. M. Souweidane, R. Ting, +2 Additional Authors

Journal Articles

No abstract provided.

A New Office-Based Procedure For Treatment Of Snoring: The S.I.Le.N.C.E. Study., M. Friedman, M. B. Gillespie, F. A. Shabdiz, D. H. Hiltzik, T. A. Meyer, J. Ahn, P. J. Catalano, N. J. Joseph

Journal Articles

Objective:Demonstrate the safety and effectiveness of palatal foreshortening and stiffening in reducing snoring severity in nonobstructive sleep apnea (non-OSA) patients complaining of chronic disruptive snoring. Methods:In a US-based 8-center, open-label, prospective, single-arm cohort study, 52 consenting adults with chronic disruptive snoring (snoring impacting a patient's life and causing patient or bed partner to seek medical intervention) were treated via office-based placement of resorbable, bidirectional, barbed suture implants into the soft palate under local anesthesia. Prior to intervention, home sleep tests (HSTs) were performed to rule out OSA and to document snoring noise level. Both subject and their bed/sleep partners (also …

How Can We Improve Antidepressant Adherence In The Management Of Depression? A Targeted Review And 10 Clinical Recommendations., M. Solmi, A. Miola, G. Croatto, G. Pigato, A. Favaro, M. Fornaro, M. Berk, L. Smith, C. U. Correll, A. F. Carvalho, +2 Additional Authors

Journal Articles

Adherence to antidepressants is crucial for optimal treatment outcomes when treating depressive disorders. However, poor adherence is common among patients prescribed antidepressants. This targeted review summarizes the main factors associated with poor adherence, interventions that promote antidepressant adherence, pharmacological aspects related to antidepressant adherence, and formulates 10 clinical recommendations to optimize antidepressant adherence. Patient-related factors associated with antidepressant non-adherence include younger age, psychiatric and medical comorbidities, cognitive impairment, and substance use disorders. Prescriber behavior-related factors include neglecting medical and family histories, selecting poorly tolerated antidepressants, or complex antidepressant regimens. Multi-disciplinary interventions targeting both patient and prescriber, aimed at improving antidepressant …

Literature-Guided Recommendations For Otolaryngologists During The Covid-19 Pandemic: A Contemporary Review, Mausumi Syamal

Otolaryngology Head & Neck Surgery Faculty Publications

Objective: The objective of this study was to review the current literature and guidelines on management of the novel coronavirus 2019 (COVID-19 or 2019nCoV) with respect to the field of Otolaryngology.

Design: Contemporary literature review.

Methods: Systematic literature review of global medical literature databases and communications were queried to find all available literature recommendations, research, and guidelines applicable to otolaryngologists in the COVID-19 pandemic.

Results: Guidance on personal protective equipment, office visits, and surgical scheduling, as well as recommendations for safe airway management and tracheotomy performance during the COVID-19 pandemic were compiled and interpreted.

Conclusion: Little guidance exists for otolaryngologists …

Health Care Professionals’ Compliance To Tracheal Suctioning Policy At A Tertiary Care Hospital, Rozina Khimani, Fauziya Ali, Salma Amin Rattani, Mohammad Sohail Awan

Department of Surgery

Objective: To assess the compliance of tracheal suctioning practices against the standard guidelines of a tertiary care hospital, with regard to the participants’ professional characteristics.
Methods: Using cross sectional study design, forty health care professionals (HCPs) were assessed twice, using a quantitative structured observational design, for tracheal suctioning practices, in one of the surgical care units of the tertiary care hospital. Tracheal suctioning policy which was used as a tool, its inter-rater reliability was tested and each step showed the Kappa value of 0.65 to 1.000. Data was analyzed using epidata info version 3.5.1 and SPSS version 19.
Results: From …

The Impact Of The Fda Warning On Post-Tonsillectomy Opioid Prescribing In Publicly And Privately Insured Children, Dianna J. Soelberg

Theses and Dissertations

Due to reports of significant adverse events, the U.S. FDA placed a Boxed Warning on the opioid codeine in February 2013 – contraindicating its use in pediatric patients undergoing tonsillectomy and/or adenoidectomy. Studies conducted in privately insured children showed a reduction in codeine prescribing and a slight increase in alterative opioid prescribing following the FDA warning, yet the extent to which the FDA warning impacted prescribing in publicly insured children is unknown. Using a quasi-experimental interrupted time series design, this study evaluated codeine and alternative opioid prescribing before and after the FDA warning in both publicly and privately insured children …

Virtual Surgical Planning In Subscapular System Free Flap Reconstruction Of Midface Defects., Brian P. Swendseid, Dylan F. Roden, Swar Vimawala, Tony Richa, Larissa Sweeny, Richard A. Goldman, Adam Luginbuhl, Ryan N. Heffelfinger, Shachika Khanna, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Reconstruction of the midface has many inherent challenges, including orbital support, skull base reconstruction, optimizing midface projection, separation of the nasal cavity and dental rehabilitation. Subscapular system free flaps (SF) have sufficient bone stock to support complex reconstruction and the option of separate soft tissue components. This study analyzes the effect of virtual surgical planning (VSP) in SF for midface on subsite reconstruction, bone segment contact and anatomic position.

MATERIALS AND METHODS: Retrospective cohort of patients with midface defects that underwent SF reconstruction at a single tertiary care institution.

RESULTS: Nine cases with VSP were compared to fourteen cases …

Mutation Signature Analysis Identifies Increased Mutation Caused By Tobacco Smoke Associated Dna Adducts In Larynx Squamous Cell Carcinoma Compared With Oral Cavity And Oropharynx., Andrew P. South, Nicoline Y Den Breems, Tony Richa, Uche Nwagu, Tingting Zhan, Shiv Poojan, Ubaldo E. Martinez-Outshoorn, Jennifer M. Johnson, Adam J. Luginbuhl, Joseph Curry

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Squamous cell carcinomas of the head and neck (HNSCC) arise from mucosal keratinocytes of the upper aero-digestive tract. Despite a common cell of origin and similar driver-gene mutations which divert cell fate from differentiation to proliferation, HNSCC are considered a heterogeneous group of tumors categorized by site of origin within the aero-digestive mucosa, and the presence or absence of HPV infection. Tobacco use is a major driver of carcinogenesis in HNSCC and is a poor prognosticator that has previously been associated with poor immune cell infiltration and higher mutation numbers. Here, we study patterns of mutations in HNSCC that are …

Lifestyle Management For Individuals With Vestibular Disorders, Michelle Pock, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

Individuals with vestibular disorders have concerns that impact lifestyle including limiting activities of daily living, limiting participation in social events, difficulty driving, and difficulty working (Cohen, 2014). Occupational therapists are able to help individuals with vestibular disorders by task analyzing symptom provoking activities, assessing the impact of symptoms on occupations, providing adaptations, and providing ways to modify environments (Gronski, Neville, Kannenberg, & Cohen, 2017). While occupational therapists are qualified to provide services to sustain and improve the occupational performance of individuals with vestibular disorders, occupational therapy is not well represented in this area particularly in addressing lifestyle components for vestibular …

Voice Analysis With Iphones: A Low Cost Experimental Solution, Benjamin Van Der Woerd

Electronic Thesis and Dissertation Repository

Background:

Acoustic voice analysis requires a resource intensive setup, including a soundproof booth. This project evaluates smartphone microphone and recording environment impacts on voice sample collection for acoustic voice analysis. A proprietary analysis algorithm is presented for validation.

Methods:

Microphone and recording environment were evaluated using previously collected voice samples presented in four conditions to test two microphones and two recording environments. Prospective samples were used to test the proprietary algorithm, whereby samples were analyzed using this and Praat.

Results:

Microphone and recording environment had small, clinically unimportant impacts on most measurements. The proprietary algorithm reliably analyzed sustained vowels, with …

Reconstructive Trends And Complications Following Parotidectomy: Incidence And Predictors In 11,057 Cases., Cory D Bovenzi, Peter Ciolek, Meghan Crippen, Joseph M Curry, Howard Krein, Ryan Heffelfinger

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: Parotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy is utilized to address contour deformity and facial nerve paralysis. This study aims to demonstrate national trends in parotidectomy patients and identify factors associated with adverse postoperative outcomes. This study includes the largest patient database to date in determining epidemiologic trends, reconstructive trends, and prevalence of adverse events following parotidectomy.

METHODS: A retrospective review was performed for parotidectomies included in the ACS-NSQIP database between January 2012 and December 2017. CPT codes were used to identify the …

Enhancing The Evidence Base In Orofacial Myology, Hope C. Reed

International Journal of Orofacial Myology and Myofunctional Therapy

The purpose of this article is to stimulate research in orofacial myology. The research-to-practice gap may be reduced by highlighting concepts relating to evidence-based practice. Information is also presented on the International Association of Orofacial Myology Institutional Review Board process.

Development Of Lip Closing Function During Taking Food Into The Mouth In Children With Down Syndrome, Tomoko Isoda, Fumiyo Tamura, Takeshi Kikutani, Miki Mizukami

International Journal of Orofacial Myology and Myofunctional Therapy

Children with Down Syndrome (DS) show developmental retardation of gross motor function including acquisition of oral movements related to eating and swallowing. To characterize the process of development/acquisition of eating/swallowing function of children with DS, interlabial pressure (IP) during taking food into the mouth was assessed. This study included 99 children with DS (birth to 4 year-old), and 112 age-matched control children showing typical development. IP during taking food into the mouth was measured as an objective index of lip closing function. The system for measuring IP during taking food into the mouth consisted of a strain gauge-pressure sensor connected …

Feasibility Of Using A Tongue-Activated Joystick By Healthy Pre-Teen Children, Mariana Souza Amaral, Ranata Maria Moreira Moraes Furlan, Guilherme Andre Santana, Clarice Magnani Figueiredo

International Journal of Orofacial Myology and Myofunctional Therapy

PURPOSE: To investigate the motivation and the effects of: tongue movement direction; resistance force level; repetition number; and sustained tongue contraction duration on tongue motor performance in healthy pre-teen children using computer games. METHODS: An analytical observational cross-sectional study was conducted with 15 healthy 11-13 year-old children with normal lingual strength. The participants played six computer games using a tongue-controlled joystick. The series varied the time for continuous force application on the target (3 and 5 seconds) and the target force level (0.5, 1 and 2 N). After the tests, the participants answered a questionnaire about their impressions and reactions …

Investigating Factors Related To The Acquisition Of Masticatory Function In Down Syndrome Children, Miki Mizukami, Takeshi Kikutani, Miwa Matsuyama, Keigo Nagashima

International Journal of Orofacial Myology and Myofunctional Therapy

Down syndrome (DS) has the highest prevalence of any chromosomal abnormality identified in newborns. DS children have specific eating and swallowing difficulties such as poor tongue control, mouth opening, swallowing food without chewing, and both facial and occlusal abnormalities. DS children are also at high risk of aspiration, and swallowing food without chewing is considered to be a factor associated with increased risk of aspiration and eating problems. This study aimed to identify factors preventing the acquisition of masticatory function in DS children. The subjects were 75 outpatient DS children (44 males, age range 12 to 36 month-old, mean age …

An Unusual Presentation Of Subglottic Stenosis Necessitating Urgent Tracheostomy, Jacob Burdett, Alexander Manteghi

Otolaryngology (ENT) Resident Research

By definition, the subglottis is the area of the larynx immediately below the vocal folds extending to the level of the inferior border of the cricoid cartilage. This area represents the narrowest portion of the pediatric airway and is the most common site of iatrogenic stenosis. This stenosis is generally secondary to increased rates of intubation in infants of prematurity. Evaluation and treatment for subglottic stenosis represents one of the most common airway consultations within pediatric otolaryngology. Goals of therapy include securing a safe airway and restoring subglottic patency. In this clinical case, we present a unique pattern and presentation …

An Interesting Secondary Airway Lesion In An Infant With Laryngomalacia, William L. Valentino, David Lafferty, Alexander Manteghi

Otolaryngology (ENT) Resident Research

A 2-month-old male with a prior diagnosis of laryngomalacia (LM) presented to the emergency department in respiratory distress with worsening inspiratory stridor, suprasternal retractions, and a dry cough. A chest X-ray and lateral neck radiograph were performed and demonstrated no abnormalities. Flexible laryngoscopy revealed the same, previously observed moderately prolapsed arytenoids and an omega-shaped epiglottis with shortened aryepiglottic (AE) folds. He also had a right lower neck mass. He was scheduled for a direct laryngoscopy and bronchoscopy (DLB) and supraglottoplasty. During the DLB, LM and anterior compression of the midtrachea was noted. Lysis of the AE folds was performed in …

Prognostic Significance Of Tumor-Associated Macrophage Content In Head And Neck Squamous Cell Carcinoma: A Meta-Analysis., Ayan Tyagi Kumar, Alexander Knops, Brian Swendseid, Md, Ubaldo E. Martinez-Outshoorn, Larry Harshyne, Nancy Philp, Ulrich Rodeck, Adam Luginbuhl, David Cognetti, Jennifer Johnson, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Head and neck squamous cell carcinoma (HNSCC) exists within a microenvironment rich in immune cells. Macrophages are particularly abundant in and around tumor tissue, and have been implicated in the growth, malignancy, and persistence of HNSCC (1). However, current literature reports variable degrees of association between the density of tumor-associated macrophages (TAMs) and clinicopathologic markers of disease (2, 3). These inconsistent findings may be a result of differences in approach to TAM detection. Authors have measured total TAMs in tumor tissue, while others have stained tumor samples for individual subtypes of TAMs, which include pro-inflammatory (M1-like) and immunosuppressive (M2-like). …

Moisture Chamber For Eye Care After Facial Nerve Injury, Ryan Rimmer, Md, Lauren Bogdan, Md, Gregory Epps, Md, Nikolaus Hjelm, Md, Erin Reilly, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Introduction

• Patients with various lesions of the head and neck may have compromise of facial nerve function.
• Facial nerve (CN VII) has various roles, including movement of facial muscles and, importantly, eye closure.
• When facial nerve is sacrificed or damaged during a surgical cases, steps are often taken intraop to surgically correct the deficit and allow eye closure. However, these patients may not immediately realize the benefit of these interventions.
• In the postop period, appropriate eye care is critical to prevent exposure keratopathy due to inability to close eye.
• Exposure keratopathy is damage to the cornea that occurs primarily due …

Treatment Summaries For Head And Neck Cancer Survivors: Improving Patient Self Efficacy And Survivorship Care, Michael C. Topf, Md, Jena Patel, Ramez Philips, Md, David Cognetti, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objective

• To determine if receiving treatment summaries enhances patient understanding and recall of cancer and treatment details, improves patient self efficacy, and serves as a useful patient tool after completion of head and neck (HNC) therapy