Otolaryngology Commons^™

Implementation Of A Tracheostomy Discharge Education Class For Nicu Nurses, Todd N. Chamoy

Doctor of Nursing Practice Final Manuscripts

Infants who are ventilator-dependent or have anatomic anomalies of their airway frequently require tracheostomy placement prior to discharge from the hospital in order to be cared for safely at home. At this large quaternary children’s hospital in Southern California, preparing these infants for discharge after tracheostomy placement has not been the role of the NICU nurse. There was no system in place on how to train caregivers, and the NICU staff felt unprepared. Evidence supports use of intensive educational programs to improve nurse knowledge and skills of tracheostomy care, allowing NICU nurses to provide improved care and pre-discharge teaching.

A …

Intertrial Coherence As A Measure Of Synchrony In Ocular Vestibular Evoked Myogenic Potentials And The Effect Of Gaze Angle, Sydney Brown

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to stimuli. These responses reflect utricular function and can be recorded using surface electromyography electrodes. Traditional analysis of oVEMPs is limited to time-domain waveform measurements, such as amplitude and latency of response peaks. Objective synchrony-based measures have not yet been applied to the analysis of oVEMPs, particularly in the comparison of synchrony across gaze angles. We followed the new time-frequency method of analysis developed by Clinard et al. (2022) that was successfully applied to cervical VEMPs to quantify response synchrony. Air-conducted oVEMPs …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …

Understanding The Effects Of Hormone Treatments On The Transgender Singer: A Pedagogical Study And Voice Studio Guide, Erin M. Hannon

Theses and Dissertations--Music

Transitioning from one gender to another can be an arduous and emotionally charged experience, accompanied by many physical and mental transformations. The journey of self-discovery and vocal explorations is both unique and deeply personal. Modifications that emerge in an individual's vocal characteristics have a profound influence on their capacity to communicate and express themselves.

Transgender vocal students and professional singers must navigate the delicate balance between their vocal and gender identities while considering the possible risks of Gender Affirming Hormone Therapy. Though these therapies may significantly alter one's appearance and overall well-being, they are also capable of causing notable declines …

Implementation Of A Vestibular Disorder Screening Tool In An Urgent Care, Kathleen A. Probst

Dissertations

Implementation of a Vestibular Disorder Screening Tool in an Urgent Care

Kathleen A. Probst

M.S.N., University of Missouri-Columbia, 2007

B.S.N., University of Missouri-Columbia, 2004

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice

August 2023

Advisory Committee

Susan Dean-Baar, PhD, RN, CENP, FAAN

Chairperson

Jennifer Vines, DNP, MSN, RN

Troy Dinkel, MD

Copyright, Kathleen A. Probst, 2023

Abstract

Problem: Vestibular disorders disrupt everyday living and can cause reduced quality of life. Guidelines developed to screen for vestibular disorders are not efficient to use …

The Perception Of Prosody In English-Speaking Children With Cochlear Implants: A Systematic Review, Grace R. Smith

Dissertations, Theses, and Capstone Projects

Objective: The goal of this paper was to systematically review literature in order to investigate the perception of prosody in English-speaking children with cochlear implants.

Methods: A comprehensive search utilizing various peer-reviewed databases accessible through the City University of New York (CUNY) Graduate Center Library was conducted to identify relevant studies. Inclusion criteria included studies that examined prosody perception in pre-and post-lingually deafened children with cochlear implants. Children who utilized unilateral, bilateral, and bimodal configurations of cochlear implants were therefore included in this search.

Results: 9 studies met the inclusion criteria for this systematic review. The findings …

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 …

Lifestyle Management For Vestibular Disorders, Michelle Pock

Student Capstone Papers

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 …

Is Lifitegrast 5.0% Ophthalmic Solution Effective In Improving Eye Dryness And Safe, In Terms Of Ocular Adverse Effects, In Adults 18 Years Or Older With Dry Eye Disease?, Aubrey E. Cole

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not lifitegrast 5.0% ophthalmic solution is effective in improving eye dryness and safe, in terms of ocular adverse effects, in adults 18 years or older with dry eye disease (DED).

Study Design: Systematic review of three primary double-blinded, randomized placebocontrolled trials that were published in peer-reviewed journals between 2014-2017.

Data Sources: Studies were obtained through the PubMed database based on relevance to the clinical question and evaluation of patient-oriented outcomes.

Outcomes Measured: Efficacy of lifitegrast treatment was measured based on the eye dryness …

A Developmental Study Of Apoptotic Markers And Histamine In Cephalopod Statocysts, Samantha Nicole Leef

Honors Theses and Capstones

Cephalopods can participate in complex navigation using landmarks that show context due to their statocysts. Statocysts are analogous to the vertebrate vestibular and auditory system encased in cartilage rather than bone making them more easily accessible. Age and anatomical dysfunctions are the reasons for many human vestibular malfunctions. Two of these sources are endolymph hydrops and aging. In the past, endolymph pressure changes were attributed to the ineffectual ion transport. Recent studies have illuminated the possibility of histamine receptors in the semicircular canal could be responsible for patients’ endolymph pressure changes rather than the previous belief that the pressure changes …

Changes In The Transverse Dimension Of The Nasomaxillary Complex Following Rapid Palatal Expansion – A Post-Retention, Cbct Evaluation, Allison Schubert

Theses & Dissertations

Purpose: The purpose of this investigation was to evaluate the immediate and long-term effects of palatal expansion on the transverse dimension of the nasomaxillary complex.

Materials and Methods: Twenty-eight patients’ CBCTs were obtained at four time points: pre-expansion (T₁), post-expansion (T₂), pre-treatment (T₃), and middle or end of orthodontic treatment (T₄). The patients’ age, sex, cervical vertebral maturation stage, and the number of instructed expander turns were recorded. Measurements of the nasal floor, nasal passage, maxillary sinus, maxillary first molar mesiolingual cusp, maxillary first molar palatal cusp, maxillary first molar buccal cortical …

Alcohol Drives Oxidation-Dependent Desensitization Of Airway Cilia Motility Responsiveness, Michael Price

Theses & Dissertations

Alcohol abuse, which can impair clearance of pathogens and debris from the airway, is associated with an increase in complications and a higher mortality rate during the progression of pneumonia. With prolonged alcohol exposure, mucociliary clearance (MCC), which depends on the coordinated beating of cilia, is dysfunctional. Effective MCC relies on cAMP-dependent protein kinase (PKA) activation of ciliary beat frequency (CBF). PKA activation and stimulation of CBF are blunted with chronic exposure to alcohol. This phenomenon is known as alcohol-induced ciliary dysfunction (AICD). Previous studies have shown that concomitant feeding of mice with alcohol and antioxidants prevents AICD, suggesting a …

Melodic Contour Identification And Speech Recognition By School-Aged Children, Michael P. Morikawa

Dissertations, 2014-2019

Using the Sung Speech Corpus (SSC), which encompasses a single database that contains musical pitch, timbre variations and speech information in identification tasks, the current study aimed to explore the development of normal-hearing children’s ability to use the pitch and timbre cues. Thirteen normal hearing children were recruited for the study ages ranging from 7 to 16 years old. Participants were separated into two separate groups: Younger (7-9) and Older (10-16). Musical Experience was taken into account as well. The Angel Sound ™ program was utilized for testing which was adopted from previous studies, most recently Crew, Galvin, and Fu …

Breathing New Life: Investigating Ways To Improve The Mental Health Of People Living With Chronic Obstructive Pulmonary Disease In Western Australia, Tina Phan

Theses: Doctorates and Masters

Anxiety and depression are common comorbidities in people with chronic obstructive pulmonary disease (COPD), contributing to greater morbidity and mortality in an already vulnerable population. Despite the prevalence, few recommendations exist in global management guidelines for the detection and treatment of these comorbidities, reflecting the limited literature available on effective strategies for dealing with mental health issues in COPD populations. There is promising evidence that cognitive behavioural therapy (CBT) improves mental health outcomes in people with COPD. However, investigational studies have commonly reported participants’ lack of transport, lack of time and illness as barriers to recruitment and successful completion. This …

Promotion Of Early Pediatric Hearing Detection Through Patient Navigation, Matthew L. Bush

Theses and Dissertations--Clinical and Translational Science

Congenital hearing loss is the most common neonatal sensory disorder and it is crucial to diagnose hearing loss as soon as possible after birth in order to facilitate rapid treatment. Universal standards of infant hearing healthcare dictate that infant hearing screening should be completed by one month of age and abnormal screening tests should be followed with definitive audiological testing by three months of age. Obtaining diagnostic testing can be complicated by limited access to care in rural areas, breakdowns in communication, lack of parental support, and poor coordination of care. There is no established method to address appointment non-adherence …

A Dramaturgical Analysis Of The Miracle Worker, Abby Butzer

All Graduate Theses, Dissertations, and Other Capstone Projects

This document is a thesis submitted in partial fulfillment of the Master of Arts degree in theatre. It is a dramaturgical analysis for William Gibson's play The Miracle Worker, providing a reference for directors and actors. The thesis explores the play's medical and pedagogical history in six chapters: the physiology and psychology of language acquisition as it pertains to sight and/or hearing impaired children, a pedagogical comparison of Samuel G. Howe and Annie Sullivan, a modern diagnosis of the fever that destroyed Helen Keller's vision and hearing, the 19th century pathology and treatment options for the disease of the eye …

Patient-Reported Variables Associated With The Success Of Behavioral Intervention For Patients With Chronic Cough, Bridget Loomis

Graduate Student Theses, Dissertations, & Professional Papers

Purpose: To determine if patient-related variables exist that can potentially discriminate patients with refractory chronic cough (RCC) that are reasonable candidates for behavioral cough therapy (BCT). This study is a small sub-set of a larger, ongoing study, which aims to create and validate a screening tool that primary care physicians can use in order to refer patients early and appropriately for medical or behavioral intervention.

Methods: In this prospective, exploratory study, 20 adult participants, aged 29-68 years of age, answered a bank of questions developed by an expert panel, and the Leicester Cough Questionnaire (LCQ), before and after BCT. Questions …

Investigating The Efficacy Of Vocal Function Exercises In Improving Vocal Function In Adults Irradiated For Laryngeal Cancers: A Three Part Dissertation, Vrushali Angadi

Theses and Dissertations--Rehabilitation Sciences

Deterioration in voice quality following radiation therapy for the treatment of laryngeal cancers (LC) is well documented in literature. The majority of studies show that these voice problems are long term and in some cases permanent. Deterioration in voice quality, especially over a period of time could lead to significant communication difficulties in daily life or in some cases could even result in loss of profession. Despite the negative effects of radiation therapy on voice quality being well documented, few studies have focused on the efficacy of voice therapy in the irradiated LC population.

The purpose of this study was …

Ent Educational Patient Bedside Tool, Alina M. Toma

Master's Projects and Capstones

Early educational and discharge preparations are an advantage to patients, the interdisciplinary team, and hospital. It was determined that lack in communication and coordination among staff members led to inadequate patient teaching, therefore an educational tool that is kept at the bedside may facilitate accountability and smoother transition to home.

The aim of the project is to improve the education of patients with tracheostomies and laryngectomies, and enhance staff communication and coordination by December 2014.

Analysis methods used included Failure Mode Effects Analysis (FMEA), fishbone diagram, process map, and SWOT analysis. The social learning theory is the framework chosen for …

Cochlear Development And Auditory Function In The Absence Of Thyroid Hormone Transporters Mct8 And Oatp1c1, Richard Sinn

All Graduate Theses, Dissertations, and Other Capstone Projects

Thyroid hormone (TH) is essential for the development and maturation of the nervous system. The thyroid gland secretes an active form of TH, triiodothyronine, and a prohormone, thyroxine, into the blood. TH is charged, which prevents it from passively diffusing across cell membranes and thus requires cell membrane transporters to facilitate its movement into and out of cells. However, whether TH transporters are required for TH-mediated developmental events, including the auditory system, is largely unknown.

The purpose of the present study was to investigate two specific TH transporters, monocarboxylate transporter 8 (Mct8) and organic anion transporting polypeptide 1c1 (Oatp1c1), and …

Is The Use Of Intestinal Helminths Safe And Effective In The Treatment Of Allergic Rhinitis?, Tanner Mccalley

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether the use of intestinal helminths is safe and effective in the treatment of allergic rhinitis.

STUDY DESIGN: Review of three English language, blinded randomized controlled trials from 2009, 2010, and 2010.

DATA SOURCE: Randomized, controlled, blinded trials comparing the use of intestinal helminths versus visually matched placebo as a treatment for allergic rhinitis found using PubMed and Ovid databases.

OUTCOMES MEASURED: Several different systems were used to evaluate the symptoms or occurrence of AR. Bager et al.2010 uses symptom scores of AR scale of 0 …

Tp53 As A Biomarker In Head And Neck Squamous Cell Carcinoma, Thomas J. Ow Md

Dissertations and Theses (Open Access)

Currently, there are no molecular biomarkers that guide treatment decisions for patients with head and neck squamous cell carcinoma (HNSCC). Several retrospective studies have evaluated TP53 in HNSCC, and results have suggested that specific mutations are associated with poor outcome. However, there exists heterogeneity among these studies in the site and stage of disease of the patients reviewed, the treatments rendered, and methods of evaluating TP53 mutation. Thus, it remains unclear as to which patients and in which clinical settings TP53 mutation is most useful in predicting treatment failure.

In the current study, we reviewed the records of a cohort …

Heat Shock Protein Induced Protection Against Cisplatin-Induced Hair Cell Death, Tiffany Gray Baker

MUSC Theses and Dissertations

Cisplatin is a highly successful and widely used chemotherapy for the treatment of various solid malignancies in both adult and pediatric patients. Side effects of cisplatin include nephrotoxicity and ototoxicity. Cisplatin's ototoxic effect results in part from damage to and death of cochlear hair cells. Mechanisms underlying cisplatin-induced hair cell death are poorly understood and have been attributed to DNA damage, oxidative stress, and inflammation. This study was designed to determine the role of p53 in cisplatin-induced hair cell death and to investigate heat shock proteins (HSPs) as potential protectants against cisplatin-induced hair cell death using adult mouse utricle as …

Hearing Screening Of Infants Using Evoked Otoacoustic Emissions : The Effect Of External And Middle Ear Conditions, P. K. Vanaja P. K. Krishna Poduval

Student Works (2000-2009)

The aim of the study was to determine if Transient Evoked Otoacoustic Emissions (TEOAEs) can be used as a method of Screening for hearing impairment and to study the effects of External and Middle ear conditions on the outcome of TEOAEs. TEOAE and Tympanometry tests were performed on 193 infants (386 ears). External and Middle ear abnormalities were evaluated by ear examinations and Tympanometry, and assigned to two groups based on the tympanogram results. Group A had normal external and middle ear with 'Type A' Tympanograms and group B with external and/ middle ear abnormalities and abnormal tympanograms other than …

Identification, Localization, And Characterization Of Sodium/Hydrogen Exchanger Isoforms 1 And 3 In The Gerbil Cochlea, Brian R. Bond

MUSC Theses and Dissertations

Mongolian gerbils were used in an investigation into the expression of cochlear sodium/hydrogen (NHE) exchanger isoforms 1,2,3 and 4. NHE 1-4 gene products were identified in the gerbil inner ear by reverse-transcription polymerase chain reaction (RT-PCR). The distribution of NHE-1 and 3 subsequently was mapped in the adult gerbil inner ear using isoform-specific polyclonal antibodies generated against rat antigens. Changes in the cellular expression level of NHE-1 protein in response to treatment with dexamethasone or NH4 CI-induced acidification were then assessed by semiquantitative immunohistochemical analysis. Cochlear cDNA was amplified by the polymerase chain reaction (PCR) using NHE isoform-specific primers based …

The Effect Of Masking On The Acoustic Reflex Threshold, Nancy E. Aldrich

Loma Linda University Electronic Theses, Dissertations & Projects

This study investigated the effect of masking noise on the threshold for stapedial reflex. It has been shown that masking which shifts the hearing threshold causes a loudness function typical of recruitment. It was hypothesized that the stapedial reflex threshold remains the same in a masked situation as in the unmasked situation . It was suggested that this demonstrates recruitment in that the presence of noise reduces the range between hearing thresholds and stapedial reflex thresholds.

Ten subjects, with no known hearing loss or pathology involving the ear or reflex arc were used in this study. A 1000 Hz tone …

Management Of Chronic Otitis Media, Bruce A. Sanderson

Loma Linda University Electronic Theses, Dissertations & Projects

The author presents a detailed review of the methods used in the management of chronic otitis media. The advances made in the diagnosis and treatment of this condition during the past twenty-five centuries are listed. Medical and surgical procedures to eliminate chronic otitis media are reviewed.

The author presents the results of his research studies which have helped to demonstrate a more effective way of preventing recurrent infections of the respiratory system and the ears.

A research project using rabbits has shown that bioflavonoids, Heparin, and rage prevent the inflammatory reaction incidental to the Schwartzman's phenomenon, whereas chilling the rabbit …

Stapes Ankylosis And Its Mobilization, Emery I. Pick

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included - Preface Included Here]

Otosclerosis is a frequent affliction resulting in progressive hearing loss. With the advance of ear surgery during the past 25 years various procedures have been proposed for the correction of this condition. Among their number surgical mobilization of the stapes has assumed considerable importance. In this paper, which is presented as a thesis to fulfill the requirements for the degree of Master of Science, the operation will be discussed on the basis of the literature and the author's own experiences with the procedure.

A Statistical Review Of 436 Submucous Resections With Post-Operative Results Of 338 Cases, D. Wilson Hales

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]