Otolaryngology Commons^™

Congenital Pulmonary Airway Malformation (Cpam): An Interesting Ent Consultation., James Ding, Lauren E Melley, Alexander Manteghi

Otolaryngology (ENT) Resident Research

A 13-month-old boy was referred to the emergency department from the pediatrician’s office for increased shortness of breath. A 2-view chest X-ray was ordered revealing right hemithorax hyperlucency, minimal lung markings, and leftward mediastinal shift.

A Genome-Wide Association Study Identifies Two Novel Susceptible Regions For Squamous Cell Carcinoma Of The Head And Neck, Sanjay Shete, Hongliang Liu, Jian Wang, Robert Yu, Erich M Sturgis, Guojun Li, Kristina R Dahlstrom, Zhensheng Liu, Christopher I Amos, Qingyi Wei

Faculty, Staff and Students Publications

To identify genetic variants for risk of squamous cell carcinoma of the head and neck (SCCHN), we conducted a two-phase genome-wide association study consisting of 7,858,089 SNPs in 2,171 cases and 4,493 controls of non-Hispanic white, of which 434,839 typed and 7,423,250 imputed SNPs as the discovery. SNPs with P <1×10–3 were further validated in the OncoArray study of oral and pharynx cancer (5,205 cases and 3,232 controls of European ancestry) from dbGaP. Meta-analysis of the discovery and replication studies identified one novel locus 6p22.1 (P = 2.96×10–9 for the leading rs259919) and two cancer susceptibility loci 6p21.32 (rs3135001, HLA-DQB1) and 6p21.33 (rs1265081, CCHCR1) associated with SCCHN risk. Further stratification by tumor site revealed four known cancer loci (5p15.33, 6p21.32, 6p21.33, and 2p23.1) associated with oral cavity cancer risk and oropharyngeal cancer risk, respectively. In addition, one novel locus 18q22.2 (P = 2.54×10–9 for the leading SNP rs142021700) was identified for hypo-pharynx and larynx cancer risk. For SNPs in those reported or novel loci, we also performed functional annotations by bioinformatics prediction and eQTL analysis. Collectively, our identification of four reported loci (2p23.1, 5p15.33, 6p21.32, and 6p21.33) and two novel loci (6p22.1 and 18q22.2) for SCCHN risk highlight the importance of HLA loci for oropharyngeal cancer risk, suggesting that immunologic mechanisms are implicated in the etiology of this subset of SCCHN.

Nasal Bone Fractures: Differences Amongst Sub-Specialty Consultants, Jason E. Cohn, Sammy Othman, Michael Toscano, Tom Shokri, Jason D Bloom, Seth Zwillenberg

Otolaryngology (ENT) Resident Research

BACKGROUND: Nasal fractures constitute the largest proportion of facial trauma each year, however, there is no consensus management. In this study, we investingated the role of the consultant and the functional and aesthetic outcomes of procedures performed to address nasal bone fractures.

METHODS: A retrospective chart review of patients who sustained nasal bone fractures was conducted from 8/1/14 through 1/23/18. Categorical variables were analyzed using chi-squared testing and Fisher's exact test, where appropriate, while continuous variables were compared using Mann-Whitney U testing.

RESULTS: During the study period, 136 patients met inclusion criteria for full analysis. The mean age of this …

Novel Application Of Vinylpolysiloxane Hearing Aid Impression Mold As Patient-Specific Bolus For Head And Neck Cancer Radiotherapy., Anne Elizabeth Gunter, John Burgoyne, Min Park, Namou Kim, Daliang Cao, Vivek Mehta

Articles, Abstracts, and Reports

Hearing aid impression material composed of vinylpolysiloxane is an ideal bolus material which may be used to aid in delivery of adjuvant radiation to complex surgical defects of the head and neck. It is affordable, easily accessed, and efficient.

Sleep Patterns And Problems Among Children With 22q11 Deletion Syndrome., Jill M. Arganbright, Meghan Tracy, Susan Starling Hughes, David G. Ingram Md

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: To delineate sleep habits and problems in children with 22q11.2 deletion syndrome (22q11DS).

METHODS: Thirty children, age 1-15 (mean 6.8) years, participated in the study, which was an internet-based anonymous survey of parents of children with 22q11DS administered via the 22q11.2 Foundation. The main outcome was the Childhood Sleep Habits Questionnaire (CSHQ).

RESULTS: Scores on the CSHQ demonstrated clinically significant sleep problems in 29 of the 30 children. When compared with previously reported normative values for typically developing children of the same age, children with 22q11DS had significantly greater sleep problems. Only 30% of children had previously undergone sleep …

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 …

Covid-19: Implications, Reactions And Future Directions, Rahim Dhanani, Mohammad Wasif, Hamdan Ahmed Pasha,, Muntazir Hussain, Shayan Khalid, Abdul Basit Shah Vardag, Khadija Mahmood, Raza Hussain

Section of Otolaryngology, Head & Neck Surgery

Humanity has faced several foes over the centuries, a formidable one amongst them is the current pandemic of COVID-19. The symptoms of COVID-19 are more or less related to the nose and throat. Therefore, patients more often present to Ear Nose Throat (ENT) clinics with symptoms including cough, sore throat, fever and shortness of breath. In the management of head and neck pathologies, as the airway is a direct source of infection, the impact of COVID-19 holds special significance. This review has attempted to explain the various aspects of the disease itself, its diagnosis, the use of personal protective equipment …

Non-Recurrent Laryngeal Nerve: A Case Report And Review Of Literature, Muhammad Hassan Danish, Rahim Dhanani, Huzaifa Moiz, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Right recurrent laryngeal nerve can take a "Non-Recurrent" course and can present as a Non Recurrent Laryngeal nerve which is a rare entity. Such anomalies can lead to difficulty in locating the laryngeal nerve during thyroid surgeries and there are higher chances of it being injured. Therefore, surgeons should be mindful of this entity. We report the case of a 53-year-old lady who underwent thyroid surgery and a right Non Recurrent Laryngeal Nerve was identified intra-operatively.

To Balloon Or Not To Balloon, The Current State Of Management Of Eustachian Tube Dysfunction., David J. Lafferty, Brian J Mckinnon

Otolaryngology (ENT) Resident Research

While otologic complaints are a common reason for patients to present to an otolaryngologist, Eustachian tube dysfunction (ETD) remains a poorly understood disease whose management is unclear. Among the general population in the United States, ETD has a prevalence of 4.6% among adults and 6.1% among children. Eustachian tube dysfunction is not just a common diagnosis for otolaryngologists, ETD accounted for 2 million visits for patients less than 20 years old to primary care providers and over 2 million visits for patients older than 20 years old between 2005 and 2012. Despite the commonality of ETD, opinions differ wildly among …

Audiologic Clinical Practice Patterns: Infant Assessment, Ursula M. Findlen, Nicole D. Schuller

Journal of Early Hearing Detection and Intervention

The purpose of the present study was to report the current clinical practice patterns for assessment of infants after a referred newborn hearing screening within the context of available guidelines and to examine how the advent of newer stimuli, technology, and/or instrumentation has changed clinical practice patterns for audiologic infant assessment. A mixed-method survey that included both quantitative and qualitative questions was disseminated to pediatric audiologists in 2017. Quantitative data were analyzed via descriptive statistics while qualitative questions were analyzed via content analysis and combined with associated quantitative data. Lastly, infant assessment test battery categorization was completed to ascertain the …

Neonatal Abstinence Syndrome And Infant Hearing Assessment: A Kids’ Inpatient Database Review, Liza Creel, Adam Van Horn, Alex Hines, Matthew L. Bush

Journal of Early Hearing Detection and Intervention

Objective: Neonatal abstinence syndrome (NAS) has become an epidemic. This study assesses documented rates of failed newborn hearing screening (NBHS) or hearing loss diagnosis (HL) in NAS infants, and sociodemographic factors associated with abnormal inpatient hearing results.

Methods: The 2016 HCUP/KID national database was used to identify a weighted sample of infants with failed NBHS/HL during birth hospitalization. Independent variables included diagnoses of NAS/in-utero opioid exposure, HL risk factor presence and sociodemographic data. Univariate analyses and multivariate logistic regression were used to determine associations between NAS and abnormal hearing assessment.

Results:NAS infants had lower odds ratio (OR) of documented …

A Comprehensive Examination Of The Immediate Recovery Of Children Following Tonsillectomy And Adenoidectomy, Bryan K. Lao, Zeev N. Kain, Dina Khoury, Brooke N. Jenkins, Jeremy Prager, Robert S. Stevenson, Brenda Golianu, Jeannie Zuk, Jeffrey I. Gold, Qiu Zhong, Michelle A. Fortier

Psychology Faculty Articles and Research

Objectives

Using multiple well-validated measures and a large sample size, the goal of this paper was to describe the immediate clinical and behavioral recovery of children following tonsillectomy with or without an adenoidectomy (T&A) during the first two weeks following surgery.

Study design

Observational, longitudinal study.

Setting

Four major pediatric hospitals in the U.S. consisting of Children's Hospital of Orange County, Children's Hospital of Los Angeles, Lucile Packard Children's Hospital, and Children's Hospital Colorado.

Subjects

and Methods: Participants included 827 patients between 2 and 15 years of age who underwent tonsillectomy with or without adenoidectomy surgery. Baseline and demographic …

Otosclerosis: Experience With Stapes Surgery, Muhammad Shaheryar Ahmed Rajput, Asif Ali Arain, Arsalan A. Rajput, Mohammad Adeel, Anwar Suhail, Mohammad Sohail Awan

Section of Ophthalmology

Introduction: Otosclerosis is a disorder in which the footplate of the stapes is replaced by an abnormal bone, thereby affecting sound transmission to the inner ear at the level of the oval window. The solution to this condition is to reestablish this mechanism back to normal via the ossicular chain to the inner ear. The aim of stapes surgery is to improve the hearing level to thresholds appropriate enough to obviate the need for hearing aid. The hearing improvement achieved after surgery often lasts for many years. The purpose of the current study was to review our experience and find …

Surgical Management And Outcome Of Newly Diagnosed Glioblastoma Without Contrast Enhancement (Low-Grade Appearance): A Report Of The Rano Resect Group, Ameya A Jategaonkar, Vivian F Kaul, Eric Lee, Eric M Genden

Faculty, Staff and Student Publications

The palatomaxillary structure plays critical roles in both form and function of the midface. Surgical defects of the palate and maxilla can be associated with significant morbidity and deformity. Various defect classification systems have been used to assist in reconstruction and rehabilitation. Reconstructive options include prosthetic rehabilitation, local flaps, and free tissue transfer. Here, we review the functional and surgical anatomy of the palatomaxillary complex, defect classification systems, and provide an overview of reconstructive options.

Organ Preservation For Advanced Laryngeal Cancer: Experience With Concurrent Chemoradiation Therapy, Asif Ali Arain, Muhammad Shaheryar Ahmed Rajput, Shabbir Akhtar, Arsalan A. Rajput, Mohammad Adeel, Ahmad Hatem, Ahmed Nadeem Abbasi

Section of Otolaryngology, Head & Neck Surgery

Introduction: The larynx is a part of the upper respiratory tract that performs many essential functions including breathing, speaking, and swallowing. For this reason, the quality of life is significantly affected by laryngeal cancer and its treatment. Therefore, the focus of management for the last few decades has been on preserving the function of a larynx without compromising survival. This study was done with the purpose of reviewing our experience of organ preservation approach with concurrent chemoradiation therapy (CCRT) for locally advanced cancers of larynx.
Methods: A retrospective chart review was carried out for the data of pathology reports and …

Neurochemical Characterization Of Brainstem Pro-Opiomelanocortin Cells, Teodora Georgescu, David Lyons, Barbora Doslikova, Ana Paula Garcia, Oliver Marston, Luke K Burke, Raffaella Chianese, Brian Y H Lam, Giles S H Yeo, Justin J Rochford, Alastair S Garfield, Lora K Heisler

Faculty, Staff and Student Publications

Genetic research has revealed pro-opiomelanocortin (POMC) to be a fundamental regulator of energy balance and body weight in mammals. Within the brain, POMC is primarily expressed in the arcuate nucleus of the hypothalamus (ARC), while a smaller population exists in the brainstem nucleus of the solitary tract (POMCNTS). We performed a neurochemical characterization of this understudied population of POMC cells using transgenic mice expressing green fluorescent protein (eGFP) under the control of a POMC promoter/enhancer (PomceGFP). Expression of endogenous Pomc mRNA in the nucleus of the solitary tract (NTS) PomceGFP cells was confirmed using fluorescence-activating cell sorting (FACS) followed by …

Effect Of Montelukast On The Symptom Severity Score Of Allergic Rhinitis, Muhammad Shaheryar Ahmed Rajput, Asif Ali Arain, Arsalan A. Rajput, Mohammad Adeel, Shehzad Ghaffar, Anwar Suhail

Section of Ophthalmology

Introduction: Rhinitis is a common respiratory disorder that can be broadly defined as an inflammation of nasal mucosa. Allergic rhinitis is the most common form of chronic rhinitis characterized by one or more symptoms including sneezing, nasal itching, nasal congestion, postnasal drip, and rhinorrhea. Montelukast is an antagonist to the leukotriene receptor. It is non-sedating, dosed once daily, and has a safety profile similar in adults and children, with approval down to six months of age. The purpose of the study was to see the improvement in the severity of symptoms of the patients with allergic rhinitis treated with montelukast. …

Improving Hearing Screenings With Tele-Otology, Ryan J. Miller, Joshua George-Lopez, Robert S. Hong Md, Phd

Medical Student Research Symposium

Introduction: The Lions Hearing Center of Michigan (LHC-MI) is an assistance program in Detroit that provides hearing aids to individuals in need. LHC-MI has provided thousands of hearing aids, but such efforts have been costly, requiring patients to make multiple appointments at multiple locations. To streamline this process, the LHC-MI is piloting a new program, titled “Hear Now! Detroit!”, that uses telemedicine to reach patients at community sites.

Purpose: To evaluate the feasibility of a hearing screening program that uses telemedicine to reduce the number of visits required to acquire hearing aids.

Methods: Teams of community volunteers were deployed to …

Ewing Sarcoma Of Larynx: A Rare Case In A 5-Year-Old Boy, Hamdan Ahmed Pasha, Shayan Khalid, Muhammad Wasif, Moghira Siddiqui, Nasir Ud Din

Section of Otolaryngology, Head & Neck Surgery

Ewing Sarcoma of the head and neck region is an extremely rare entity. Treatment usually involves surgery, chemotherapy and radiotherapy in varying sequences. We present the third case to date of Ewing sarcoma of the larynx in a paediatric population. A 5-year-old boy presented to emergency room with acute respiratory distress. Computerized tomography scan showed a mass in the supraglottis; he was intubated using videolaryngoscope and tracheostomy was avoided, mass was removed by cold dissection. Final histopathologic examination revealed Ewing sarcoma. Further workup showed no systemic metastasis. Patient was advised adjuvant therapy which the family refused. Currently he is doing …

Iatrogenic Trauma Following Percutaneous And Minimally Invasive Surgical Interventions, M Hammad Ather, Tashfeen Ahmad, Shabbir Akhtar, Tabish Chawla, Aneela Darbar, Wardah Rafaqat, Syed Shahabuddin, Noman Shahzad, Shahid Ahmed Sami

Section of Urology

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery. The application of MIS should follow the good medical practice dictum by Hippocrates i.e. "First do no harm". To remain abreast with new procedures, the medical personnel are required to update and enhance their knowledge and skill. To ensure safety, the innovations are rigorously tested and tried. The learning curve of MIS is shortened by simulator training and proctorship. Credentialing processes are in place to enhance safe delivery of care. …