The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol )

Description

The ANNALS publishes original manuscripts of clinical and research importance in otolaryngology-head and neck medicine and surgery, bronchoesophagology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, speech pathology, and related specialties. In this official journal you will find papers of historical interest, computer software reviews and applications in otolaryngology, imaging case studies, clinicopathological studies, book reviews, and letters to the editor. Also published are in-depth studies (supplements). All journal articles and supplements are peer-reviewed.

Impact factor 1.05

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    Impact factor
  • 5-year impact
    1.48
  • Cited half-life
    0.00
  • Immediacy index
    0.08
  • Eigenfactor
    0.01
  • Article influence
    0.48
  • Website
    Annals of Otology, Rhinology & Laryngology website
  • Other titles
    The Annals of otology, rhinology & laryngology, Annals of otology, rhinology and laryngology
  • ISSN
    0003-4894
  • OCLC
    1481398
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publications in this journal

  • The Annals of otology, rhinology, and laryngology 01/2015; 124(1):83.
  • The Annals of otology, rhinology, and laryngology 01/2015; 124(1):83.
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    ABSTRACT: Sublingual immunotherapy (SLIT) has been described as a significant intervention in the treatment of allergic rhinitis (AR). However, factors that may predict treatment outcomes with respect to quality of life (QoL) results and mainly the role of olfactory function are still being underestimated. In this study, we investigated determinants that best predict treatment outcomes for QoL, exploring mainly the role of olfaction. One hundred forty-five patients following SLIT, 45 placebo-controls, and 48 healthy subjects were studied. Olfactory function was objectively evaluated using "Sniffin' Sticks" test pre- and post-cessation of SLIT. Three categories of validated QoL questionnaires were filled out by all subjects: questionnaire specific for olfaction (Questionnaire of Olfactory Deficits), questionnaires for assessing psychology (Beck Depression Inventory, Zung Depression Scale, State & Trait Anxiety Inventory), general Short Form-36 health survey. Statistically significant improvement of olfactory function by 11.1% and of all QoL questionnaires results (all P < .001) was observed on final evaluation. Anosmia, asthma history, and the severity of symptoms-expressed by the Total Symptoms Score-were proven independent determinants of clinically significant improvement in patients' QoL. Several factors were found that may predict QoL outcomes in AR patients following SLIT. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: To identify the utility of peak inspiratory flow (PIF) in the assessment and management of subglottic stenosis through correlation of clinical presentation with PIF. Case report. Review of the clinical course of a 31-year-old woman with the diagnosis of granulomatosis with polyangiitis. Repeated PIF measurements at clinic visits were obtained over a 30-month follow-up. Twenty-seven PIF measurements were obtained at 31 otolaryngology clinic visits. Correlations were identified between low PIF measurements with the clinical symptom shortness of breath (2.04 ± 0.38 L/s, n = 10), clinically recorded stridor at rest (1.64 ± 0.41 L/s, n = 3), and urgent operative intervention (1.60 ± 0.23 L/s, n = 5). Correlations were identified between high PIF measurement with patient report of normal breathing (3.07 ± 0.35 L/s, n = 16) and clinical observation of absence of stridor at rest (2.81 ± 0.32 L/s, n = 23). There was a statistically significant difference in the patient's PIF values with patient-documented shortness of breath vs no shortness of breath (P = .001) and clinician-noted stridor vs no stridor (P = .017). Peak inspiratory flow measurements correlate with degree of airway compromise and are helpful to monitor the degree of airway obstruction and document response to treatment. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: Well-characterized cell lines represent useful scientific tools to study the pathophysiology of human disease. Chronic rhinosinusitis (CRS) is a very common condition, though the number of CRS cell lines is limited, as are data showing how closely they resemble primary cells. Searches for available human cell lines were performed using the American Type Culture Collection (ATCC) and European Collection of Cell Cultures (ECACC). Identified cells were cultured and characterized with tinctorial and immunohistochemical staining and ELISA to assess their response to common, disease-relevant inflammatory stimuli. Carefully phenotyped CRS patients were recruited with informed consent. Primary nasal epithelial cell (PNEC) brushings were harvested, cultured, and compared to the available cell lines. Searches identified 1 relevant CRS sino-nasal cell line, RPMI 2650. Cultured PNECs showed strong expression of epithelial markers while being negative for mesenchymal markers. However, RPMI 2650 cells show an atypical mixed epithelial/mesenchymal phenotype. When stimulated by pro-inflammatory ligands, PNECs responded in a dose-dependent manner, whereas RPMI 2650 cells showed limited response. The number and availability of cell lines to study the pathophysiology of CRS greatly underrepresent the disease burden. Additionally, the sole commercially available cell line appears to have a different phenotype and behavior to primary patient-derived cells. The development of further reproducible cell lines would be beneficial in our understanding of CRS. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: Several techniques are described in the literature for nasal septal perforation repair. Most of these involve interposition grafts in conjunction with local pedicled mucosal flaps. The following article describes our experience using acellular dermis as a bioscaffold to support the regrowth of nasal septal mucosa by secondary intention. Retrospective chart review of all patients who underwent repair of nasal septal perforations by the senior author using acellular dermis placed between the 2 sides of the perforation and covered with silastic splints to allow for mucosalization. Thirteen patients underwent nasal septal perforation repair using this technique. All perforations repaired were under 2 cm in greatest dimension. Two-thirds of patients had complete closure of the perforation upon initial use of bioscaffolding technique. The remaining third achieved near-total closure with bioscaffolding technique and were able to be completely closed with a single additional procedure. Acellular dermis offers an alternative to most currently described complex flaps. The method can be used in patients with defects less than 2 cm, but initial data suggest caution when using in those with wound healing impediments. This technique is also an excellent choice for patients with multiple small septal perforations. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: To evaluate the safety of outpatient airway dilation for adult patients with subglottic or tracheal stenosis. The records of patients treated with airway dilation between October 2003 and September 2013 were reviewed. Outcomes of patients who underwent dilation as inpatients versus outpatients were compared. Emergency room visits, readmissions, and 3 or more primary care physician visits within 30 days postoperatively were specifically evaluated. Postoperative hemorrhage, airway edema, recurrent laryngeal nerve paralysis, reintubation, tracheostomy, tracheal rupture, pneumomediastinum, pneumothorax, acute respiratory distress, or death were also reviewed. One hundred fourteen dilations performed in 53 patients with airway stenosis were included. Outpatient dilation was performed in 93 (82%); 21 (18%) underwent the procedure in the inpatient setting. Complications were low among both inpatient and outpatient groups (10% vs 1%, P = .09). No complications occurred during the overnight stay of the inpatient group. Outpatient airway dilation is a safe and feasible procedure. It can be routinely performed on an ambulatory basis. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: To investigate the clinical features and vestibular symptoms of patients with abnormal ocular vestibular evoked myogenic potentials (oVEMPs) and/or cervical VEMPs (cVEMPs) in the presence of normal caloric responses. Retrospective chart review. Tertiary referral center. One thousand five hundred twenty-one consecutive patients with balance problems who underwent the caloric, cVEMP, and oVEMP tests were included, and patients who showed abnormal oVEMPs and/or cVEMPs in the presence of normal caloric responses were selected. Clinical characteristics, diagnoses, and vestibular symptoms of the patients were analyzed. Of the 1521 patients, 227 (15%) were found to have abnormal oVEMPs and/or cVEMP responses with normal caloric responses. Benign paroxysmal positional vertigo (BBPV), Meniere's disease, and vestibular migraine were the common diagnoses of these patients. Eighty-one patients (36%) could not be diagnosed with a recognizable disease. Multiple episodes of spinning vertigo with a duration of seconds to hours were their most common vestibular symptoms. BPPV, Meniere's disease, and vestibular migraine are the most frequent diagnoses showing abnormal oVEMP and/or cVEMPs without canal paresis. Apart from these clinical entities, a portion of undiagnosed patients with multiple episodes of vertigo might have a disease that involves the otolith organs only. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: To assess the impact of suspension microlaryngoscopy with balloon dilation on voice-related quality of life (V-RQOL) in laryngotracheal stenosis (LTS). Retrospective chart review of LTS patients dilated at a tertiary-care academic hospital from 2010 to 2013. Data were obtained and then analyzed. LTS was stratified by (1) subglottic or tracheal stenosis and (2) multilevel stenosis (MLS; glottic and subglottic/tracheal). Pre- and postoperative V-RQOL and grade, roughness, breathiness, asthenia, strain (GRBAS) scores were compared. The number and frequency of balloon dilation procedures over the lifetime were secondary outcome variables. Thirty-eight patients were identified: 26 subglottic/tracheal and 12 multilevel. Of these, 71.4% required multiple dilations, with greatest dilations/patient for multilevel stenosis (4.8). V-RQOL improved in the 27 patients with completed pre- and postoperative scores from a mean of 70.4 to 80 (P = .025). Pre/postoperative V-RQOLs for tracheal/subglottic (mean, 82.8/93.8) were significantly higher (P = .0001/.0001) than multilevel stenosis (48/55.3). Voice quality-of-life improvement was significant for the subglottic/tracheal cohort (P = .036) but not for the MLS group. GRBAS was performed pre- and postoperatively in 10 patients with improvement in all domains except breathiness. Laryngotracheal stenosis is associated with dysphonia. Patients with glottic involvement have significantly worse voice quality of life than those with tracheal/subglottic stenosis. Endoscopic balloon dilation improves V-RQOL in patients with subglottic/tracheal stenosis. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
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    ABSTRACT: Paralytic lagophthalmos can lead to devastating exposure keratitis. The main surgical intervention consists of upper eyelid loading. However, adjunctive lower eyelid and brow procedures are also available as necessary. We sought to analyze the use of periocular procedures in paralytic lagophthalmos at Johns Hopkins. The method was a retrospective review of patients treated at a single tertiary care center from 2006 to 2012. One hundred one patients met inclusion criteria, and 20 patients were excluded for not meeting the minimum follow-up. Upper eyelid loading was required on 95/101 patients (95%). Adjunctive procedures were necessary in 73% (73/101) of patients. Lower eyelid procedures were used in 47% (47/101) and brow lifts in 47% (47/101). Older patients (>50 years) were more likely to require lower eyelid procedures (P = .04) and more likely to require revision (P = .003). Medial canthopexy and direct brow lift were associated with the need for revision (P = .006, P = .03). Paralytic lagophthalmos management is not one-size-fits-all. Upper eyelid loading is the mainstay of treatment; however, adjunctive procedures to the lower eyelid and brow are indicated in the majority of patients. Our retrospective review has allowed us to continue to refine our strategy for managing these patients. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 12/2014;
  • The Annals of otology, rhinology, and laryngology 12/2014; 123(12):887-8.
  • The Annals of otology, rhinology, and laryngology 12/2014; 123(12):887.
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    ABSTRACT: No consensus exists on appropriate timing for the first tracheostomy tube change. The purpose of this study is to evaluate the safety of early tracheostomy change in the pediatric population. A case series of all children undergoing tracheostomy at a tertiary children's hospital between 2008-2013 was retrospectively reviewed. A total of 151 children undergoing tracheostomy were identified. The average age was 48.1 ± 66 months and median age was 10 months. The initial tracheostomy tube change occurred on postoperative day 3 (POD 3) in 65 children (43.0%) safely without any complications. Early tracheostomy tube change was safely performed in a significant portion of this population. Routine tube change on POD 3 in many children could save resources by reducing the length of ICU and hospital stays. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014;
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    ABSTRACT: The management of sialorrhea can be difficult for both the patient and the clinician. Current management includes behavioral modification, anticholinergics, botulinum injections, and a variety of surgical options, which all have demonstrated some efficacy. As minimally invasive procedures flourish, we explore the feasibility of highly selective transoral submandibular neurectomy (TOSN) for the management of sialorrhea. Ten human cadaver dissections of the floor of mouth were performed bilaterally, for a total of 20 separate cases. An intraoral technique for highly selective, submandibular ganglion neurectomy is demonstrated. A transoral submandibular ganglion neurectomy was performed in 10 cadavers (20 neurectomies) easily and reliably, without injury to the submandibular duct or the main trunk of the lingual nerve. Transoral submandibular neurectomy is an attractive addition to the armamentarium of surgical options for the treatment of medically intractable sialorrhea. Further study in selected patients would need to be performed to demonstrate clinical feasibility. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014;
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    ABSTRACT: A subgroup of oropharyngeal squamous cell carcinoma (OPC) is infected with high-risk human papillomavirus (HPV). The object of this study is to evaluate the efficacy of adjuvant chemotherapy with S-1, an oral 5-fluorouracil prodrug, on survival of patients with OPC according to HPV status. Among OPC patients of stage III or IV who received definitive treatment from 1998 to 2008, 38 who were confirmed tumor-free after primary treatment were analyzed. Before 2003, none of the patients received S-1 adjuvant chemotherapy (S-1(-)-group); however, all patients who were eligible were administered S-1 (S-1(+)-group) after 2003. The expression of thymidylate synthase (TYMS) involved in 5-FU metabolism was also examined in protein and mRNA levels. Although there was a trend to disease-free and overall survival benefit in HPV-negative patients with S-1, it did not achieve statistical significance (P = .082 and P = .065, respectively). For the HPV-positive patients, the survivals were similar with or without S-1 administration. TYMS-expression in HPV-positive OPC tissues was significantly higher than in HPV-negative ones in both protein and mRNA levels (P = .0489 and P = .0446, respectively). The current study provides a rationale to plan a randomized trial to compare the efficacy of S-1 according to the HPV status in OPCs. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014;
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    ABSTRACT: Achieving hemostatic control after intracapsular adenotonsillectomy with minimal cauterization may potentially lead to improved outcomes with respect to return to normal diet, normal activity, and less use of narcotic pain medications. A prospective, nonrandomized, consecutive series of children with obstructive tonsils and adenoids at a tertiary children's hospital was undertaken. One hundred consecutive children (52 boys/48 girls) ages 0-16 (mean = 4.8, SD = 3.7, median = 4.0) years were recruited with complete data available on all 100. Mean total procedure time was 19.8 (SD = 4.3, median = 19.5) minutes, including mean total cauterization time of 155.3 (SD = 59.7 seconds, median = 143.0) (adenoids: mean = 60.9, SD = 31.5, median = 53.0; tonsils: mean = 94.5, SD = 41.9, median = 82.0) minutes. Mean estimated blood loss was 29.4 (SD = 40.9, median = 25.0) ml. There were no major complications (0/100 episodes of bleeding or dehydration after surgery). Mean return to normal diet was 3.4 (SD = 2.2, median = 3.0) days; mean return to normal activity was 2.8 (SD = 2.1, median = 3.0) days, and mean days to no further narcotics was 3.0 (SD = 2.3, median = 2.0) days. Mean days to complete recovery (normal diet, normal activity, and no narcotics) was 4.5 (SD = 2.1, median = 4.0, range: 1-10). Total cautery time was significantly correlated with time to complete recovery (P < .05). Intracapsular microdebrider tonsillectomy with adenoidectomy utilizing QuikClot to enhance the hemostasis results in recovery times better than previously reported for this common operation in children. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014;
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    ABSTRACT: According to the literature, voice rest following phonosurgery, as recommended in clinical practice, varies between 3 and 7 days. However, up until now, no randomized trials have been published comparing voice rest of short versus long duration. This is an ongoing prospective randomized study, comparing strict voice rest of 5 versus 10 days on the voice following phonosurgery. Thirty-one elective patients operated on for benign laryngeal lesions were randomized. They completed pre- and postoperative assessments, including perceptual voice quality (Grade, Roughness, Breathiness, Asthenia, Strain, Instability scale), Voice Handicap Index total score, and voice analysis with both acoustic and aerodynamic measurements. Additional factors such as smoking, vocal abuse, reflux, and preoperative speech therapy were also taken into account. Sixteen patients were randomized to follow 5 days' voice rest and 15 patients were randomized to 10 days' voice rest. Statistical analysis showed no significant differences in pre- or postoperative measurements between the 2 groups. However, multilinear regression analysis for the effect of voice rest duration on postoperative values showed a significant improvement in maximum phonation time (MPT) with 10 days' voice rest. Preliminary results show a benefit of prolonged voice rest (10 days' duration) on MPT. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014;
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    ABSTRACT: Accidental caustic ingestion occurs mainly in the 2- to 3-year-old age group. Up to 33% of patients develop long-term complications that principally involve the gastroesophageal tract, whereas their occurrence at the level of pharyngeal and laryngeal structures is less frequent. When present, strictures are the main disorders that can be observed. In this pathological situation, surgery is the treatment of choice, and several procedures have been described. We report the history of a 3-year-old boy affected by pharyngolaryngeal stenosis due to accidental caustic ingestion. After careful diagnosis, the child underwent surgery by transoral CO2 laser. The patient had immediate improvement and restarted oral feeding 1 day after the surgical procedure. An analysis of diagnosis and treatment of this long-term complication is also presented.
    The Annals of otology, rhinology, and laryngology 11/2014;
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    ABSTRACT: We investigated the additional diagnostic yield of the mutation test and evaluated the frequency of the BRAF mutation in conventional PTC (cPTC) according to ultrasound (US) features and the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on the BRAF(V600E) mutation status. During the study period, 279 patients who underwent FNA with an additional BRAF(V600E) mutation test were diagnosed as cPTC after surgery. We analyzed the association between the mutation and several clinical factors. Of the 279 cPTCs, 250 (89.6%) had the BRAF(V600E) mutation. The BRAF mutation test was helpful in diagnosing an additional 19% (53/279) of cPTCs. The frequency of the BRAF mutation in cPTCs with suspicious US features was higher than that of cPTCs with negative US features regardless of the BSRTC. Suspicious US features may be helpful in deciding whether an additional BRAF(V600E) mutation test should be done in thyroid nodules with indeterminate cytology. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014;