The Laryngoscope (Laryngoscope )

Publisher: American Laryngological, Rhinological, and Otological Society, John Wiley and Sons

Description

For more than 100 years, otolaryngologists, clinicians, and researchers around the world have read The Laryngoscope to keep pace with and learn how to take advantage of the most important advances in the diagnosis and treatment of head and neck disorders. Moreover, the journal is the first choice among otolaryngologists to publish their most important findings and share their own successful techniques with their colleagues.

  • Impact factor
    1.98
  • 5-year impact
    2.27
  • Cited half-life
    9.30
  • Immediacy index
    0.29
  • Eigenfactor
    0.02
  • Article influence
    0.69
  • Website
    Laryngoscope, The website
  • Other titles
    Laryngoscope. Supplement (Online), Laryngoscope (Online), The Laryngoscope
  • ISSN
    1531-4995
  • OCLC
    42657561
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

John Wiley and Sons

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • See Wiley-Blackwell entry for articles after February 2007
    • On personal web site or secure external website at authors institution
    • Deposit in institutional repositories is not allowed
    • JASIST authors may deposit in an institutional repository
    • Non-commercial
    • Pre-print must be accompanied with set phrase (see individual journal copyright transfer agreements)
    • Published source must be acknowledged with set phrase (see individual journal copyright transfer agreements)
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • 'John Wiley and Sons' is an imprint of 'Wiley'
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives/HypothesisTo determine the distribution of the number and types of mutant alleles of SLC26A4 and their correlations with hearing phenotypes in Korean bilateral enlargement of vestibular aqueduct (EVA) patients.Study DesignProspective cohort study.Methods To determine the number and type of mutant alleles, Sanger sequencing of coding region of SLC26A4 was performed for 56 patients with bilateral EVA who were consecutively recruited. Their correlations with hearing phenotypes were analyzed based on 0.5-, 1-, 2-, and 3-kHz air conduction averages of pure-tone audiometry.ResultsMost patients with bilateral EVA (83.9%) carried two mutant alleles of SLC26A4 (M2), and all others (16.1%) had only one detectable mutant allele of SLC26A4 (M1) in the Korean population. There were no cases with zero mutations. p.H723R/p.H723R was the most frequently observed mutant allelic pair (34%), followed by p.H723R/c.919-2A>G (20%). There was no significant difference in hearing threshold, progression, or fluctuation of hearing level between the M1 and M2 groups. However, focusing on the type of mutations exclusively in the M2 group, cases with p.H723R/c.919-2A>G were associated with more frequent progression of hearing loss during the follow-up period. The cases with p.H723R/c.919-2A>G tended to show slightly better hearing than p.H723R homozygotes, although the difference was not statistically significant. There appears to be a different genotype-auditory phenotype correlation among ethnicities.Conclusions Our data suggest that the auditory phenotype of Korean bilateral EVA patients is more strongly correlated with the type rather than the number of mutations in SLC26A4.Level of EvidenceNA Laryngoscope, 2014
    The Laryngoscope 12/2014;
  • The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/HypothesisTo investigate the effect of age at cochlear implant activation on oral narrative ability in children implanted before 2.5 years of age and to examine the role of other variables (gender, parental education level, stimulation modality) in narrative skills.Study designretrospective nonrandomized group studyMethods Thirty children (21 females; 9 males) with congenital, bilateral severe-to-profound sensorineural hearing loss were included in this study. The mean age at cochlear implant activation was 14.7 months (standard deviation [SD] ± 5.3). The Renfrew Bus Story was used to analyze oral narrative skills at mean chronological age of 63 months (SD ± 0.2).ResultsThe total information on the Renfrew Bus Story raw score ranged from 8 to 40, with a mean of 22.7 (SD ± 8.6). Children produced on average 7.5 words in a sentence (SD ± 1.5). The mean score for complexity was 2.2 (SD ± 1.5). Regression analysis revealed a highly significant and negative linear effect of age at cochlear implant activation on all outcomes. The mother's education level had a positive strong effect on sentence length but a weak effect on total information and complexity. The paternal education score had a weak influence on the sentence length. Gender, age at diagnosis, and stimulation modality were not correlated with the narrative outcomes.Conclusions Early implanted children can develop narrative skills close to normal hearing children. The sociocultural context, expressed by maternal and paternal educational level, are positively related to the development of oral narrative.Levels of Evidence4. Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objective Tracheostomy tube displacement may occur at any time in the course of patient management. Although an infrequent occurrence, such displacement is potentially serious. The purpose of this study was to evaluate the advantages and complications of the stay suture technique in tracheostomy.Study DesignProspective cohort study.Methods The SST involves the placement of sutures between the anterior tracheal wall and the skin in order to hasten the formation of a mature stoma. The study patients were divided into two groups. One group underwent tracheostomy with the SST (n =104), and the other group was treated with a conventional tracheostomy (n = 101). The postoperative complications for each group were then reviewed.ResultsThe most common indication for tracheostomy was prolonged endotracheal intubation (79.3%), and the most common complication in each group was postoperative stoma infection. Unexpected decannulation occurred in three patients from the conventional tracheostomy group, causing death of the patients. However, the SST group did not show any occurrence of unexpected decannulation.Conclusions Unexpected decannulation was a fatal complication. Because this complication was not observed in any patients who underwent the SST, our study recommends use of this method as a countermeasure for unexpected decannulation.Level of Evidence4. Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/HypothesisEx vivo models are routinely used to investigate the barrier function of the vocal fold epithelium. However, there are limited reports on assays that can be used to investigate the effect of clinically relevant challenges on vocal fold epithelial tissue viability. Our objective was to determine the utility of two assays routinely used in cell culture—a cellular metabolic activity assay and a cell membrane integrity assay—to investigate the viability of ex vivo porcine vocal fold epithelium.Study DesignProspective, ex vivo animal study.Methods Porcine vocal folds were exposed to acrolein, hydrochloric acid, or hydrogen peroxide challenge. An untreated, sham challenge was included as a control. Assays including metabolic activity, cell membrane integrity, and histology were used to determine whether challenges reduced epithelial viability as compared to sham.ResultsCell membrane integrity and metabolic activity assays detected reductions in viability following hydrochloric acid and hydrogen peroxide challenges but not acrolein challenge as compared to sham. No challenge produced significant changes in epithelial appearance as evidenced by light microscopy.Conclusions Metabolic activity and cell membrane integrity assays are valuable tools that can be used to evaluate the viability of ex vivo vocal fold epithelial tissue following clinically relevant challenges. As viability is reduced, the ability of epithelial tissue to maintain its barrier function is compromised. Accurate assessment of viability may provide us clues into understanding mechanisms underlying vocal fold epithelial injury and disease.Level of EvidenceNA Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/HypothesisFollowing endoscopic ventral skull base surgery (EVSBS), it is common practice to obtain early postoperative imaging. The role of postoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans in these patients remains unclear. This study aims to determine the clinical utility of early postoperative imaging after EVSBS for detecting postoperative complications.MethodsA retrospective chart analysis of 224 cases of purely EVSBS between 2009 and 2014 was performed. Data were collected regarding postoperative CT and MRI as well as hospital course. Interpretations of postoperative imaging were separated into two groups: 1) using radiologist's interpretation alone and 2) using surgeon knowledge of the case in tandem with imaging.ResultsPostoperative imaging was obtained in 213 cases (204 CT, 170 MRI) within 48 hours of surgery. Interpretation by a radiologist yielded a significantly higher rate of false positives (FP) on CT (15/204) and MRI (8/170) when compared to surgeon interpretation (CT FP =1/204 and MRI FP = 1/170) (P = 0.0004 and P = 0.0366, respectively), as well as a significantly lower rate of true negatives (TN) on CT (172/204 vs. 186/204) (P = 0.0497), whereas MRI data had a similar rate of TN (150/170 vs. 157/170; P = 0.2717). The rate of postoperative complications was 7.14% (16/224). In all cases of postoperative complications that required intervention, patients exhibited clinical symptoms.Conclusion Based on our findings, the benefit of early postoperative imaging to detect complications may be limited. When positive imaging findings were encountered, their value were somewhat negated by preceding clinical symptoms.Level of Evidence4. Laryngoscope, 2014
    The Laryngoscope 12/2014;
  • Che‐Ming Wu, Li‐Ang Lee, Wei‐Chieh Chao, Yung‐Ting Tsou, Yen‐An Chen
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    ABSTRACT: Objectives1) To investigate different aspects of paragraph reading in Mandarin-speaking students with cochlear implants (CIs) and the factors associated with unfavorable outcomes, and 2) to understand the replaceability of a paragraph-reading test with a sentence-reading test.Study DesignCross-sectional, case-controlled study.Methods Fifty-three students with CIs (aged 11.0 ± 1.4 years) and 53 grade- and gender-matched children with normal hearing (NH) participated in the study. A paragraph-reading comprehension test was conducted. Sentence and word reading, speech perception, language skills, and child/family characteristics were examined. An unfavorable paragraph-reading outcome was defined as a score lower than one standard deviation below the NH mean.ResultsThe CI subjects had significantly worse paragraph-reading comprehension than did the NH controls (P = 0.017, d = 0.54). Their performance in grades 5 to 6 was not significantly higher than of those with NH in grades 2 to 4. The CI children's abilities to understand semantics (P = 0.012) and syntax (P = 0.020) significantly fell behind the NH controls in grades 2 to 4, and the lag continued in grades 5 to 6 (P = 0.039, P = 0.002, respectively). Grade and sentence reading were independently associated with unfavorable paragraph-reading outcomes (R2 = 0.453). The optimal sensitivity and specificity of the sentence-reading test in identifying unfavorable paragraph-reading outcomes were 90.9% and 90.0%, respectively (area under the curve = 0.923).Conclusions Specialists should pay attention to CI students' development of different reading skills. Paragraph-reading tests enable a multidimensional evaluation of reading competence. Use of sentence-reading tests is suggested only as a tool for preliminary screening for basic reading capacities.Level of Evidence3b. Laryngoscope, 2014
    The Laryngoscope 12/2014;
  • The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/HypothesisThe aim of this study was to identify any possible predictive factors of lateral neck recurrence in patients with papillary thyroid carcinoma with no ultrasonographic and/or cytological evidence of lymph node metastasis at time of diagnosis. The influence of lateral neck recurrence on survival was also investigated.Study DesignObservational retrospective study.Methods Retrospective review of clinical records of 610 patients surgically treated for papillary thyroid carcinoma with clinically negative lymph nodes at the Otolaryngology Unit of the Arcispedale Santa Maria Nuova–IRCCS, Reggio Emilia, Italy, from January 1984 to December 2008.ResultsLateral neck recurrences were ipsilateral to the primary tumor in all cases and were associated with the occurrence of more aggressive histological variants and central neck metastasis. Lateral neck recurrences were more frequently observed in patients with distant metastases and were associated with a reduced disease-specific survival.Conclusion Lateral neck compartment ipsilateral to the tumor was the most common site of recurrence, with about half of cases appearing in the first 28 months of follow-up. In patients with papillary thyroid carcinoma, detection of lateral neck metastases prior to first surgery is crucial to surgical planning. Aggressive histological variants and postsurgical evidence of lymph node metastasis from papillary thyroid carcinoma in central neck compartment are associated with a higher risk of lateral neck recurrence. In these patients, a closer postsurgical ultrasound surveillance of the lateral neck compartments seems worthwhile.Level of Evidence4. Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/HypothesisThe objective of this study was to compare the viability of cartilage grafts embedded in platelet-rich fibrin matrix (PRFM) wrapped with no material (bare diced cartilage grafts), oxidized methylcellulose (Surgicel), or acellular dermal tissue (AlloDerm).Study DesignExperimental study.Methods In this study, six New Zealand rabbits were used. Cartilage grafts including perichondrium were excised from each ear and diced into 2-mm-by 2-mm pieces. There were four comparison groups: 1) group A, diced cartilage (not wrapped with any material); 2) group B, diced cartilage wrapped with AlloDerm; 3) group C, diced cartilage grafts wrapped with Surgicel; and 4) group D, diced cartilage wrapped with PRFM. Four cartilage grafts were implanted under the skin at the back of each rabbit. All rabbits were sacrificed at the end of 10 weeks. The cartilages were stained with hematoxylin-eosin, Masson's Trichrome, and Orcein. After that, they were evaluated for the viability of chondrocytes, collagen content, fibrillar structure of matrix, and changes in peripheral tissues.ResultsWhen the viability of chondrocytes, the content of fiber in matrix, and changes in peripheral tissues were compared, the cartilage embedded in the PRFM group was statistically significantly higher than in the other groups (P < 0.05).Conclusion We concluded that PRFM has significant advantages in ensuring the chondrocyte viability of diced cartilage grafts. It is also biocompatible, with relatively lesser inflammation and fibrosis.Level of EvidenceN/A. Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objective To evaluate the mechanism and level of upper airway obstruction in obstructive sleep apnea (OSA) patients during natural sleep, together with synchronous electroencephalogram and respiratory events registration at 3-Tesla magnetic resonance imaging (MRI) platform with high spatial and temporal resolution.Study DesignA prospective cohort study of 20 randomly selected OSA patients.Methods Fifteen of 20 patients were able to complete spontaneous sleep during MRI. While asleep, dynamic MR images of pharynx were obtained in the midline sagittal view. During the scan, nasal and oral airflow, thoracoabdominal wall effort, and electroencephalogram were synchronously recorded. The physiologic data were retrospectively scored to identify periods of apneas and synchronized with dynamic MR images.ResultsIn all 15 patients, the site of complete airway obstruction occurred at the retropalatal space. We noticed different positions of the soft palate during apneic events. In seven of 15 patients (47%), the soft palate was attached to the tongue base and moved backward, compressing the airway. In five of 15 patients (33%), the soft palate was detached from the tongue base and solely moved backward, compressing the airway. In three patients (20%), we recorded both mechanisms of complete airway obstruction. In cases with attached soft palate to the tongue base, we noticed significant narrowing of the retrolingual space during apneic events.Conclusion We describe a novel mechanism of obstruction dependent on the position of soft palate. This mechanism might play an important role in selecting candidates for surgery or treatment with hypoglossal nerve stimulation.Level of Evidence2b. Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/HypothesisParotid gland calcifications can be incidental findings on computed tomography (CT) and have been reported to be associated with chronic inflammatory conditions. Associations between parotid gland calcification and other common medical conditions have not been reported.Methods Following institutional review board approval, 1,571 patients who underwent noncontrast head CT with 1.25-mm slice thickness on a 64-detector row CT between January 2011 and July 2011 were retrospectively reviewed for parotid gland calcifications. Medical records were reviewed for chronic kidney disease, alcoholism, autoimmune conditions, endocrine disorders, elevated alkaline phosphatase, and HIV (human immunodeficiency virus) status. Statistical analyses were performed using Fisher's exact test and multiple logistic regression.ResultsSixty-three of 1,571 (4%) patients had parotid gland calcifications. Significant associations were observed between parotid gland calcifications and HIV infection (P = 0.002), chronic kidney disease (P < 0.0001), alcoholism (P < 0.0001), elevated alkaline phosphatase (P = 0.003), and autoimmune disease (P = 0.02).Conclusion Parotid gland calcifications were associated with HIV, alcoholism, chronic kidney disease, autoimmune disease, and elevated alkaline phosphatase.Level of Evidence4. Laryngoscope, 2014
    The Laryngoscope 12/2014;
  • Kenneth H. Lee, Mark E. Warchol, Karen S. Pawlowski, Dongmei Shao, Elena Koulich, Constance Q. Zhou, James Lee, Mark J. Henkemeyer
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    ABSTRACT: Objectives/HypothesisDetermine if the neuronal pathfinding cues resulting from Eph/ephrin interaction in the inner ear play a role in establishing the tonotopic innervation of the cochlea.Study DesignProtein expression of Ephs and ephrins was evaluated in the inner ear of mice and chicks. Subsequently, in vitro, in vivo, and functional electrophysiologic studies were performed to indicate that Ephs and ephrins play a role regulating the normal innervation patterns in the mouse inner ear.Methods Eph and ephrin protein expression was identified in the inner ear by western blotting and localized by fluorescence immunohistochemistry and X-gal staining. Eph/ephrin effects on neurite outgrowth was assessed via co-culture with EphB2 expressing COS-1 cells. Anatomic effects of disrupting Eph/ephrin signaling on cochlear innervation were determined with lipophilic dye tracing and functional effects with auditory brainstem response (ABR).ResultsExpression of several different Ephs and ephrins were found in the inner ear of chicks and mice. The changes in ephrin-A2 immunoreactivity after gentamicin ototoxicity coincide with the spatio-temporal pattern of hair cell loss and regeneration in the chick cochlea. EphB2 inhibited outgrowth of spiral ganglion cell neurites. Knockout mice with null function of EphB1, EphB2, and EphB3 demonstrated abnormal inner ear innervation and elevated ABR thresholds, indicating hearing loss.Conclusions Ephrin-A2 may be involved in the guidance of ganglion cells to hair cells in the chick. Disruption of Eph/ephrin signaling results in abnormal innervation and hearing loss, suggesting that these proteins play a role in establishing normal innervation patterns in the mouse cochlea.Level of EvidenceNA Laryngoscope, 2014
    The Laryngoscope 12/2014;
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    ABSTRACT: Objectives/Hypothesis This study aimed to evaluate the changes in electrocochleography (EcohG) measurements after intratympanic (IT) dexamethasone therapy and to correlate them with the long-term effects on the control of vertigo. Study Design Prospective outcomes research. Methods This study included 62 patients with unilateral Ménière's Disease (MD) refractory to medical therapy for at least 1 year. Each patient was treated with a fixed protocol of three consecutive weekly injections of a commercial 4 mg/mL dexamethasone preparation. The 1995 American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) criteria for reporting treatment outcomes for MD were used. Electrocochleography (EcohG) measurements were performed 1 month before and 1 and 12 months after IT steroid therapy. Caloric test and vestibular evoked myogenic potential (VEMPs) were performed before the IT treatment. The summating potential/action potential (SP/AP) ratio was measured before and after the IT treatment. A Kaplan-Meier analysis was used to evaluate the control of vertigo over a 2-year period. Results Complete vertigo control (class A) was achieved in 26 patients (41.9%) at the 12-month follow-up and in 12 patients (19.3%) at the 24-month follow-up. A significant reduction (P < 0.01) in the SP/AP ratio after the IT steroid treatment was observed in the first-month determination, but no significant differences were found when the initial and 12-month determination were compared. Conclusions IT dexamethasone provides an alternative treatment for patients with Ménière's Disease. A transitory reduction of the endolymphatic hydrops is detected by the EcohG 1 month after treatment. The hydrops levels returned to their initial values in the 1-year EcohG follow-up. Level of Evidence 2b. Laryngoscope, 2014
    The Laryngoscope 11/2014;
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    ABSTRACT: Obstructive sleep apnea (OSA) and balance disorders are common chronic diseases seen in the general population. The aim of this study was to evaluate vestibular functions in individuals with OSA. STUDY DESIGN: Cross-sectional clinical study. METHODS: Patients who were referred to the sleep clinic in our hospital were classified into two groups according to a polysomnographic test: a moderate-to-severe OSA group and a mild OSA group. A vestibular system assessment of all patients was performed subjectively with the Dizziness Handicap Inventory (DHI) survey and objectively with videonystagmography. RESULTS: The current investigation produced four major findings: 1) Apnea-hypopnea index was significantly correlated with age and body mass index, whereas it was not correlated with Epworth Sleepiness Scale scores. 2) There was a significant difference in study groups in terms DHI scores, particularly in the physical subgroup. Moderate-to-severe OSA patients had higher scores in the physical subgroup of DHI. 3) Nystagmus and canal paresis rates were significantly higher in the moderate-to-severe OSA group when compared to the mild OSA group. 4) Results of the Romberg test, tandem Romberg test, cerebellar examinations, and positional tests were normal in both. CONCLUSIONS: Abnormal vestibular responses are common in individuals suffering from severe OSA, and dizziness has negative effects on the quality of life in these individuals.
    The Laryngoscope 11/2014;
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    ABSTRACT: A previously healthy 10-year-old female reported a 1-month history of wheezing and hemoptysis. Initial evaluation and treatment were focused on refractory reactive airway disease and infectious etiologies prompted by her recent travels in Africa. Worsening respiratory distress prompted emergent evaluation with imaging and endoscopy. Bronchoscopy diagnosed a distal tracheal tumor; pathology of this tumor was benign fibrous histiocytoma. Successful management of this condition included imaging, rigid bronchoscopy with biopsy, and tracheal resection to surgically excise the lesion. Although rare, tracheal tumors should be considered when presentation of asthma is atypical and nonresponsive to medical interventions. Laryngoscope, 2014
    The Laryngoscope 11/2014;
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    ABSTRACT: Objectives/HypothesisTo determine if training with a chicken wing model improves performance of endoscopic endonasal surgery (EES) with microvascular dissection.Study DesignRandomized experimental study.MethodsA single-blinded randomized clinical trial of trainees with various levels of endoscopic experience was conducted to determine if prior training on a nonhuman model augments endoscopic skill and efficiency in a surrogate model for live surgery. Medical students, residents, and fellows were randomized to two groups: a control group that performed an endoscopic transantral internal maxillary artery dissection on a silicone-injected anatomical specimen, and an interventional group that underwent microvascular dissection training on a chicken wing model prior to performing the anatomic dissection on the cadaver specimen. Time to completion and quality of dissection were measured.ResultsA Mann-Whitney test demonstrated a significant improvement in time and quality outcomes respectively across all interventional groups, with the greatest improvements seen in participants with less endoscopic experience: medical students (P = .032, P = .008), residents and fellows (P = .016, P = .032).Conclusions Prior training on the chicken wing model improves surgical performance in a surrogate model for live EES.Level of Evidence1b. Laryngoscope, 2014
    The Laryngoscope 11/2014;
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    ABSTRACT: Objectives/HypothesisVocal fold paralysis is the second most common congenital laryngeal anomaly in newborns. Bilateral paralysis is a severe condition and often remains of unknown etiology. We report our experience of congenital idiopathic bilateral vocal fold paralysis in newborns and infants, and discuss the therapeutic options.Study DesignRetrospective review.MethodsA retrospective review was carried out at a single tertiary referral center over a 15-year period of children presenting with congenital idiopathic bilateral laryngeal paralysis (CIBP).ResultsTwenty-six patients were identified and managed over period of the study (mean follow-up, 6.7 years). A tracheostomy was eventually performed in 14 patients, 12 during the neonatal period. Endoscopic treatment was performed in 16 patients and an external approach in five patients after endoscopic failure. Three patients were managed by watchful waiting. Spontaneous recovery occurred in 16 patients (median age, 14.5 months), including nine with a tracheostomy. Decannulation was achieved in 12 patients (median age, 42 months), and noninvasive positive pressure ventilation (NPPV) was applied in six patients.Conclusions Only inhomogeneous series of pediatric bilateral laryngeal palsies have been published so far, making it difficult to identify prognostic and predictive markers, as well as therapeutic guidelines. Focusing on CIBP, our data suggest that the management strategy must take into account the possibility of a delayed spontaneous recovery. NPPV is an interesting therapeutic tool in this situation. A systematic somatic assessment is mandatory to look for associated conditions.Level of Evidence4 Laryngoscope, 2014
    The Laryngoscope 11/2014;
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    ABSTRACT: Objective/HypothesisChronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by significant goblet hyperplasia and mucus hypersecretion. However, the molecular mechanism underlying mucin overexpression in CRSwNP has not been well characterized. This study sought to assess the expression of SAM-pointed domain-containing Ets-like factor (SPDEF) and its regulation of mucin production in CRSwNP patients.Study designProspective laboratory-based study.Methods Polyp and control nasal tissues were collected from 27 CRSwNP patients and 15 control subjects. The expression of SPDEF and MUC5AC in the nasal tissues was examined by immunohistochemistry staining, quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blotting. In addition, SPDEF and MUC5AC expression was evaluated in cultured polyp epithelial cells and bronchial epithelial cells (BECs) in the presence of proinflammatory cytokines, corticosteroids and SPDEF small interfering RNA (siRNA) using qRT-PCR and western blot analysis.ResultsWe found significantly increased SPDEF and MUC5AC expression in CRSwNP patients compared to the controls (P < .05); the mRNA level of SPDEF was positively correlated with MUC5AC expression in CRS patients (P < .05). There was a significant difference in SPDEF and MUC5AC expression in eosinophilic and noneosinophilic CRSwNP patients (P < .05). Interleukin (IL)−13, IL-8, and IL-17A significantly increased SPDEF and MUC5AC expression in vitro (P < .05). SPDEF siRNA significantly inhibited SPDEF and MUC5AC expression in BECs in response to IL-13, IL-8, and IL-17A (P < .05).Conclusions Our findings suggested that SPDEF may be regarded as a promising therapeutic target for modulating mucus hypersecretion in CRSwNP.Level of EvidenceN/A. Laryngoscope, 2014
    The Laryngoscope 11/2014;
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    ABSTRACT: Objectives/HypothesisDetermine the prevalence of smell disturbance and taste disturbance and associated factors in adults.Study DesignCross-sectional analysis of nationwide household health survey.Methods Data from the taste and smell disorders component of the National Health and Nutrition Examination Survey (NHANES) 2011 to 2012 were examined. The prevalence of self-reported problems with taste and/or smell among adults and the associated symptom frequency, related healthcare provider interactions, and symptoms/etiologies (e.g., persistent cold/flu, dry mouth, or head injury, etc.) were determined. Associations between sex and age with smell and taste disturbances as well as the relationship between smell and taste disturbances were determined.ResultsAmong 142.5 ± 12.6 million adult Americans (raw N = 3,594), there were an estimated 15.1 ± 2.1 million individuals (10.6% ± 1.0%) with self-reported smell disturbance in the prior 12 months. Sex was not associated with the prevalence of self-reported smell disturbance (P = 0.146), but increasing age was associated with an increasing prevalence of smell disturbance (odds ratio [OR] 1.147; 95% confidence interval [CI], 1.003–1.312). An estimated 7.5 ± 0.6 million individuals (5.3% ± 0.3%) reporting a problem with taste in the prior 12 months. Sex was not associated with the prevalence of taste disturbance (P = 0.947) but increasing age was (OR 1.202; 1.037–1.395). Among 19.4 ± 2.2 million reporting smell and/or taste abnormality, 20.2% ± 2.3% discussed this with a healthcare provider and 5.8% ± 1.4% felt it interfered with their daily life.ConclusionA significant number of adult Americans report problems with smell disturbance and taste disturbance. Further work to identify patients whose smell or taste disturbance can be helped is warranted.Level of Evidence2b. Laryngoscope, 2014
    The Laryngoscope 11/2014;