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  • ISSN: 2379-948X
    Volume 3, Issue 12
    Case Report
    Nanna Browaldh*, Yinghua Li, Lars Falk, Andreas Ekborn, Bjorn Westrup, and Georgios Papatziamos
    Abstract:
    Laryngeal or tracheal injury in neonates is a severe and life-threatening condition. Early diagnosis of airway damage is crucial. In the present case, a laryngeal rupture occurred during a difficult vaginal delivery. In this case report, we describe the advantages of ECMO treatment in connection with acute airway surgery and also the need for multidisciplinary management of the troublesome pediatric airway.
    Kristine Galek* and Amanda Sumrall2
    Abstract:
    Introduction: The purpose was to report the effect of a novel eclectic dysphagia intervention for head and neck cancer (HNC) survivors suffering with late effects of radiation. Two HNC patients completed theeclectic dysphagia protocol.
    Method: The protocol incorporated the McNeill Dysphagia Therapy Program (MDTP), visual and tactile biofeedback, muscle strengthening, and muscle stretching.
    Results: At time of data collection, both patients sustained adequate hydration and nutrition orally.
    Discussion: An eclectic dysphagia protocol was successful in promoting improved swallow function, muscle strength, range of motion, and oral-pharyngeal sensation. Quality of life was positively impacted.
    Alireza Mohebbi, Zhaleh Faham, Shaheen Rajaeih, and Hadi Ghanbari*
    Abstract:
    Forgotten entities in nose and paranasal sinuses have different presentations. A 34 years old woman had malodor discharge and unilateral nasal obstruction for long period of time. She had unilateral rhinosinusitis and obstruction of osteameatal complex confirmed by Paranasal computed tomography (CT) scan which was unresponsive to medical therapy. The case underwent functional endoscopic sinus surgery under general anesthesia and nasoantral polyps and unexpectedly 2 pieces of wooden stick were taken from the right maxillary sinus.
    Priyesh N Patel*, Sunshine M Dwojak, and Sarah L Rohde
    Abstract:
    The pectoralis major myocutaneous flap (PMMF) is a widely used pedicled flap for soft tissue reconstruction. While commonly cited complications associated with PMMF relate to the pedicled flap itself, there are fewer reports of complications related to the thoracic donor site. This case report describes the etiology and management of a non healing donor site found to have devitalized rib after a PMMF in a 73-year-old male. Although ribs have a robust blood supply, in elevating a PMMF there is a risk of injury to rib periosteum. This likely resulted in devitalization of bone, with resulting rib sequestration, osteomyelitis, and poor wound healing. As many patient’s undergoing PMMF reconstruction may have underlying vascular disease and poor perfusion to tissue, extra care during elevation of the flap to avoid the rib periosteum should be exercised in these patients.
    Deepak Verma*, Naveen Sharma, Anil Pandey, and Megha Verma
    Abstract:
    Epidermoid and dermoid cysts are rare in oral cavity. We are presenting here three such cases of sublingual dermoid cyst with submental extension (plunging dermoid) who presented in outpatient department with complaints of a slow growing painless swelling in the oral cavity and difficulty in chewing and swallowing solid foods. On clinical examination cystic swelling was seen in floor of mouth displacing the tongue superiorly and posteriorly. Ultrasonography followed by contrast CT scan of neck revealed well defined cystic swelling involving floor of mouth with submental extension. Surgical excision is treatment of choice in these cases. Although the cysts were large and extending through the mylohyoid muscle, intraoral approach was adopted for excision of cyst in all three cases avoiding extraoral neck incision for cosmetic reasons.
    Short Communication
    Samy Elwany*, Zeyad Mandour, and Mahmoud Ibrahim
    Abstract:
    Background: The high surgical success rates for tonsillectomy or adeno-tonsillectomy in children with obstructive sleep apnea (OSA) have been described and confirmed in various studies. The situation in adults is not that clear since many other factors seem to influence the outcome of isolated tonsillectomy in adult patients suffering from OSA and tonsillar hypertrophy. The present study was, therefore, geared at exploring the efficacy of isolated tonsillectomy as a treatment of OSA in adults with tonsillar hypertrophy with special emphasis on the effect of the position of the palate in relation to the tongue base on the outcome of the operation.
    Study design: 40 adult patients with obstructive sleep apnea and tonsillar hypertrophy (Friedman grades 3 or 4) were included in the study. Patients with body mass index > 40, or other obvious causes of OSA were excluded from the study. The patients were randomly allocated to two equal groups according to Friedman palatal position score. Conventional extracapsular tonsillectomy and standard preoperative and postoperative polysomnography were performed for all patients. The criteria for successful surgical response were defined as a 50% drop and below 20 of postoperative AHI.
    Results: The mean apnea hyperpnoea index (AHI) of group (A) was 31.6 preoperatively and 10.7 postoperatively and the difference between pre- and postoperative indices was statistically significant. The mean apnea hyperpnoea index (AHI) of group (B) was 50.3 preoperatively and 44.7 postoperatively and the difference between pre- and postoperative indices was not statistically significant. The outcome of isolated tonsillectomy of group (A) was significantly better than the outcome of the procedure of group (B).
    Conclusions: Adult patients with OSA who are likely to benefit from isolated tonsillectomy, in the absence of other causes of OSA, are those with mild OSA, Friedman tonsillar grades 3 or 4, and Friedman palatal scores 1 or 2.
    Mahmoud El-Sayed Ali*, Shruti Parikh, and Jeffrey P Pearson
    Abstract:
    Introduction: Bile acids, as a constituent of refluxed and aspirated duodenal juice, could alter upper and lower airway major mucins such as MUC5AC in the airway mucosa. Human goblet cell line derived from the human colon carcinoma cells HT29-MTX has been found to express MUC5AC as the main mucin and could be employed to study this hypothesis.
    Methods: The cell line HT29-MTX was challenged by various concentrations of a physiologic combination of bile salts. We modified an ELISA technique to measure the expressed MUC5AC within the culture media.
    Results: The Cultured HT29-MTX cells viability was maintained when challenged with bile salts up to 20 µmol/L. MUC5AC mucin production was upregulated by bile salts in a dose dependant manner within the first 24 hours.
    Discussion: Amongst the other constituents of duodenal reflux that reaches the upper and lower airways, bile salts could represent an important element of airway mucin alteration by upregulating MUC5AC production. This effect could be direct due to stimulated mucin release from cell stores or indirect via the release of pro-inflammatory cytokines which stimulate mucin biosynthesis and release.
    Conclusion: Bile salts challenge of the HT29-MTX cell line resulted in MUC5AC upregulation and this effect could be extrapolated to the airway goblet cells.
    Benoit Drion*, and Jerome Laubreton
    Abstract:
    Several medical, linguistic, cultural and social factors are known to affect care for deaf people who communicate in sign language, hampering their understanding of their own state of health. A nationwide network of specific structures has been developed in France to facilitate access to care in sign language.
    Research Article
    Randa Barazi, Ibrahim Bawab, Gabriel Dunia, and Mohamad A Bitar*
    Abstract:
    Objectives: To assess the efficacy of topical (group 1) vs. oral (group2) antibiotics in paediatric chronic rhinosinusitis.
    Methods: Retrospective controlled study. Patients were divided, after 4-week treatment, into 3 categories (0, 1 or 2 or more symptoms). Outcome measured through decrease in frequency of symptoms (chi-square test) and reduction in total symptoms score (two sample t-test).
    Results: We included 99 patients (mean age 5.5y). The results showed no significant difference in age (p =0.11), gender (p=0.98), or pre-treatment total symptoms score (p=0.45). We found significant decrease in frequency of symptoms post-treatment (p <0.05) and the symptom control was similar in both groups; 69.74% symptom-free in group 1 vs. 47.83% in group 2 (p=0.06). The total symptom score decreased more significantly in group 1 (p= 0.01). We found no positive impact of adjuvant therapy on the results.
    Conclusion: Topical intranasal antibiotics might be as effective as oral antibiotics in treating children with uncomplicated chronic rhinosinusitis.
    Ruiying Ding* and Fangchao Ma
    Abstract:
    Introduction: Studies that compared the use of neuromuscular electrical stimulation (NMES) with traditional dysphagia therapy (TDT) have been inconclusive. All previous meta-analysis studies have only used subjective measures to assess swallow function. The objective of the study is to perform a systematic review and meta-analysis evaluating the effectiveness of NMES for treatment of dysphagia associated with neurological impairment utilizing both subjective measures of swallows function and objective measures such as penetration-aspiration scale and pharyngeal transit time (PTT).
    Methods: A systematic search of PUBMED, Cochrane Central Register of Controlled Trials, EMBASE and Google Scholar between 1January 2001 to 31 March, 2016 was conducted to identify all relevant articles that compared NMES versus TDT for treatment of adult patients with acute neurological impairments, mainly stroke and brain injury. A total of 12 studies were included in the study. Relevant data were extracted and the standardized mean difference (SMD) is used as summary statistics.
    Results: The pooled SMD revealed that NMES group showed significant improvement in swallowing function 1-3 month post treatment as compared to TDT group (SMD=1.14, 95% CI: 0.94-1.34, p<0.001), in reduction of penetration/aspiration (SMD=-0.85, 95% CI: -1.17 - -0.52, p<0.001), and in reduction of PTT (SMD=-0.86, 95% CI: -1.17- -0.55, p<0.001).
    Conclusion: The present meta-analysis finds NMES is an effective adjunct modality to TDT for patients suffering from stroke and traumatic brain injury.
    Alleluia Lima Losno Ledesma*, MoniqueAntunes De Souza Chelminski Barreto1, Carlos Augusto Costa Pires De Oliveira, and FayezBahmad
    Abstract:
    Objective: To assess the effect of caffeine in the following vestibular function tests: Cervical Vestibular Evoked Potential (cVEMP), Ocular Vestibular Evoked Potential (oVEMP) and Caloric Test.
    Methods: Randomized, prospective triple-blind, placebo controlled clinical trial. All participants underwent otoscopy, tympanometry and responded to the Profile of Mood State (POMS). They were submitted to the cVEMP, oVEMP and caloric tests. After that they received placebo capsule (maize starch) or caffeine capsule (300mg) and repeated the procedures 45 minutes later.
    Results: There were no statistically significant differences in latencies, peak to peak amplitudes, asymmetry ratio or rate of change in cVEMP. A statistically significant difference was observed in the caffeine group (p15 latency of left ear) in oVEMP. The Non-caffeine group showed statistically significant difference between the relative values in caloric test. No variable of any test was influenced by caffeine intake.
    Conclusions: Moderate caffeine consumption does not significantly alter vestibular function tests. Significance: This study provides the evidence that cVEMP, oVEMP and caloric test do not suffer influence from moderate caffeine consumption.
    Review Article
    Laure-Helene Canette*, Danilo Spada, Marion Pineau, Barbara Tillmann, and Emmanuel Bigand
    Abstract:
    Cross-domain transfer effects between musical training and language processing are well documented and this finding has clinical implication for different pathologies, such as dyslexia. Only few studies have examined the impact of musical training on linguistic abilities in cochlear-implanted children. The present review investigates whether musical training facilitates language processing in cochlear-implanted children. Priming studies demonstrated that linguistic processing can benefit from prior exposure to rhythmic musical sequences. This was found by combining rhythmic primes and linguistic exercises in short and long-term paradigms. Other studies have compared musician and non-musician cochlear-implanted children, or have assessed several abilities before and after a musical training. They revealed better performance in linguistic tasks for musically trained children. Although these studies differ in many characteristics, they highlight the possibility of transfer effects from music training to language processing in cochlear-implanted children. These findings can be understood in light of different theoretical frameworks: the Dynamic Attending Theory appears to be useful for the interpretation of priming, while the expanded OPERA hypothesis and the auditory scaffolding hypothesis are relevant to understand training studies.
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