The Laryngoscope
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Whether adenotonsillectomy (AT) is sufficient for pediatric obstructive sleep apnea syndrome (OSAS) with persistent severe allergic rhinitis (PSAR) remains unclear. This study attempts to identify the role of inferior turbinate reduction in treating pediatric OSAS with PSAR. ⋯ Analytical results suggest that AT with concurrent MAIT achieves favorable subjective and objective outcomes in pediatric OSAS with PSAR. We believe that volume reduction of the inferior turbinate plays an important role in treating pediatric OSAS with inferior turbinate hypertrophy.
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To evaluate the effect of larynx and esophageal inlet sparing on dysphagia recovery after intensity-modulated radiotherapy (IMRT) for stage III-IV oropharyngeal squamous cell carcinoma. ⋯ A dose constraint on the larynx and esophageal inlet during IMRT planning reduces dose to pharyngeal constrictors and expedites PEG tube removal.
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The endoscopic endonasal transcribriform approach (EETA) is a viable alternative option for resection of selected anterior skull base (ASB) tumors. However, this technique results in the creation of large cribriform defects. Some have reported the use of a rigid substitute for ASB reconstruction to prevent postoperative frontal lobe sagging. We evaluate the degree of frontal lobe sagging using our triple-layer technique [fascia lata, acellular dermal allograft, and pedicled nasoseptal flap (PNSF)] without the use of rigid structural reconstruction for large cribriform defects. ⋯ Rigid structural repair may not be necessary for ASB defect repair after endoscopic endonasal resection of the cribriform plate. Our technique for multilayer cranial base reconstruction appears to be satisfactory in preventing delayed frontal lobe sagging.
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Comparative Study
Impact of fellowship training on research productivity in academic otolaryngology.
Assessment of scholarly productivity as measured by research output is a key component of decisions regarding appointment and advancement in academic otolaryngology. An increasing number of graduating residents are pursuing postresidency fellowships, and evaluation of research productivity among these subspecialists is important in determining their role in academic otolaryngology departments. The h-index is a reliable indicator of research productivity, as it takes into account both quantity and relevance of research contributions. Our objective was to evaluate and compare trends in research productivity among the various otolaryngology subspecialties. ⋯ Fellowship-trained otolaryngologists had higher h-indices, and faculty members trained in the subspecialties with the highest research productivity were disproportionately represented in positions of leadership within academic otolaryngology, probably reflecting the importance of research contributions in the academic advancement process, although other factors, such as educational contributions and clinical performance, may also be important factors.
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Comparative Study
Retrospective evaluation of laboratory-based diagnostic tools for cervical necrotizing fasciitis.
Cervical necrotizing fasciitis (CNF) is challenging to diagnose and associated with high morbidity and mortality. The objective of this study is to evaluate the utility of two laboratory-based diagnostic tools for distinguishing necrotizing from non-necrotizing infection when specifically applied to neck infection. ⋯ Neither the LRINEC score nor the use of admission white blood cell count and sodium level were useful for distinguishing cervical necrotizing fasciitis from non-necrotizing neck infection.