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Journal of Otolaryngology—Head & Neck Surgery

Fanny Gabrysz-Forget, Paul Tabet, Akram Rahal, Eric Bissada, Apostolos Christopoulos, Tareck Ayad
OBJECTIVE: The present review focuses on comparative studies of reconstruction with free flaps (FF) versus pedicled flaps (PF) after oncologic resection. METHOD: A systematic review was developed in compliance with PRISMA guidelines and performed using the Pubmed, Medline, EMBASE, Amed and Biosis databases. RESULTS: A total of 30 articles were included. FF are associated with a longer operative time, a higher cost and a higher incidence of postoperative revisions compared to PF...
March 14, 2019: Journal of Otolaryngology—Head & Neck Surgery
Alexandra Maby, Benoit Guay, François Thuot
BACKGROUND: Infantile myofibromatosis is the most common benign fibrous tumor in infants. Three different types have been reported in the literature. The most commonly affected areas are the head, the neck and the trunk. Our patient showed a very high level of mandibular destruction resistant to all mandibular sparing treatment strategies requiring segmental mandibulectomy and complex reconstruction. CASE PRESENTATION: We describe a rare case of multicentric infantile myofibromatosis with mandibular bone destruction...
March 14, 2019: Journal of Otolaryngology—Head & Neck Surgery
Rana Barake, Tamer El Natout, Marc Bassim, Mohammad Ali El Natout
BACKGROUND: The study aims at reporting our experience with loop underlay tympanoplasty, a modification of the underlay technique previously reported, for the reconstruction of anterior, subtotal or total tympanic membrane perforations. METHODS: A retrospective review of charts of patients who have undergone loop underlay tympanoplasty from January 2002 to January 2012 was performed. One thousand one hundred patients were included. Hearing test results preoperatively and postoperatively were reported...
March 12, 2019: Journal of Otolaryngology—Head & Neck Surgery
Phillip Staibano, Daniel Lelli, Darren Tse
BACKGROUND: Vertigo remains a diagnostic challenge for primary care, emergency, and specialist physicians. Multidisciplinary clinics are increasingly being employed to diagnose and manage patients with dizziness. We describe, for the first time in Canada, the clinical characteristics of patients presenting with chronic and acute dizziness to both a multidisciplinary chronic dizziness clinic (MDC) and a rapid access dizziness (RAD) clinic at The Ottawa Hospital (TOH). METHODS: We performed a retrospective review of all patients presenting to the MDC and RAD clinics at TOH from July 2015 to August 2017...
March 11, 2019: Journal of Otolaryngology—Head & Neck Surgery
Lily H P Nguyen, Ilana Bank, Rachel Fisher, Marco Mascarella, Meredith Young
BACKGROUND: A longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education. METHODS: Residents participated in four different simulation-based training modules using animal models, cadavers, task trainers, and crisis scenarios using high fidelity manikins. Scenarios were based on various clinical settings (i.e. emergency room, operating room) and were followed by video-assisted structured debriefings...
February 19, 2019: Journal of Otolaryngology—Head & Neck Surgery
Kiyoshi Sato, Hiroaki Shimamoto, Yumi Mochizuki, Hideaki Hirai, Hirofumi Tomioka, Risa Shimizu, Eriko Marukawa, Haruhisa Fukayama, Ryoichi Yoshimura, Hiroo Ishida, Hiroyuki Harada
BACKGROUND: Malignancies occur in approximately 1:1000 pregnancies; the most common being breast (46%) and hematological (18%) malignancies. Oral cancers account for only 2% of all cancers in pregnant women, and there are no standard guidelines for the treatment of oral cancer during pregnancy. METHODS: Between 2007 and 2014, our department managed 1109 patients with oral cancers; four (0.4%) had tongue carcinomas during pregnancy. These cases were retrospectively reviewed...
February 4, 2019: Journal of Otolaryngology—Head & Neck Surgery
Pier-Luc Beaudoin, Mathilde Labbé, Amanda Fanous, Meredith Young, Jamie Rappaport, Yoon Soo Park, John Manoukian, Lily H P Nguyen
BACKGROUND: Effective communication has been linked to a reduction in adverse events and improved patient compliance. Currently in Otolaryngology - Head and Neck Surgery (OTL-HNS) residency programs, there is limited explicit teaching of communication skills. Our objective was to implement an educational program on communication skills for residents using multisource assessment in several simulation-based contexts throughout residency. METHODS: For three consecutive years, OTL-HNS residents were recruited to participate in a total of nine simulation-based clinical scenarios in which communication skills could be honed...
January 28, 2019: Journal of Otolaryngology—Head & Neck Surgery
D A Lelli, D Tse, J P Vaccani
BACKGROUND: The bedside head impulse test (bHIT) is a clinical method of assessing the vestibulo-ocular reflex (VOR). It is a critical component of the bedside assessment of dizzy patients, and can help differentiate acute stroke from vestibular neuritis. However, there is evidence showing the bHIT is often not performed in appropriate clinical settings or is performed poorly. To date, there have been no studies evaluating the bHIT competence of graduating physicians. METHODS: 23 final year Otolaryngology -Head &Neck Surgery (OTL-HNS) residents in Canada were evaluated on the use of bHIT using a written multiple-choice examination, interpretation of bHIT videos, and performance of a bHIT...
January 18, 2019: Journal of Otolaryngology—Head & Neck Surgery
Z Chaudhry, M Campagna-Vaillancourt, M Husein, R Varshney, K Roth, A Gooi, Lhp Nguyen
BACKGROUND: Discrepancies between resident and faculty perceptions regarding optimal teaching and feedback during surgery are well known but these differences have not yet been described in Otolaryngology - Head and Neck Surgery (OTL-HNS). The objectives were thus to compare faculty and resident perceptions of perioperative teaching and feedback in OTL-HNS residency programs across Canada with the aim of highlighting potential areas for improvement. METHODS: An anonymous electronic questionnaire was distributed to residents and teaching faculty in OTL-HNS across Canada with additional paper copies distributed at four institutions...
January 17, 2019: Journal of Otolaryngology—Head & Neck Surgery
Andre Le, Daniel A Lelli, Sasha Van Katwyk, Debora Hogan, Kednapa Thavorn, Darren Tse
BACKGROUND: In the Canadian health care system, determining overall costs associated with a particular diagnostic subgroup of patients, in this case dizzy patients, is the first step in the process of determining where costs could be saved without compromising patient care. This study is the first Canadian study that evaluates these costs at a tertiary care hospital and will allow for the extrapolation of cost data for other similar academic health science centers, regional health initiatives, and provincial healthcare planning structures...
January 16, 2019: Journal of Otolaryngology—Head & Neck Surgery
Viannique Rolland, François Meyer, Matthieu J Guitton, Richard Bussières, Daniel Philippon, Isabelle Bairati, Mathieu Leclerc, Mathieu Côté
BACKGROUND: Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity. METHODS: Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR)...
January 16, 2019: Journal of Otolaryngology—Head & Neck Surgery
David Forner, Matthew H Rigby, Derek Wilke, S Mark Taylor, Nathan Lamond
OBJECTIVE: The incidence of oropharyngeal squamous cell carcinoma is increasing with a growing proportion of diagnoses associated with human papillomavirus (p16 + OSCC), which generally confers a favorable prognosis. For these reasons, novel risk stratification models specific to the p16 + OSCC population have recently been proposed to guide future research on treatment de-intensification for appropriate patients. This study aimed to quantify patient risk distribution using multiple published risk models and investigate the hypothesis that the local p16 + OSCC population includes a smaller proportion of low-risk patients due to a high prevalence of concurrent tobacco exposure...
January 14, 2019: Journal of Otolaryngology—Head & Neck Surgery
Kylen Van Osch, Daniel Allen, Bradley Gare, Thomas J Hudson, Hanif Ladak, Sumit K Agrawal
OBJECTIVES: The primary objective of this study was to use high-resolution micro-CT images to create accurate three-dimensional (3D) models of several intratemporal structures, and to compare several surgically important dimensions within the temporal bone. The secondary objective was to create a statistical shape model (SSM) of a dominant and non-dominant sigmoid sinus (SS) to provide a template for automated segmentation algorithms. METHODS: A free image processing software, 3D Slicer, was utilized to create three-dimensional reconstructions of the SS, jugular bulb (JB), facial nerve (FN), and external auditory canal (EAC) from micro-CT scans...
January 11, 2019: Journal of Otolaryngology—Head & Neck Surgery
Shanmugappiriya Sivarajah, Morris Kostiuk, Cameron Lindsay, Lakshmi Puttagunta, Daniel A O'Connell, Jeffrey Harris, Hadi Seikaly, Vincent L Biron
BACKGROUND: This study aims to investigate EGFR as a prognostic biomarker in oropharyngeal squamous cell carcinoma (OPSCC). METHODS: OPSCC patients from retrospective (1998-2009) and prospective cohorts (2014-2017) were included. Retrospectively collected tumors were used to construct tissue microarrays (TMAs), which were stained with EGFR, p16, DAPI and Pan-cytokeratin, and digitally quantified. EGFR, CDKN2A and HPV E6/7 levels from prospectively collected OPSCC was measured by droplet digital PCR (ddPCR)...
January 10, 2019: Journal of Otolaryngology—Head & Neck Surgery
Benjamin van der Woerd, Krupal B Patel, Anthony C Nichols, Kevin Fung, John Yoo, S Danielle MacNeil
OBJECTIVES: Organ preserving surgery (OPS) and radiotherapy (RT) are both accepted treatment options for early stage supraglottic cancer (SGC). Radiation has supplanted surgery in most cases, because of the perception that surgery results in poorer functional outcomes. However, evidence suggests that OPS with a neck dissection may be associated with improved survival. Our objective was to conduct a systematic review of the literature to compare functional outcomes of OPS and RT for early SGC...
December 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
Kimberly Luu, Amirreza Pakdel, Edward Wang, Eitan Prisman
BACKGROUND: 3-Dimensional (3D) printing can be applied to virtual planning and creation of surgical guides for mandibular reconstruction. Such systems are becoming increasingly prevalent in head and neck reconstruction. However, third party access to this technology is costly and removes the opportunity to design, create, and modify the bony reconstructions, as third party technology is a black box. This series is a pilot study to document the feasibility of an in-house software tool...
December 12, 2018: Journal of Otolaryngology—Head & Neck Surgery
Alexandra E Quimby, Nicole L Lebo, Rebecca Griffiths, Stephen Hall, Jim Dimitroulakos, Stephanie Johnson-Obaseki
BACKGROUND: We sought to expand upon preliminary data suggesting that metformin confers a survival benefit to patients with head and neck squamous cell carcinoma (HNSCC). METHODS: A large-scale retrospective cohort study of all patients in Ontario diagnosed with squamous cancer of the larynx, hypopharynx, and nasopharynx between Dec 1st 2007 to Dec 1st 2012 was undertaken. The Institute for Clinical and Evaluative Sciences was accessed to obtain patient demographic, treatment and outcome information...
December 4, 2018: Journal of Otolaryngology—Head & Neck Surgery
Michael Xie, Michael K Gupta, Stuart D Archibald, B Stanley Jackson, James Edward Massey Young, Han Zhang
BACKGROUND: Marijuana is the most widely used illicit substance in Canada. To date, no conclusive study has looked at the epidemiologic basis of marijuana use and head and neck cancer (HNC). Due to the imminent recreational legalization of marijuana in Canada, the epidemiologic relationship between marijuana use and HNC is becoming increasingly important. OBJECTIVE: To examine the epidemiologic characteristics of HNC patients who are recreational marijuana users...
November 22, 2018: Journal of Otolaryngology—Head & Neck Surgery
Yaeesh Sardiwalla, Nicholas Jufas, David P Morris
OBJECTIVE: Minimally Invasive Ponto Surgery (MIPS) was recently described to facilitate the placement of percutaneous bone anchored hearing devices. As early adopters of this new procedure, we sought to perform a quality assurance project using our own small prospective cohort to justify this change in practice. We chose to examine device stability and to gauge our patients' perspective of the surgery and their overall satisfaction with the process. METHODS: A total of 12 adult patients who underwent MIPS between 2016 and 2017 with a minimum post-operative follow-up of 12 months were included in this study...
November 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
Josie Xu, Paolo Campisi, Vito Forte, Brian Carrillo, Allan Vescan, Ryan Brydges
BACKGROUND: Portable educational technologies, like simulators, afford students the opportunity to learn independently. A key question in education, is how to pair self-regulated learning (SRL) with direct instruction. A cloud-based portable otoscopy simulator was employed to compare two curricula involving SRL. Pre-clerkship medical students used a prototype smartphone application, a 3D ear attachment and an otoscope to complete either otoscopy curriculum. METHODS: Pre-clerkship medical students were recruited and randomized to two curriculum designs...
November 20, 2018: Journal of Otolaryngology—Head & Neck Surgery
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