New Research Findings Published in May Medical Journal

Newswise — Some 21 original articles are featured in the May 2005 edition of Otolaryngology—Head and Neck Surgery, the peer-reviewed scientific journal of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. This issue can be accessed at http://www.mosby.com/oto; abstracts of the articles can be viewed online. Among the new research studies are:

1. Seldinger-Assisted Videotelescopic Intubation (SAVI): A Common Sense Approach to the Difficult Pediatric Airway:Researchers in Texas describe the Seldinger-assisted videotelescopic intubation (SAVI) technique as offering an additional practical clinical solution to the difficult pediatric airway. Although ultimately establishing the airway depends on the skills of the operator, the SAVI technique has saved multiple lives by using common equipment through a common-sense approach.

2. Outcome of Adenotonsillectomy for Obstructive Sleep Apnea in Children Under Three Years:A prospective study conducted at the University of New Mexico Children's Hospital shows that children under three years show significant improvement in respiratory distress index after adenotonsillectomy for obstructive sleep apnea, but they may develop complications after surgery. Postoperative polysomnography is recommended for children under three years of age to monitor the severity of persistent obstructive sleep apnea.

3. Long-Term Histological Outcomes of Injected Autologous Fat into Human Vocal Folds After Secondary Laryngectomy:Japanese researchers conclude that liposuctioned autologous fat injection histologically offered long-term improvement in patients with impaired glottal closure from vocal fold paralysis. The researchers injected liposuctioned fat for vocal fold augmentation in patients with vocal fold paralysis. They suctioned autologous fat from the low abdomen. The histological examination histological evaluation of two patients who required total laryngectomy after autologous fat injection into the vocal folds revealed normal-appearing viable adipocytes with minimal inflammatory response in both patients.

4. Antigen Challenge Induces a Supraglottic but not a Subglottic Edema in the Rat Larynx:To determine whether a type I hypersensitivity reaction can elicit a supraglottic and subglottic edema, researchers examined the reaction of mast cells in the larynx of sensitized rats after allergen challenge. Results from a rat study indicate that the supraglottic and subglottic regions react differently to allergen challenge. In the challenged rats, the allergen produces a marked edema in the epiglottis but not in the subglottic area. 5. Intrinsic Laryngeal Muscle Reinnervation with Nerve-Muscle Pedicle:Research conducted on the laryngeal muscles of five mongrel dogs indicates the nerve-muscle pedicle technique could eliminate the need for arytenoidectomy and laterofixation in patients with unilateral or bilateral vocal fold paralysis. It has also been suggested that the quality of life and voice may be improved. The video records of the five dogs examined showed the return of mobility of the PCA muscle reinnervated by the nerve-muscle pedicle technique.

6. Trends in the Diagnosis and the Management of Meniere's Disease: Results of a Survey:A 15-item intervention questionnaire given to members of the American Neurotology Society reveals that Meniere's disease continues to pose a difficult diagnostic and therapeutic problem, resulting in a variety of approaches to both evaluation and treatment. Despite the 1995 American Academy of Otolaryngology guidelines in the diagnosis of Meniere's disease, most clinicians rely in part on ENG or ECOG in diagnosing Meniere's disease. Furthermore, despite the passing of 20 years since the publications claiming a purely placebo effect, ESS is the most commonly employed initial surgical treatment for Meniere's disease.

7. Cochlear Implantation in Patients with Osteogenesis Imperfecta:Hearing loss has been shown to occur in 42 percent to 58 percent of patients with osteogenesis imperfecta (OI), with deafness arising in 25 percent to 60 percent of the patients. Implantation in patients with OI is relatively rare, with only four prior single case reports published in the English-language literature. Johns Hopkins University research has found that not only is cochlear implantation in patients with OI technically possible, but the results are similar to implant outcomes for patients with sensorineural hearing loss from a variety of other causes.

8. Benign Positional Vertigo after Cochlear Implantation:Research out of Johns Hopkins indicates benign positional vertigo is an uncommon development after cochlear implantation, although it occurs more frequently than in the general population. Two theories were proposed: the introduction of bone dust into the labyrinth and the dislodging of otoconia during surgery. The diagnosis, treatment, and prognosis of benign positional vertigo after cochlear implantation do not differ from those for non-cochlear implantation"associated benign positional vertigo. Dizziness after cochlear implantation usually develops as a result of vestibular hypofunction. Benign positional vertigo, which is a hyperfunctioning form of vestibular dysfunction, should be recognized as a possible condition following as a consequence cochlear implantation.

9. Reliability of Cochlear Implants:Cochlear implant reliability data should be considered during the choice of an implant for each individual patient. A report of 192 cochlear implants from different manufacturers shows an overall cumulative implant survival rate was 91.7% for a period of 11 years. The calculation of cumulative survival rates including all hard failures of cochlear implants is suitable to report objectively about cochlear implant reliability.

10. Virtual Endoscopy of Laryngeal Carcinoma: Is it Useful?: Italian researchers say virtual endoscopy is a useful tool for staging and presurgery treatment of cancer of the larynx. Virtual endoscopy shows high sensitivity in the identification of exophytic lesions of the larynx and can establish relationships between cancer and nearby structures. It can be performed in the presence of severe stenosis and does not require sedation and additional scanning. On the other hand, virtual endoscopy show limits in the identification of flat lesions and does not allow biopsies and functional imaging to be performed.

These, and 11 other research findings are available in the May 2005 edition of Otolaryngology—Head and Neck Surgery.