Pleural Space Management in Thoracic Trauma.

Thoracic injuries are common, occurring in up to 60% of polytrauma patients and represent 25% of trauma deaths. Thoracic trauma frequently involves injury to the pleural space resulting in hemothorax and pneumothorax-effective management of the pleural space is essential. Reviewed in this article is management of the pleural space in chest wall trauma (including pneumothorax and hemothorax), and chest tube placement, indications for video-assisted thoracoscopic surgery, management, and complications.

Cost-Effectiveness of Depression Screening for Otolaryngology-Head and Neck Surgery Residents.

Objectives: This study aims to determine the cost-effectiveness of screening and treating otolaryngology-head and neck surgery residents for depression.

Methods: A Markov model was built using TreeAgePro, version 2019 (TreeAge Software Inc.; Williamstown, MA) to assess the cost-effectiveness of five potential treatment algorithms: 1) treat all residents with psychotherapy, 2) screen and treat depressed residents with psychotherapy, 3) screen and treat depressed residents with pharmacotherapy, 4) screen and treat depressed residents with combination psychotherapy/pharmacotherapy, and 5) no intervention.

Quantitative second harmonic generation imaging of leporine, canine, and porcine vocal fold collagen.

Objectives/hypothesis: Vocal fold collagen composition is an important determinant of material properties and mucosal wave propagation. Collagen alignment and straightness are quantitatively characterized by second harmonic generation (SHG) imaging. We examined leporine, canined and porcine vocal folds showing collagen composition variation that is species, location, and strain specific.

Photodynamic therapy induces antifibrotic alterations in primary human vocal fold fibroblasts.

Objectives/hypothesis: Photodynamic therapy (PDT) is a promising treatment modality for laryngeal dysplasia, early-stage carcinoma, and papilloma, and was reported to have the ability to preserve laryngeal function and voice quality without clinical fibrotic response. We aimed to investigate the mechanism behind the antifibrotic effects of PDT on primary human vocal fold fibroblasts (VFFs) in vitro.

Study Design: In vitro analysis from one human donor.

Oropharyngeal squamous cell carcinoma incidence and mortality trends in the United States, 1973-2013.

Objective: To analyze oropharyngeal squamous cell carcinoma incidence and mortality trends in the United States for the years 1973 through 2013.

Study Design: Cross-sectional study using a large population-based cancer database.

Methods: Data on incidence and mortality rates were extracted from the Surveillance, Epidemiology, and End Results (SEER) 9 Database.

Excised larynx evaluation of subthyroid cartilage approach to medialization thyroplasty.

Objectives/hypothesis: To describe an alternative approach to medialization thyroplasty involving dissection underneath the thyroid cartilage with placement of a Gore-Tex implant, and to evaluate its effect on a range of phonatory measures using an excised canine larynx model.

Study Design: Animal model.

Methods: On each of eight excised canine larynges, the conditions of normal, paralysis, medialization thyroplasty by standard transthyroid cartilage approach, and medialization thyroplasty by experimental subthyroid cartilage approach were performed.

A Preliminary Case Report of a High-Quality Cost-effective Rigid Laryngoscopy Setup.

Objective: To evaluate a cost-effective modified rigid laryngoscopy setup with a portable light source and high-resolution commercially available digital camera for use in smaller otolaryngology and family practice clinics.

Methods: The modified setup was used to obtain images of the larynx using both a traditional light source and a portable light source. Varying shutter speeds and ISOs were evaluated, and the optimal settings were determined for the modified setup.

Evaluation of type II thyroplasty on phonatory physiology in an excised canine larynx model.

Objectives/hypothesis: Type II thyroplasty is an alternative treatment for spasmodic dysphonia, addressing hyperadduction by incising and lateralizing the thyroid cartilage. We quantified the effect of lateralization width on phonatory physiology using excised canine larynges.

Methods: Normal closure, hyperadduction, and type II thyroplasty (lateralized up to 5 mm at 1-mm increments with hyperadducted arytenoids) were simulated in excised larynges (N = 7).

Extension and Application of High-Speed Digital Imaging Analysis Via Spatiotemporal Correlation and Eigenmode Analysis of Vocal Fold Vibration Before and After Polyp Excision.

Objectives/hypothesis: To evaluate the spatiotemporal correlation of vocal fold vibration using eigenmode analysis before and after polyp removal and explore the potential clinical relevance of spatiotemporal analysis of correlation length and entropy as quantitative voice parameters. We hypothesized that increased order in the vibrating signal after surgical intervention would decrease the eigenmode-based entropy and increase correlation length.

Study Design: Prospective case series.

The Potential Role of Subglottal Convergence Angle and Measurement.

Objective: This study aimed to explore subglottal convergence angle measurement. We hypothesize that the angle will change with glottis closure condition. Changes to the angle may alter vocal fold stress distribution, which could result in vocal fold pathologies.

Bioengineered vocal fold mucosa for voice restoration.

Patients with voice impairment caused by advanced vocal fold (VF) fibrosis or tissue loss have few treatment options. A transplantable, bioengineered VF mucosa would address the individual and societal costs of voice-related communication loss. Such a tissue must be biomechanically capable of aerodynamic-to-acoustic energy transfer and high-frequency vibration and physiologically capable of maintaining a barrier against the airway lumen.

Characterizing liquid redistribution in a biphasic vibrating vocal fold using finite element analysis.

Objectives: Vocal fold tissue is biphasic and consists of a solid extracellular matrix skeleton swelled with interstitial fluid. Interactions between the liquid and solid impact the material properties and stress response of the tissue. The objective of this study was to model the movement of liquid during vocal fold vibration and to estimate the volume of liquid accumulation and stress experienced by the tissue near the anterior-posterior midline, where benign lesions are observed to form.

Permeability of canine vocal fold lamina propria.

Objectives/hypothesis: Determine the permeability of excised canine vocal fold lamina propria.

Study Design: Basic science.

Methods: Vocal folds were excised from canine larynges and mounted within a device to measure the flow of 0.

Voice Outcome of Modified Frontolateral Partial Laryngectomy in Excised Canine Larynges and Finite Element Model.

Objective: To evaluate vocal parameters after modified frontolateral partial laryngectomy (MFLPL) and frontolateral partial laryngectomy (FLPL) in both excised canine and finite element models.

Study Design: FLPL and MFLPL were compared, using a prospective paired case control laboratory study with excised canine larynx and computational modeling.

Setting: Basic science study conducted in university laboratory.

Combined type IIIB with bilateral type I thyroplasty for pitch lowering with maintenance of vocal fold tension.

To evaluate type IIIB thyroplasty using the excised larynx bench apparatus and determine how altering vocal fold contour by performing bilateral medialization of the inferior vocal fold affects phonation. This procedure could be performed in patients for whom pitch lowering is desirable, such as female-to-male transsexuals or male patients with mutational falsetto in whom intensive voice therapy was insufficient. Aerodynamic, acoustic, and high-speed videokymographic data were collected for nine larynges at three subglottal pressure inputs for each of three conditions: normal; type IIIB thyroplasty; and combined type IIIB with modified bilateral type I thyroplasty intended to create a more rectangular glottal configuration.

Excised larynx evaluation of wedge-shaped adjustable balloon implant for minimally invasive type I thyroplasty.

Objectives/hypothesis: To describe the method of inserting a wedge-shaped adjustable balloon implant (wABI) via a minithyrotomy for medialization thyroplasty and evaluate its effect on a range of phonatory parameters using the excised larynx bench apparatus.

Study Design: Repeated measures with each larynx serving as its own control.

Methods: A prototype wABI was deployed in six excised canine larynges of various sizes through a minithyrotomy and then filled with saline.

A clinical study of serum lipid disturbance in Chinese patients with sudden deafness.

Background: Pathological levels of blood lipids could be one of the causes of sudden sensorineural hearing loss (SSNHL). The objective of this manuscript is therefore to evaluate the relationship between blood lipid content and sudden sensorineural hearing loss (SSNHL).

Methods: The correlation between serum lipid parameters, including total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein AI (apo AI), apolipoprotein B (apo B), and lipoprotein A (Lp(a)), and the onset of SSNHL was analyzed from a data set of 250 patients and an age, gender and weight matched control group of 250 subjects.

Evaluation of auditory and visual feedback for airflow interruption.

Introduction: Clinical application of mechanical interruption methods for measuring aerodynamic parameters has been hindered by relatively high intrasubject variability. To improve the intrasubject reliability, we evaluated the effect of auditory and visual feedback on subject performance when measuring aerodynamic parameters with the airflow interrupter.

Methods: Eleven subjects performed four sets of 10 trials with the airflow interrupter: no feedback (control); auditory feedback (tone matching subject's F0 played over headphones); visual feedback (real-time feedback of sound pressure level, frequency, and airflow); and combined auditory and visual feedback.

Classification of glottic insufficiency and tension asymmetry using a multilayer perceptron.

Objective: Laryngeal function can be evaluated from multiple perspectives, including aerodynamic input, acoustic output, and mucosal wave vibratory characteristics. To determine the classifying power of each of these, we used a multilayer perceptron artificial neural network (ANN) to classify data as normal, glottic insufficiency, or tension asymmetry.

Study Design: Case series analyzing data obtained from excised larynges simulating different conditions.

Aerodynamic and nonlinear dynamic acoustic analysis of tension asymmetry in excised canine larynges.

Purpose: To model tension asymmetry caused by superior laryngeal nerve paralysis (SLNP) in excised larynges and apply perturbation, nonlinear dynamic, and aerodynamic analyses.

Method: SLNP was modeled in 8 excised larynges using sutures and weights to mimic cricothyroid (CT) muscle function. Weights were removed from one side to create tension asymmetry, mimicking unilateral SLNP.

Ultrastructural and in vivo confocal microscopic evaluation of interface after Descemet's Stripping Endothelial Keratoplasty in rabbits.

Purpose: To study healing at the donor-recipient interface after Descemet's Stripping Endothelial Keratoplasty (DSEK) in rabbits by ultrastructural and in vivo confocal microscopic evaluation.

Methods: The right eye of eight New Zealand White rabbits underwent DSEK. Postoperatively, each rabbit was subjected to routine slitlamp examination daily for 2 weeks and then weekly for 6 weeks.