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Objective: To evaluate the concept and efficacy of an adjustable implant (Prototype SH30: porcine implant and APrevent® VOIS: human concept) for treatment of unilateral vocal fold paralysis (UVFP) via in vivo mini‐pig studies, human computed tomographic (CT) and magnetic resonance (MR) image analysis, ex‐vivo aerodynamic and acoustic analysis. Methods: Feasibility testing and prototype implantation were performed using in‐vivo UVFP porcine model (n = 8), followed by a dimensional finding study using CT and MR scans of larynges (n = 75) for modification of the implant prototypes. Acoustic and aerodynamic measurements were recorded on excised canine (n = 7) larynges with simulated UVFP before and after medialization with VOIS‐Implant. Results: The prototype showed in the in‐vivo UVFP porcine model an improved glottic closure from grade 6 incomplete closure to complete closure (n = 5), to grade 2 incomplete closure (n = 2) and grade 3 incomplete closure (n = 1). On human CT/MR scans the identification of the correct size was successful in 97.3% using the thyroid cartilage alar "distance S" as the only parameter, which is an important step towards procedure standardization and implant design. Results were confirmed with implantation in human laryngeal cadavers (n = 44). Measurements of the acoustic and aerodynamic effects after implantation showed a significant decreased phonation threshold pressure (p =.0187), phonation threshold flow (p =.0001) and phonation threshold power (p =.0046) on excised canine larynges with simulated UVFP. Percent jitter and percent shimmer decreased (p =.2976; p =.1771) but not significant. Conclusions: Based on the preclinical results four sizes, differing in medial length, implant width and expansion direction of silicone cushions, seem to be enough to satisfy laryngeal size variations. This concept is significantly effective in medializing UVFP and improving the aerodynamic and acoustic qualities of phonation as reported in a preliminary clinical outcome study with long‐term implantation. Level of Evidence: N/A [ABSTRACT FROM AUTHOR]

Objective: Endoscopic endonasal transsphenoidal surgery is safe and effective for sellar and parasellar tumor removal. Partial middle turbinate (MT) resection is sometimes performed to optimize the surgical field and facilitate postoperative care. Disturbances in olfaction are concerning because of the lack of randomized studies in this field.Study Design: Prospective randomized trial.Setting: Single academic medical center.Methods: We resected the lower halves of bilateral MTs in the resected group and laterally fractured bilateral MTs in the preserved group. Olfactory outcomes and sinonasal conditions were assessed by using the validated Taiwan Smell Identification Test and Lund-Kennedy Endoscopy Score, respectively. Forty-nine patients were enrolled in the final analysis, of whom 23 underwent partial MT resection.Results: The average Taiwan Smell Identification Test result was 36.9 one month after surgery, with a significant change of -4.4 ± 3.1 (mean ± SD; P < .01) from baseline. The impact was not significant at 3 months (-2.1 ± 2.6, P = .13) or 6 months (0.3 ± 2.0, P = .79). Between the MT resection and preservation groups, there were no significant differences at postoperative 1 month (P = .60), 3 months (P = .86), and 6 months (P > .99). Lund-Kennedy Endoscopy Score was still higher at 3 months (P = .006) after surgery but returned to the preoperative level at 6 months (P = .63).Conclusions: Endoscopic endonasal transsphenoidal surgery may affect olfaction at 1 month after surgery, and olfactory function is expected to return after 3 months. Partial MT resection did not result in additional olfactory loss. It is safe to perform partial MT resection during surgery without compromising the olfactory outcomes. [ABSTRACT FROM AUTHOR]

Keywords: adult; humans; language; paranasal sinuses; speech; voice EN adult humans language paranasal sinuses speech voice 1022 1024 3 05/28/21 20210601 NES 210601 Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease of the paranasal sinuses. The final polyp grading score, which was obtained by adding the results of Meltzer polyp grading of both sides, ranged from 0 to 8 (no polyp: 0, mild: 1 to 2, moderate 3 to 5, and severe 6 to 8). Effect of CRS severity on nasalance scores The correlation between the polyp grading scores and nasalance scores were statistically significant for nasal sentences ( I p i < 0.001) and the mixed passage ( I p i = 0.03) but was nonsignificant for the oral passage ( I p i = 0.206). [Extracted from the article]

Background: The endoscopic modified Lothrop procedure (EMLP) is used to manage ongoing refractory frontal sinusitis after failed previous endoscopic sinus surgery (ESS), but this approach has a significant restenosis rate. We evaluated the potential benefits of mucosal grafts and pedicled flaps on the opening of the newly formed frontal ostium. Methods: Fifty patients with refractory frontal sinusitis or mucoceles after ESS were randomized to undergo EMLP, either with (n = 27) or without (n = 23) mucosal grafts and pedicled flap reconstruction of the neo‐ostium. The frontal neo‐ostium was measured with Lindholm distending forceps, and anteroposterior (A‐P) and lateral dimensions were measured intraoperatively, and then again at 6 weeks, 6 months, and 12 months postoperatively. Olfaction outcomes were assessed using the Taiwan Smell Identification Test (TWSIT) and a smell visual analog scale (VAS) score preoperatively and at 6 months postsurgery. Results: The initial intraoperative mean lateral and A‐P dimensions were 23.2 ± 2.7 mm and 14.8 ± 2.3 mm and were significantly decreased at all time‐points postoperatively. The mucosal grafts and pedicled flaps had greater lateral and A‐P dimensions, and a greater percentage of intraoperative frontal neo‐ostium area at all time‐points postoperatively (all p < 0.05). At 6 months postoperatively, TWSIT (p = 0.027), but not the smell VAS score (p = 0.063), was significantly improved compared with baseline. TWSIT and smell VAS score changes did not differ between groups (p = 0.92 and p = 0.85, respectively). Conclusion: The use of mucosal grafts and pedicled flaps reduces stenosis of the frontal neo‐ostium postsurgery and should be considered after EMLP. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study is to investigate the role of Caveolin-1 (Cav-1) in nasopharyngeal carcinoma (NPC) progression and correlated with clinical outcomes. Methods We used quantitative real-time PCR (qPCR) to detect the difference in the expression of mRNA level of Cav-1 mRNA in NPC, non-NPC cell lines, and 74 NPC and 29 nontumorous nasopharyngeal mucosa biopsies. Western blotting and immunohistochemistry staining were used to detect the protein expression of Cav-1 in cell lines and biopsy tissues. We collected clinical follow-up data to investigate the association with expression of Cav-1 mRNA. Also, transfection of Cav-1 and suppression by delivery of shRNA against Cav-1 into NPC derived cell lines to analyze its influence in Akt signaling. Results By use of qPCR, immunohistochemical staining, and western blotting, we found that not only is Cav-1 overexpressed in human NPC tumor cells and NPC-derived cell lines but high Cav-1 mRNA expression is associated with poor overall survival time of NPC patients. Furthermore, phosphorylated Akt expression was enhanced by Cav-1 transfection and suppressed by delivery of shRNA against Cav-1. These data suggested a possible regulatory mechanism of Cav-1 on Akt signaling pathway. We also transfected the Cav-1 construct and shRNA in TW01 cells to prove the effect on Akt protein expression. Conclusions Overexpression of Cav-1 is related to poor prognosis in NPC patients, which correlated with Akt signaling pathway. Abrogation of Akt signaling by shRNA-mediated knockdown of Cav-1 decreased malignant properties of tumor cells. These data suggest the potential for Cav-1 as a possible novel therapeutic target in NPC treatment. Level of Evidence N/A. Laryngoscope, 125:E231-E238, 2015 [ABSTRACT FROM AUTHOR]

Objective The National Health Insurance (NHI) in Taiwan raised the physician fee for myringotomy with ventilation tube insertion (VTI) from $61.5 to $117.6 in July 2004. This study aimed to evaluate if the increased payment affected the decision making of physicians. Methods This study is a retrospective analysis by using NHI databank in Taiwan. All children less than 12 years old who underwent VTI from 1 July 2003 to 30 June 2006 were included. Waiting time and case numbers before and after the increased VTI payment were compared. The waiting time between public and private hospitals was also examined. Results From the 7408 cases evaluated, there was no difference in waiting time before and after the raise of VTI payment, and no difference within each year group. The case number of VTI increased significantly after the increase in VTI payment ( P < 0.05). The waiting time of VTI performed in private hospitals was shorter than that in public hospitals ( P = 0.0001). Conclusion The waiting time of VTI for children with otitis media with effusion (OME) has not been shortened after the increase in VTI payment. Waiting time in private hospitals is shorter than that in public hospitals. Increased payment for VTI has no effect on the physicians' decision making regarding to waiting time for children with OME in Taiwan. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluates the effects of uvulopalatopharyngoplasty (UPPP) on serum levels of nitric oxide derivatives (NOx) and endothelial function by endothelium dependent flow-mediated dilation (FMD) in obstructive sleep apnea syndrome (OSAS). Study Design: Prospective study. Subjects and Methods: Fifteen healthy subjects and 30 subjects with moderately severe to severe OSAS who desired UPPP were prospectively enrolled. FMD was measured by high-resolution B-mode ultrasonography; serum level of NOx from peripheral blood samples was also measured. All subjects participated in sleep studies. These studies were repeated 3 months after UPPP in OSAS patients. Results: For healthy patients, there was no difference in serum level of NOx and FMD between baseline and 3 months later. The serum levels of NOx in 14 of 30 patients with OSAS – designated surgical responders – increased from 13.9 ± 5.5 μM preoperation to 28.9 ± 8.2 μM postoperatively. FMD increased from 5.2 ± 5.0 preoperatively to 10.0 ± 4.7 postoperatively. For the 16 unresponsive patients, serum NOx and FMD remained impaired after UPPP. Conclusion: Successful treatment of OSAS with UPPP leads to restoration of FMD and normal serum levels of NOx. [Copyright &y& Elsevier]

Background. Inhibitors of apoptosis proteins (IAPs), which counteract apoptosis by potently inhibiting caspase activation, are promising targets of new anti-tumor therapy. However, their roles in the pathogenesis of nasopharyngeal carcinoma (NPC), an Epstein-Barr virus (EBV)-associated carcinoma, are not fully understood. Herein, we investigated the expression and regulation of IAPs in NPC. Methods and Results. Using real-time quantitative polymerase chain reaction (PCR) analysis, we found that among the IAPs family only the transcription of survivin, HIAP-1, and HIAP-2 was consistently up-regulated in NPC and metastatic NPC tissues. Immunohistochemical staining showed that their proteins were more predominantly expressed in tumor cells nests. Noteworthy, these IAPs were upregulated by interleukin-1α stimulation or EBV infection, and subsequently resulted in triggering rapid proliferation of NPC verified by strong Ki-67 staining. Conclusion. Survivin, HIAP-1, and HIAP-2 were distinctly upregulated in NPC, suggesting they may play significant roles in NPC tumorigenesis and serve as tumor markers with prognostic and therapeutic implications. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [ABSTRACT FROM AUTHOR]

Objectives: Seven‐valent pneumococcal conjugate vaccine (PCV7) has been proved to be very effective on preventing invasive pneumococcal disease (IPD) and pneumonia in children and having indirect effect on unvaccinated age groups. Previous studies also showed that PCV7 vaccination decreased the incidence of otitis media and tympanostomy tubes (TT) insertions in vaccinated children. However the indirect effect of PCV7 on TT insertions has seldom been mentioned. PCV7 was released in Taiwan in 2005. It is only for high risk group and in the private market. Partial vaccination makes Taiwan a perfect model to study the indirect effect. We tried to examine the indirect effect of PCV7 on TT insertions in a population based setting. Methods: This retrospective study used the National Health Insurance databank for the period 2000 to 2009 in Taiwan. Every child under 18 years old who received TT in this 10‐year period was identified and analyzed. The TT insertion rates in different age groups before and after the year 2005 were compared. Results: The TT insertion rate of children under 2 years old decreased significantly and increased in children 2 to 9 years after the year 2005. There is no obvious change in TT insertions for children older than 9 years old through the study period. Conclusions: The PCV7 may reduce TT insertion rate for children under 2 years old in Taiwan. This effect may be the direct effect or both direct and indirect effect of the vaccine. There was no indirect effect of PCV7 on TT insertions in children older than 2 years old. [ABSTRACT FROM AUTHOR]