A prospective comparison of WALANT technique and general anesthesia in forefoot surgery.

Introduction: Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has been widely used in hand surgery, but there are few prospective data on its use in forefoot surgery.

Hypothesis: The WALANT technique reduces pain compared to general anesthesia for bone surgery on the first ray of forefoot.

Methods: This was a prospective, longitudinal, comparative, non-randomized cohort study in adult patients undergoing bone surgery on the first ray of forefoot.

What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts.

Objectives: Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives.

Methods: A total of 12 surgeons participated in this targeted consultation.

Resident's preparedness for independent practice following Otorhinolaryngology-Head and Neck Surgery residency program: a cross-sectional survey.

Purpose: Evaluate perception of preparedness for independent practice following the Otorhinolaryngology-Head and Neck Surgery residency program of Université de Montréal.

Methods: Cross-sectional survey of graduates from the past 10 years. Participants were asked about their level of confidence at the end of their residency for various procedures using a 5-point Likert scale.

Superiorly based facial artery musculomucosal flap: A versatile pedicled flap.

Background: The superiorly based facial artery musculomucosal (FAMM) flap is pedicled on the angular artery. This flap offers a well-vascularized mucosal surface allowing closure of medium size defects, most frequently within the oral cavity and intranasal region.

Methods: We describe a superiorly based harvest of the FAMM flap, which may be used for closure of multiple head and neck surgical defects.

Biocompatibility and pharmacokinetics of fluticasone-eluting sinus implant in a rabbit model.

Background: A novel, bioabsorbable, fibrinogen-based implant has been developed as a mucosal dressing after endoscopic sinus surgery (ESS). This implant can be formulated with fluticasone propionate (FP) for local elution of corticosteroid to reduce postoperative inflammation and promote mucosal healing.

Objective: This study investigated the biocompatibility and pharmacokinetics of the implant in a rabbit model.

Objective Assessment of Technical Skills in Otorhinolaryngology-Head and Neck Surgery Residents: A Systematic Review.

Objectives The primary goal is the indexation of validated methods used to assess surgical competency in otorhinolaryngology-head and neck surgery (ORL-HNS) residents. Secondary goals include assessment of the reliability and validity of these tools, as well as the documentation of specific procedures in ORL-HNS involved. Data Sources MEDBASE, OVID, Medline, CINAHL, and EBM, as well as the printed references, available through the Université de Montréal library.

Modified Facial Artery Musculomucosal Flap for Reconstruction of Posterior Skull Base Defects.

Objectives The superiorly pedicled facial artery musculomucosal (FAMM) flap has been successfully used for reconstruction of head and neck defects since 1992. Common sites of defects include the oral cavity and oropharynx. This article presents a clinical case in which we have successfully used a newly developed modification of the FAMM flap for bulky nasopharyngeal and skull base reconstruction.

Sustained Inner Ear Steroid Delivery via Bioabsorbable Stent: A Tolerability and Feasibility Study on Guinea Pigs.

Objective: To determine the feasibility and tolerability of a steroid-eluting middle ear device on an animal model.

Study Design: Prospective experimental.

Setting: Experimental animal study.

Effects of Fluticasone Furoate on Clinical and Immunological Outcomes (IL-17) for Patients With Nasal Polyposis Naive to Steroid Treatment.

Objectives: We investigated the effect of topical steroids on clinical outcomes and related immune response of chronic rhinosinusitis with nasal polyp (CRSwNP) patients and in eradicating some polyps. We want to explore a new potential mechanism linked to Th-17 cells.

Methods: Prospective, double-blind, placebo-controlled studies with 24 allergic and nonallergic patients were randomized to either placebo or fluticasone furoate for 12 weeks.

Intratympanic corticosteroids injections: a systematic review of literature.

The objective of the study was to determine the evidence of intratympanic steroids injections (ITSI) for efficacy in the management of the following inner ear diseases: Ménière's disease, tinnitus, noise-induced hearing loss (NIHL) and idiopathic sudden sensorineural hearing loss (ISSNHL). The data sources were literature review from 1946 to December 2014, PubMed and Medline. A systematic review of the existing literature was performed.

3D+t brain MRI segmentation using robust 4D Hidden Markov Chain.

In recent years many automatic methods have been developed to help physicians diagnose brain disorders, but the problem remains complex. In this paper we propose a method to segment brain structures on two 3D multi-modal MR images taken at different times (longitudinal acquisition). A bias field correction is performed with an adaptation of the Hidden Markov Chain (HMC) allowing us to take into account the temporal correlation in addition to spatial neighbourhood information.

Steroid-eluting sinus implant for in-office treatment of recurrent nasal polyposis: a prospective, multicenter study.

Background: Treatment options for chronic rhinosinusitis with recurrent polyposis (CRSwNP) after endoscopic sinus surgery (ESS) are limited, and include frequent use of systemic steroids and revision surgery. A bioabsorbable, steroid-eluting implant was studied for its ability to dilate sinuses obstructed by polyps and provide localized, controlled steroid delivery to reestablish sinus patency. This study assessed the initial feasibility, safety, and efficacy of steroid-eluting implants placed in the office setting in patients who were candidates for revision ESS.

Facial artery musculomucosal flap for reconstruction of skull base defects: a cadaveric study.

Objectives/hypothesis: Failure in skull base defects reconstruction following tumor resection can have serious consequences such as ascending meningitis and pneumocephaly. The nasoseptal flap showed a very low incidence of cerebrospinal fluid leak but is not always available. The superiorly pedicled facial artery musculomucosal (FAMM) flap has been successfully used for reconstruction of head and neck defects.

Interrater reliability of endoscopic parameters following sinus surgery.

Objectives/hypothesis: To determine the interrater reliability of a set of postoperative endoscopic scoring parameters in patients with chronic rhinosinusitis who have undergone endoscopic sinus surgery (ESS).

Study Design: Prospective cohort with retrospective review.

Methods: One hundred twenty video-endoscopic evaluations in 20 subjects recorded at 14, 30, and 45 days after ESS were scored in real time by the clinical investigators who performed the endoscopies and recorded the videos and retrospectively by an independent panel of four sinus surgeons who were blinded to all information.

Selective irrigation of paranasal sinuses in the treatment of recalcitrant chronic sinusitis.

Background: Chronic rhinosinusitis (CRS) refractory to medical and surgical therapy is a challenging entity to treat. Topical antibiotics and anti-inflammatory drugs have been increasingly used in managing this disorder. The aim of this pilot study is to evaluate the role of maxillary sinus antrostomy tubes (MAST) in selectively irrigating paranasal sinuses with topical antibiotics with anti-inflammatory in treating recalcitrant CRS.

Effect of Th2 type cytokines on hCLCA1 and mucus expression in cystic fibrosis airways.

Correlations between expression of interleukin (IL)-9, the calcium-activated chloride channel hCLCA1 and mucus expression in cystic fibrosis (CF) airways have suggested a causal relationship. To verify this hypothesis mucosal tissue from upper airways of CF patients (N=5) was stimulated with the Th2 type cytokines IL-4, IL-9, or IL-13. Expression of hCLCA1 mRNA and protein as well as mucus and mucin (MUC5AC) gene expression was quantified using real time PCR, immunohistochemistry (hCLCA1) and PAS staining (mucus).

Extracranial complications of endoscopic transsphenoidal sellar surgery.

Background: The endoscopic transsphenoidal approach for the resection of sellar tumours has rapidly increased in popularity. However, few studies report on the extracranial complications of this procedure. To be able to critically evaluate all of the outcomes from this approach, the occurrence of any extracranial complications that result from its performance needs to be established.

Local induction of a specific Th1 immune response by allergen linked immunostimulatory DNA in the nasal explants of ragweed-allergic subjects.

Background: Allergen immunotherapy is effective in allergic individuals however efforts are being made to improve its safety, convenience, and efficacy. It has recently been demonstrated that allergen-linked immunostimulatory DNA (ISS) is effective in stimulating an allergen-specific Th1 response with decreased allergenicity. The objective of this study is to investigate whether ISS linked to purified ragweed allergen Amb-a-1 (AIC) can inhibit local allergen-specific Th2 and induce allergen-specific Th1 responses in explanted nasal mucosa of ragweed-sensitive subjects.

Delayed-iatrogenic injury of the thoracic aorta by an anterior spinal instrumentation.

We present a case of a 15-year-old girl who presented to us with an unusual low back pain. About 7 years ago, this patient had corrective surgery for her idiopathic left thoracolumbar scoliosis. Recent surgery revealed a laceration of the posterior wall of the thoracic aorta by an impending screw thread.

Amb a 1-immunostimulatory oligodeoxynucleotide conjugate immunotherapy increases CD4+CD25+ T cells in the nasal mucosa of subjects with allergic rhinitis.

Background: We have previously shown that short-course treatment with Amb a 1-immunostimulatory phosphorothioate oligonucleotide conjugate (AIC) before the ragweed season modifies the response of the nasal mucosa to allergen challenge in ragweed-sensitive patients by increasing Th1 cytokines and decreasing both Th2 cytokines and eosinophilia after the ragweed season. The effect of AIC immunotherapy on CD4+CD25+ T cell expression in the nasal mucosa is unknown.

Objective: To determine the in vivo effect of short-course AIC immunotherapy on CD4+CD25+ regulatory T cells in the nasal mucosa of ragweed-sensitive subjects.

Montreal's experience with Cyranose heat and moisture exchanger use in 15 laryngectomized patients.

Objective: Evaluate the effects of the improvement of filtration, heating and humidification of inspired air with Cyranose heat and moisture exchanger (HME) on voice quality, breathing, and secretion handling in laryngectomized patients.

Design: Prospective study.

Setting: Fifteen laryngectomized patients, mean age 68, ages ranging from 50 to 91 years.

Performing the apnea of the single-breath carbon monoxide diffusing capacity: relaxation on the shutter or full inspiration with near atmospheric intrapulmonary pressure?

Study Objectives: The aim of the study was to measure the single-breath diffusing capacity of the lung for carbon monoxide (D(LCO)sb) in healthy subjects in the following two conditions originally proposed by the American Thoracic Society (ATS) guidelines: relaxation against the shutter; and full inspiration without straining.

Setting: D(LCO)sb was measured in 76 young adults in duplicate, in the two conditions. Mouth pressure was recorded during all of the trials.

Niflumic acid and MSI-2216 reduce TNF-alpha-induced mucin expression in human airway mucosa.

Background: Human chloride channel, calcium-activated 1 (hCLCA1) has been shown to induce mucin (MUC) gene expression and mucus production in bronchial epithelial cells. Objective To investigate whether blocking hCLCA1 decreases mucus production.

Methods: Expression of hCLCA1 and mucus was stimulated with TNF-alpha in human upper airway mucosal explant tissue.

Selective irrigation of the sinuses in the management of chronic rhinosinusitis refractory to medical therapy: a promising start.

Background: Although endoscopic sinus surgery has been widely used for the treatment of chronic rhinosinusitis, some patients fail to derive clinical benefit from this procedure. We evaluated the efficacy of a treatment regimen consisting of selective irrigation of diseased sinus mucosa with topical antibiotics and steroids in conjunction with oral antibiotics and steroids.

Methods: Twenty patients suffering from chronic rhinosinusitis and resistant to medical treatment (mean duration 3.