Airway and Voice Outcomes After Thyroarytenoid Myomectomy for Bilateral Vocal Fold Immobility.

Introduction: Type 4 posterior glottic stenosis and bilateral vocal fold paralysis are clinically challenging causes of bilateral vocal fold immobility (BVFI) that result in glottic airway obstruction. Established procedures for BVFI typically worsen dysphonia. We hypothesize the use of thyroarytenoid myomectomy (TAM) in the setting of BVFI will improve dyspnea with decreased detriment to voice.

Electrospun composite-coated endotracheal tubes with controlled siRNA and drug delivery to lubricate and minimize upper airway injury.

Endotracheal Tubes (ETTs) maintain and secure a patent airway; however, prolonged intubation often results in unintended injury to the mucosal epithelium and inflammatory sequelae which complicate recovery. ETT design and materials used have yet to adapt to address intubation associated complications. In this study, a composite coating of electrospun polycaprolactone (PCL) fibers embedded in a four-arm polyethylene glycol acrylate matrix (4APEGA) is developed to transform the ETT from a mechanical device to a dual-purpose device capable of delivering multiple therapeutics while preserving coating integrity.

EGG CELL 1 contributes to egg-cell-dependent preferential fertilization in Arabidopsis.

During double fertilization in angiosperms, the pollen tube delivers two sperm cells into an embryo sac; one sperm cell fuses with an egg cell, and the other sperm cell fuses with the central cell. It has long been proposed that the preference for fusion with one or another female gamete cell depends on the sperm cells and occurs during gamete recognition. However, up to now, sperm-dependent preferential fertilization has not been demonstrated, and results on preferred fusion with either female gamete have remained conflicting.

Changes in vocal fold gene expression and histology after injection augmentation in a recurrent laryngeal nerve injury model.

Objective: To investigate changes in neuroregenerative pathways with vocal fold denervation in response to vocal fold augmentation.

Methods: Eighteen Yorkshire crossbreed swine underwent left recurrent laryngeal nerve transection, followed by observation or augmentation with carboxymethylcellulose or calcium hydroxyapatite at two weeks. Polymerase chain reaction expression of genes regulating muscle growth (MyoD1, MyoG and FoxO1) and atrophy (FBXO32) were analysed at 4 and 12 weeks post-injection.

Automated production of gene-modified chimeric antigen receptor T cells using the Cocoon Platform.

Autologous cell-based therapeutics have gained increasing attention in recent years because of their efficacy at treating diseases with limited therapeutic options. Chimeric antigen receptor (CAR) T-cell therapy has demonstrated clinical success in hematologic oncology indications, providing critically ill patients with a potentially curative therapy. Although engineered cell therapies such as CAR T cells provide new options for patients with unmet needs, the high cost and complexity of manufacturing may hinder clinical and commercial translation.

Effect of continuous local dexamethasone on tissue biomechanics and histology after inhalational burn in a preclinical model.

Objective: Inhalational burns frequently lead to dysphonia and airway stenosis. We hypothesize local dexamethasone delivery via a novel drug-eluting electrospun polymer-mesh endotracheal tube (ETT) reduces biomechanical and histologic changes in the vocal folds in inhalational burn.

Methods: Dexamethasone-loaded polymer mesh was electrospun onto ETTs trimmed to transglottic endolaryngeal segments and secured in nine Yorkshire Crossbreed swine with directed 150°C inhalation burns.

The Case Against Stapedectomy as a Core Competency for General Practice: A Study of Care Patterns in the Department of Defense.

Objective: Stapedectomy remains a key indicator case reportable to the Accreditation Council of Graduate Medical Education despite the decline in the incidence of otosclerosis over the last half century. This study compared the rates of stapedectomy performed by otolaryngologists at academic and nonacademic centers.

Study Design: Retrospective review.

Augmentation and vocal fold biomechanics in a recurrent laryngeal nerve injury model.

Objectives/hypothesis: Composite vocal fold (VF) biomechanical data are lacking for augmentation after recurrent laryngeal nerve (RLN) injury. We hypothesize resulting atrophy decreases VF stiffness and augmentation restores native VF biomechanics.

Methods: Sixteen Yorkshire Crossbreed swine underwent left RLN transection and were observed or underwent carboxymethylcellulose (CMC) or calcium hydroxyapatite (CaHa) augmentation at 2 weeks.

Asynchronous learning among otolaryngology residents in the United States.

Objective: Otolaryngology resident learning has historically relied on didactic lectures, textbook reading, and practical hands-on patient care. However, evidence suggests that an increasing proportion of residents in other specialties are deviating from this paradigm. This work aims to characterize otolaryngology residents' current asynchronous learning practices (i.

Morphine Use in ST-Elevation Myocardial Infarction With Downstream PY Receptor Blockers-Insight From Observational Study.

Background And Aims: Morphine use for patients presenting with NSTE-ACS is associated with excess mortality. However, the role of morphine in STE-ACS is ill characterized. We have recently confirmed direct prothrombotic effect of morphine using murine models.

Three-Dimensional Technology in Rhinoplasty.

Rhinoplasty is uniquely suited to capitalize on different aspects of three-dimensional (3D) modeling technology. Currently, 3D surface imaging of preoperative and postoperative nasal structure provides a platform for better surgical planning and patient counselling as well as objective postoperative measurements. Physical nasal models using 3D printing technology can improve rhinoplasty performance intraoperatively, postoperative outcomes, together with nasal prosthetic manufacture, by tailoring to specific patient anatomy.

Releasing the Smile: Depressor Anguli Oris Excision in the Context of Managing Nonflaccid Facial Palsy.

Background: Nonflaccid facial palsy is a debilitating entity characterized by hypertonicity, synkinesis, and hypomobility. Patients with nonflaccid facial palsy often have smile asymmetry and restriction because of disruption of normal vector forces on the modiolus. Excision of the depressor anguli oris can lead to improved oral commissure excursion, smile angle, dental show, and symmetry.

Determining the Prognosis of Bell's Palsy Based on Severity at Presentation and Electroneuronography.

Objective: To examine the demographics of Bell's palsy and determine how House-Brackmann (HB) grade at nadir and electroneuronography (ENoG) results correlate with HB grade after recovery and development of synkinesis.

Study Design: Retrospective cohort study.

Setting: Tertiary care military medical center.

Podcast-Based Learning in Otolaryngology: Availability, Breadth, and Comparison with Other Specialties.

Objectives/hypothesis: Studies across multiple specialties of medical students, residents, and attending physicians demonstrate increased retention, breadth of knowledge, and literature awareness when podcasts are used as an adjunctive educational tool. This Contemporary Review aims to 1) quantify podcast availability and episode frequency for medical learners across a broad range of specialties, and 2) compare these metrics between otolaryngology-specific podcasts with those of other specialties.

Data Sources: Top five podcast platforms: Spotify (Stockholm, Sweden 2006), Apple Podcasts (Cupertino, CA 2012), Google Podcasts (Mountain View, CA 2018), Stitcher (San Francisco, CA 2008), and TuneIn (San Francisco, CA 2002).

Reliability Between In-Person and Still Photograph Assessment of Facial Function in Facial Paralysis Using the eFACE Facial Grading System.

Assessing facial function using high-quality photographs would improve long-term and objective outcomes tracking in facial palsy, facilitate automated facial grading using artificial intelligence algorithms, and allow for remote follow up. To determine agreement between in-person and photographic electronic facial function scale (eFACE) assessments, and evaluate inter-rater reliability of photographic eFACE evaluation. Retrospective review of eFACE scores from in-person interviews and standardized photographs using the Massachusetts Eye and Ear (MEE) Standard Facial Palsy Dataset.

Non-Parametric Combined Reference Regions and Prediction of Clinical Risk.

Background: Many clinical decisions depend on estimating patient risk of clinical outcomes by interpreting test results relative to reference intervals, but standard application of reference intervals suffers from two major limitations that reduce the accuracy of clinical decisions: (1) each test result is assessed separately relative to a univariate reference interval, ignoring the rich pathophysiologic information in multivariate relationships, and (2) reference intervals are intended to reflect a population's biological characteristics and are not calibrated for outcome prediction.

Methods: We developed a combined reference region (CRR), derived CRRs for some pairs of complete blood count (CBC) indices (RBC, MCH, RDW, WBC, PLT), and assessed whether the CRR could enhance the univariate reference interval's prediction of a general clinical outcome, 5-year mortality risk (MR).

Results: The CRR significantly improved MR estimation for 21/21 patient subsets defined by current univariate reference intervals.

Implantable wireless device for study of entrapment neuropathy.

Background: Disease processes causing increased neural compartment pressure may induce transient or permanent neural dysfunction. Surgical decompression can prevent and reverse such nerve damage. Owing to insufficient evidence from controlled studies, the efficacy and optimal timing of decompression surgery remains poorly characterized for several entrapment syndromes.

Employee safety single vs. dual priorities: When is the rate of work-related driving accidents lower?

Applying both occupational safety and ambidexterity theories, we investigate which situation in organizations leads to a lower number of work-related road accidents: a single-priority situation focused on road safety, or a dual-priority situation in which both road safety and customer service are priorities. Occupational safety theory puts forward an 'either-or' approach in which employee safety must be the first priority, above and beyond all others. In contrast, the ambidexterity theory's 'both-and' approach suggests a simultaneous coexistence of priorities.

Development of Internet-Based Tasks for the Executive Function Performance Test.

Objective: The Executive Function Performance Test (EFPT) is a reliable and valid performance-based tool to assess executive functions (EFs). This study's objective was to develop and verify two Internet-based tasks for the EFPT.

Method: A cross-sectional study assessed the alternate-form reliability of the Internet-based bill-paying and telephone-use tasks in healthy adults and people with subacute stroke (Study 1).

Self-training to improve UE function at the chronic stage post-stroke: a pilot randomized controlled trial.

Background And Purpose: On-going practice and use of the weaker upper extremity (UE) are important for maintaining and improving function in individuals with chronic stroke. The effectiveness of two self-training programs for UE function and daily-use was compared.

Methods: In this pilot, single-blinded clinical trial, individuals with chronic stroke were randomized to video-games or traditional self-training (1-hour/day, 6-times/week, 5 weeks).

Mechanistic modeling of hemoglobin glycation and red blood cell kinetics enables personalized diabetes monitoring.

The amount of glycated hemoglobin (HbA1c) in diabetic patients' blood provides the best estimate of the average blood glucose concentration over the preceding 2 to 3 months. It is therefore essential for disease management and is the best predictor of disease complications. Nevertheless, substantial unexplained glucose-independent variation in HbA1c makes its reflection of average glucose inaccurate and limits the precision of medical care for diabetics.