3D peak and cumulative low back and shoulder loads and postures during greenhouse pepper harvesting using a video-based approach.

Background: In agricultural field work many tasks have been cited as high priority risk factors for the development of work-related musculoskeletal disorders (WRMDs). Although video-based biomechanical approaches have been effective in documenting the physical demands and risks associated with various occupational and non-occupational tasks, to date, this method has yet to be used to document jobs such as crop harvesting in a greenhouse environment.

Objective: To document and assess the postural characteristics and 3D peak and cumulative low back and shoulder loads associated with greenhouse pepper harvesting using a video-based posture sampling approach.

Assessment of phonomicrosurgical training in otolaryngology residencies: a resident survey.

Objectives/hypothesis: The primary objective of this study is to assess the adequacy of clinical and laboratory-based phonomicrosurgical training in otolaryngology residency programs using a self-report survey. The study aims to establish whether there is a need and desire for focused surgical training in phonomicrosurgery.

Study Design: Self-report Internet-based questionnaire.

The growing geriatric otolaryngology patient population: a study of 131,700 new patient encounters.

Objectives/hypothesis: To establish the effects the changing population demographics in the United States are having on the general practice otolaryngologists.

Study Design: Retrospective analysis of 131,070 consecutive new patient visits at a large private practice otolaryngology group from 2004 to 2010.

Methods: Billing records for new patient visits from 2004 to 2010 were reviewed.

Screening and treatment of methicillin-resistant Staphylococcus aureus in children undergoing open airway surgery.

Objectives: (1) To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children undergoing open airway surgery using a screening protocol; (2) to examine the rates of postoperative infection in this cohort; and (3) to determine adherence to a MRSA antibiotic protocol.

Design: Retrospective cohort study.

Setting: Tertiary pediatric referral center.

Complications of adenotonsillectomy.

Purpose Of Review: Tonsillectomy and adenoidectomy are two of the most commonly performed pediatric surgical procedures. As with all surgical intervention, tonsillectomy and adenoidectomy are associated with a host of potential complications. Fortunately, for most children undergoing adenotonsillectomy (T&A), complications are rare.

Multifocal synchronous ipsilateral Warthin tumors: case report and review of the literature.

We report a case of a 73-year-old woman who presented with an enlarging superficial parotid mass, a concomitant ipsilateral deep-lobe parotid mass, and associated upper jugular lymphadenopathy. The clinical presentation and radiographic imaging were suggestive of malignancy, and the patient was treated with total parotidectomy with upper jugular lymph node sampling. Pathologic examination revealed two distinct masses, one in the superficial lobe and one in the deep lobe of the parotid gland, both consistent with synchronous Warthin tumors.

Automated high-level disinfection of nonchanneled flexible endoscopes: duty cycles and endoscope repair.

Purpose: Guidelines issued by the Association of Operating Room Nurses and the Association of Professionals in Infection Control and Epidemiology recommend high-level disinfection (HLD) for semicritical instruments, such as flexible endoscopes. We aim to examine the durability of endoscopes to continued use and automated HLD. We report the number of duty cycles a flexible endoscope can withstand before repairs should be anticipated.

Quantitative laryngeal electromyography: turns and amplitude analysis.

Objectives: Laryngeal electromyography (LEMG) is primarily a qualitative examination, with no standardized approach to interpretation. The objectives of our study were to establish quantitative norms for motor unit recruitment in controls and to compare with interference pattern analysis in patients with unilateral vocal fold paralysis (VFP).

Design: Retrospective case-control study

Methods: We performed LEMG of the thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) in 21 controls and 16 patients with unilateral VFP.

Isolated laryngeal myokymia: diagnosis and treatment.

Myokymia is an uncommon neuromuscular disorder that rarely affects the human larynx. No previous reports of isolated laryngeal myokymia are present in the literature, and as such, established treatment protocols are lacking. We report the first case of isolated laryngeal myokymia in a 48-year-old woman with no other neurological findings, and our successful results in initial treatment and maintenance therapy with focal intralaryngeal injections of botulinum toxin A.

Mucosal bridge and pitting of the true vocal fold: an unusual complication of cidofovir injection.

We describe a unique complication of intralaryngeal cidofovir injection and present the case of a patient with recurrent respiratory papillomatosis in whom both a mucosal bridge and a pit of the true vocal fold developed after intralaryngeal cidofovir injection. A 40-year-old man presented with laryngeal papillomatosis 19 years after being treated with surgery and adjuvant radiotherapy for leiomyosarcoma of the cervical esophagus. The patient underwent 5 papillomatosis excisions combined with subepithelial injections of cidofovir to the bilateral true vocal folds at a concentration of 5 mg/mL without any complications.

Acute glutaraldehyde mucosal injury of the upper aerodigestive tract due to damage to the working channel of an endoscope.

Objectives: Glutaraldehyde (Cidex) is a commonly used agent for cold sterilization of endoscopes despite its known irritative, allergic, and carcinogenic potential. This report details the clinical course of 2 patients who suffered acute glutaraldehyde exposure during office injection procedures.

Methods: Clinical records of 2 outpatients undergoing office injection procedures were reviewed.

Ergonomic analysis of microlaryngoscopy.

Objectives/hypothesis: To apply ergonomic principles in analysis of three different operative positions used in laryngeal microsurgery.

Study Design: Prospective case-control study.

Methods: Laryngologists were studied in three different microlaryngeal operative positions: a supported position in a chair with articulated arm supports, a supported position with arms resting on a Mayo stand, and a position with arms unsupported.

Electromyographic laryngeal synkinesis alters prognosis in vocal fold paralysis.

Objectives/hypothesis: Synkinesis, or misdirected reinnervation, is likely a confounder when predicting return of function of an immobile vocal fold. Currently, no information exists on the incidence of synkinesis in unilateral vocal fold immobility (UVFI) or the effect synkinesis has on prognosis and treatment. Our objective was to examine a vocal fold adductor synkinesis screening protocol using diagnostic laryngeal electromyography (LEMG).

Vocal process granuloma and glottal insufficiency: an overlooked etiology?

Objectives/hypothesis: Vocal process granuloma has been attributed to intubation, laryngopharyngeal reflux, and phonotraumatic/hyperfunctional vocal behaviors. Vocal process granuloma has recurrence rates following surgical excision approaching 92%. We hypothesize that a portion of persistent or idiopathic cases of vocal process granuloma result from underlying glottal insufficiency (GI) caused by paresis, scar, or atrophy.

Development and validation of the Singing Voice Handicap-10.

Objectives/hypothesis: To develop a shortened version of the validated health status instrument for singers, the Singing Voice Handicap Index (SVHI).

Study Design: Prospective item analysis of the SVHI in patients with singing voice problems and creation and validation of an abbreviated SVHI, the SVHI-10.

Methods: Patients presenting to two tertiary care voice clinics prospectively completed the SVHI.

Serratia marcescens causing cervical necrotizing oropharyngitis.

Necrotizing fasciitis is a rare, life-threatening infection. We report a case of necrotizing oropharyngitis caused by Serratia marcescens in a previously immunocompetent 6-year-old male. This necrotizing infection led to a near-total defect of the oropharynx.

Cervical thymic remnants in children.

Objective: Define the clinical presentation, diagnostic value of preoperative imaging, surgical management, and outcomes of treatment of congenital cervical thymic remnants in children.

Design: Retrospective cohort.

Setting: Single tertiary care institution.

Actinomycosis of the temporal bone with labyrinthine and facial nerve involvement.

Objectives: To demonstrate the clinical, radiologic, and pathologic findings of actinomycosis of the temporal bone.

Study Design: Case report and literature review.

Methods: Analysis of a case through medical records and literature review.

Intraoperative PTH: effect of sample timing and vitamin D status.

Objective: To assess the effect of timing of intraoperative parathormone (iPTH) samples and 25-hydroxyvitamin D (25-OHD) status on decision-making during parathyroidectomy.

Methods: A total of 77 patients with primary hyperparathyroidism and iPTH levels (preincision, preremoval, 5 (T5) and 10 (T10) minutes postremoval) performed during parathyroidectomy were reviewed.

Results: Forty-one percent of patients were 25-OHD insufficient.

Who should be a stapes surgeon? An otologist or a generalist?

Purpose Of Review: The overall experience with stapes surgery has declined, both within residency training programs, as well as in clinical practice. Does this change in the environment suggest that subspecialists rather than generalists manage patients with otosclerosis?

Recent Findings: A decreasing availability of patients with clinical otosclerosis has encouraged trainees and practitioners to adopt strategies that will enable the maintenance of quality care to these patients.

Summary: Well trained generalists should be prepared to perform stapes surgery.

Adenotonsillectomy for obstructive sleep apnea syndrome in young children: prevalence of pulmonary complications.

Objective: To determine, in a series of children younger than 6 years undergoing adenotonsillectomy for treatment of clinical obstructive sleep apnea syndrome (OSAS), the effect of age on prevalence of postoperative respiratory complications. The primary objective was to define a practice standard for postoperative hospital admission.

Design: Retrospective analysis.

Potential new avenues of treatment for chronic rhinosinusitis: an anti-inflammatory approach.

Chronic rhinosinusitis is a complex disease process, one that is characterized by much more than just infection. Until its pathophysiology is understood fully, truly definitive therapy may remain elusive. As this underlying inflammatory process begins to unravel, however, new avenues of therapy will begin to emerge.