Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. The full name of the specialty is otolaryngology-head and neck surgery. Practitioners are called otolaryngologists-head and neck surgeons, or sometimes otorhinolaryngologists (ORL). A somewhat outdated, but nevertheless commonly used, term for this speciality is ENT (ear, nose and throat).

Explanation

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Otolaryngologists are medical doctors who complete at least five years of surgical residency training (one year in general surgery, four years in otolaryngology - head and neck surgery). Following residency training, some otolaryngologists elect to complete advanced subspeciality fellowships which are usually one or two years in duration. As with all medical fellowships, acceptance is highly competitive.

More on [ Otolaryngology ]

pubmed: 0165-5876

Language development in Japanese children who receive cochlear implant and/or hearing aid.
Iwasaki S, Nishio S, Moteki H, Takumi Y, Fukushima K, Kasai N, Usami SI Language development in Japanese children who receive cochlear implant and/or hearing aid. Int J Pediatr Otorhinolaryngol. 2012 Jan 24; Authors: Iwasaki S, Nishio S, Moteki H, Takumi Y, Fukushima K, Kasai N, Usami SI Abstract OBJECTIVES: This study aimed to investigate a wide variety of factors that influence auditory, speech, and language development following pediatric cochlear implantation (CI). STUDY DESIGN: Prospective collection of language tested data in profound hearing-impaired children. HYPOTHESIS: Pediatric CI can potentially be effective to development of practical communication skills and early implantation is more effective. METHODS: We proposed a set of language tests (assessment package of the language development for Japanese hearing-impaired children; ALADJIN) consisting of communication skills testing (test for question-answer interaction development; TQAID), comprehensive (Peabody Picture Vocabulary Test-Revised; PVT-R and Standardized Comprehension Test for Abstract Words; SCTAW) and productive vocabulary (Word Fluency Test; WFT), and comprehensive and productive syntax (Syntactic processing Test for Aphasia; STA). Of 638 hearing-impaired children recruited for this study, 282 (44.2%) with >70dB hearing impairment had undergone CI. After excluding children with low birth weight (<1800g), those with >11 points on the Pervasive Developmental Disorder ASJ Rating Scale for the test of autistic tendency, and those <2 SD on Raven's Colored Progressive Matrices for the test of non-verbal intelligence, 190 children were subjected to this set of language tests. RESULTS: Sixty children (31.6%) were unilateral CI-only users, 128 (67.4%) were CI-hearing aid (HA) users, and 2 (1.1%) were bilateral CI users. Hearing loss level of CI users was significantly (p<0.01) worse than that of HA-only users. However, the threshold level, maximum speech discrimination score, and speech intelligibility rating in CI users were significantly (p<0.01) better than those in HA-only users. The scores for PVT-R (p<0.01), SCTAW, and WFT in CI users were better than those in HA-only users. STA and TQAID scores in CI-HA users were significantly (p<0.05) better than those in unilateral CI-only users. The high correlation (r=0.52) has been found between the age of CI and maximum speech discrimination score. The scores of speech and language tests in the implanted children before 24 months of age have been better than those in the implanted children after 24 months of age. CONCLUSIONS: We could indicate that CI was effective for language development in Japanese hearing-impaired children and early CI was more effective for productive vocabulary and syntax. PMID: 22281374 [PubMed - as supplied by publisher]
Prevalence of DFNB1 mutations in Slovak patients with non-syndromic hearing loss.
Minárik G, Tretinárová D, Szemes T, Kádasi L Prevalence of DFNB1 mutations in Slovak patients with non-syndromic hearing loss. Int J Pediatr Otorhinolaryngol. 2012 Jan 24; Authors: Minárik G, Tretinárová D, Szemes T, Kádasi L Abstract OBJECTIVES: Non-syndromic hearing loss is one of the most common genetically determined diseases in human. The incidence is approximately 1:700 and most of the cases are caused by mutations in specific locus - DFNB1, which contains two genes -GJB2 and GJB6. For the GJB2 gene following mutations are most prevalent in specific populations - 35delG, 235delC, W24X and 167delT for Caucasians, Asians, Indians and Ashkenazi Jews, respectively. Large deletions are common in GJB6 gene. Many other mutations and polymorphisms were found in DFNB1 focused non-syndromic hearing loss studies thus the establishment of optimal screening protocol should be based on population specific mutation screening studies and is an objective in our study. PATIENTS AND METHODS: In our study samples from 273 non-syndromic hearing loss patients were screened for mutations in coding and non-coding part of GJB2 gene and large deletion in GJB6 gene - del(GJB6-D13S1830). RESULTS: Causal mutation on both chromosomes was detected in 24.57% of patients, another 9.9% carried causal mutation on one chromosome. Totally 7 polymorphisms: V27I, M34T, F83L, 354 C→T, R127H, V153I, 684 C→A and 11 causal mutations: IVS1+1 G→A, 35delG, W24X, V37I, E47X, 167delT, V84M, L90P, 310del14, 333-334delAA, R184Q were detected. No patient carried the GJB6 deletion mutation (del(GJB6-D13S1830)). CONCLUSION: According to our results sequencing of GJB2 coding regions and IVS1+1G→A specific detection should explain approximately 25% of sporadic NSHL cases and these two tests are relevant for use as routine screening protocol for NSHL in Slovakia. The GJB6 del(GJB6-D13S1830) mutation was not detected in any of NSHL samples therefore it is not necessary to implement it in our routine screening protocol. PMID: 22281373 [PubMed - as supplied by publisher]
Congenital bilateral facial nerve hypoplasia with sensorineural hearing loss: A case report.
Hamizan AW, Yean KT, Abdullah A Congenital bilateral facial nerve hypoplasia with sensorineural hearing loss: A case report. Int J Pediatr Otorhinolaryngol. 2012 Jan 24; Authors: Hamizan AW, Yean KT, Abdullah A Abstract A 3-year-old child presented with congenital bilateral facial nerve palsy with bilateral profound sensorineural hearing loss. High Resolution Computed Tomogram (HRCT) of the temporal bones found bilateral atresia of cochlear nerve canals, incomplete partition of the cochleae and narrow facial nerve canals. Magnetic resonance imaging (MRI) revealed bilateral hypoplasia of facial nerves and aplasia of both vestibulocochlear nerves. There have been no other reported cases with this presentation. The possible aetiology and treatment options for the patient are discussed. We highlighted the review of aplasia/hypoplasia of the facial nerve and hypoplasia of cochlear nerve canal. PMID: 22281372 [PubMed - as supplied by publisher]
Coronal CT scan measurements and hearing evolution in enlarged vestibular aqueduct syndrome.
Saliba I, Gingras-Charland ME, St-Cyr K, Décarie JC Coronal CT scan measurements and hearing evolution in enlarged vestibular aqueduct syndrome. Int J Pediatr Otorhinolaryngol. 2012 Jan 24; Authors: Saliba I, Gingras-Charland ME, St-Cyr K, Décarie JC Abstract OBJECTIVE: To assess the correlation between the enlarged vestibular aqueduct (EVA) diameter and (1) the hearing loss level (mild, moderate, severe and profound and (2) the hearing evolution. The secondary objective was to obtain measurement limits on the coronal plane of the temporal bone CT scan for the diagnosis of EVA. METHODS: Retrospective study in a tertiary pediatric center. Mastoid CT scans were reviewed to measure the VA diameter at its midpoint and operculum on axial and coronal planes in a pathologic and normal population. We used their serial audiograms to assess the evolution of hearing. RESULTS: 101 EVA was identified out of 1812 temporal bones CT scan from our radiologic database in 8 years. Bone conduction was stable after a mean follow-up of 40.9±32.9 months. PTA has been the most affected in time by the EVA (p=0.006). No correlation was identified between impedancemetry and the diameter of the EVA. On the diagnostic audiogram, 61% of hearing loss were in the mild and moderate hearing levels; at the end of the follow-up 64% of hearing loss are still in the mild and moderate hearing levels. The cut-off values for the coronal midpoint and operculum planes on the CT scan to diagnose an EVA are 2.4mm and 4.34mm respectively. CONCLUSIONS: Conductive or mixed hearing loss might be the first manifestation of EVA. Coronal CT scan cuts can provide additional information to evaluate EVA especially when axial cuts are not conclusive. PMID: 22281371 [PubMed - as supplied by publisher]
Microdebrider assisted endoscopic marsupialization of congenital intranasal nasolacrimal duct cysts.
Dogan E, Yüksel NG, Ecevit MC, Yaman A, Berk AT, Sütay S Microdebrider assisted endoscopic marsupialization of congenital intranasal nasolacrimal duct cysts. Int J Pediatr Otorhinolaryngol. 2012 Jan 23; Authors: Dogan E, Yüksel NG, Ecevit MC, Yaman A, Berk AT, Sütay S Abstract OBJECTIVE: To provide information on the clinical characteristics and management of an uncommon congenital nasolacrimal system anomaly, intranasal nasolacrimal duct cyst. METHODS: Three patients treated with microdebrider assisted endoscopic marsupialization for intranasal nasolacrimal duct cysts were included in this study. Management and outcomes are compared to previous reports in the literature. RESULTS: Patients were presented in between 2007 and 2010. Diagnosis was made by clinical observation and endoscopic nasal examination. The first patient is a 1 year old child with congenital dacryocystocele presented as a right medial canthal mass and ipsilateral intranasal cyst. The second patient is a 60 days old child presented with nasal obstruction and feeding difficulty who was found to have bilateral intranasal cystic masses. The third patient was a 6 days old newborn with respiratory distress, whose nasal endoscopy revealed bilateral choanal atresia and left side intranasal cyst. All three cases were treated with nasal endoscopic marsupialization and no recurrence of symptoms and physical findings were found. CONCLUSIONS: Intranasal nasolacrimal duct cysts may lead to nasal obstruction, respiratory distress and feeding difficulty. An otorhinolaryngologist should be consulted, as nasal endoscopy is fundamental for diagnosis. Microdebrider assisted endoscopic marsupialization is a safe and curative treatment. PMID: 22277269 [PubMed - as supplied by publisher]
Is fine needle aspiration cytology appropriate for preoperatively diagnosing thyroglossal duct cysts in children under the age of 10 years?
Lee DH, Yoon TM, Lee JK, Lim SC Is fine needle aspiration cytology appropriate for preoperatively diagnosing thyroglossal duct cysts in children under the age of 10 years? Int J Pediatr Otorhinolaryngol. 2012 Jan 23; Authors: Lee DH, Yoon TM, Lee JK, Lim SC Abstract OBJECTIVE: The purpose of this study was to evaluate the use of fine needle aspiration cytology (FNAC) for the preoperative preparation of children less than 10 years old suspected to have thyroglossal duct cysts (TDCs). METHODS: A retrospective chart review was performed at Chonnam National University Hospital for the period of March 2005 to June 2011. RESULTS: A total of 33 patients with midline masses were identified, 22 of whom had undergone preoperative FNAC. Seventeen of the 22 patients were pathologically diagnosed with TDC by FNAC. The remaining five patients were diagnosed with non-specific (n=3) or inflammatory lesions (n=2). All 22 patients underwent a Sistrunk operation. Ten patients had pathologically confirmed thyroglossal duct cysts. The remaining patients had dermoid cysts (n=5), ranula (n=4), or inflammatory lesions (n=3). FNAC had a diagnostic sensitivity of 70% and a positive-predictive value of 41.2% for diagnosing TDC. CONCLUSION: Our results showed that preoperative FNAC is not routinely necessary for diagnosing TDC in children especially given the concerns about possible injury, low sensitivity, and low positive-predictive value. PMID: 22277268 [PubMed - as supplied by publisher]
Pediatric otogenic lateral sinus thrombosis: Role of anticoagulation and surgery.
Sitton MS, Chun R Pediatric otogenic lateral sinus thrombosis: Role of anticoagulation and surgery. Int J Pediatr Otorhinolaryngol. 2012 Jan 23; Authors: Sitton MS, Chun R Abstract OBJECTIVES: STUDY DESIGN: Retrospective case series. METHODS: Retrospective case series of seven patients with otomastoidits and lateral sinus thrombosis were included in the study. Type of anticoagulation used and both clinical and radiographic outcomes were compared. Pediatric literature review was conducted using PubMed search terms "thrombosis and otitis media and anticoagulation" limited to English. RESULTS: Seven patients presented with acute otomastoiditis with sigmoid sinus thrombosis. Six patients were treated with anticoagulation for 1.5-12months. Six patients underwent myringotomy with tube and 4 patients underwent cortical mastoidectomy without thrombectomy. Six patients had resolution of thrombosis by imaging in less than 6months. Literature review of 19 pts with OLST showed that 95% had mastoidectomy and 84% had myrigotomy with tube. All 19 patients received anticoagulation. Sixteen patients had complete clinical recovery with recanalization or resolution of clot in 3 patients. CONCLUSIONS: The treatment of OLST is controversial. Most (23/26) patients had complete clinical recovery despite clot resolution in 9 of the 26 patients. Four patients had bleeding complication with anticoagulation. This series and literature review highlights the controversy of surgery and use of anticoagulation in the treatment of OLST and the need for further investigation. PMID: 22277267 [PubMed - as supplied by publisher]
Circulating cytokines in patients undergoing tonsillectomy with fibrin glue.
Stiller-Timor L, Goldbart AD, Segal N, Amash A, Huleihel M, Leiberman A, Tal A, Holcberg G, Puterman M Circulating cytokines in patients undergoing tonsillectomy with fibrin glue. Int J Pediatr Otorhinolaryngol. 2012 Jan 23; Authors: Stiller-Timor L, Goldbart AD, Segal N, Amash A, Huleihel M, Leiberman A, Tal A, Holcberg G, Puterman M Abstract OBJECTIVE: Fibrin glue is used as a haemostatic agent or as a sealant. The aim of this study is to objectively evaluate the efficacy of the use of fibrin glue Quixil - a human surgical sealer - in tonsillectomy, for the reduction of post-operative inflammatory response. STUDY DESIGN: A prospective randomized single-blind study. METHODS: The study was performed on 40 consecutive patients undergoing adenotonsillectomy (T&A). Patients were randomly assigned to one of two sub-groups: a study group and a control group. The tonsillar beds of patients in the study group were coated with fibrin glue (Quixil, OMRIX biopharmaceuticals) at the end of the operation; the patients in the control group were treated for hemostasis without the use of fibrin glue. Complete blood counts and circulating pro-inflammatory cytokines (assayed by specific immunoassay - ELISA) were assessed in samples drawn pre- and 16h post-tonsillectomy. RESULTS: Forty patients (aged 5.8±2.4 years) were consecutively enrolled; 45% (18) of the patients were treated with fibrin glue, 55% (22) were not. Compared to controls, Quixil-treated patients demonstrated a reduction in post-tonsillectomy circulating leukocytes (29.2% vs. 45.4%, p<0.05), neutrophiles (28.3% vs. 42.1%, p<0.05), IL-6 (+1% vs. +42%, p<0.05), and TNF-alpha (+8% vs. +26%, p<0.05. CONCLUSIONS: Intra-operative fibrin glue therapy is associated with decreased immediate inflammatory response following T&A. Further studies are warranted to assess long-term outcome. LEVEL OF EVIDENCE: 1B. PMID: 22277266 [PubMed - as supplied by publisher]
On the threshold of effective well infant nursery hearing screening in Western Sicily.
Martines F, Bentivegna D, Ciprì S, Costantino C, Marchese D, Martines E On the threshold of effective well infant nursery hearing screening in Western Sicily. Int J Pediatr Otorhinolaryngol. 2012 Jan 23; Authors: Martines F, Bentivegna D, Ciprì S, Costantino C, Marchese D, Martines E Abstract OBJECTIVE: To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high "screen sensitivity" reducing the number of more expensive secondary level exams. METHODS: The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 - PASS without risk factor, free to go home; G2 - PASS with risk factor, retest at the age of 7 months; G3 - FAIL without risk factor, re-screening after 2 weeks for a maximum of four times before audiology assessment; G4 - FAIL with risk factor, retest after 2 weeks. RESULTS: The coverage rate increased progressively from 89.8% to 92%. The referral rate was 1.51% after second stage with a specificity value of 98.78%. The four-stage screening performed for G3 reduced the numbers of global audiology assessment to 0.91% with a final global specificity of 99.4±0.4%. CONCLUSION: Less than 1% of infants underwent audiological assessment; the false positives resulted 0.62% with hearing loss global incidence of 2.95/1000 and a mean age of confirmation of 3.5 months of age. It is reasonable to think that this screening programme could be implement to overall 42 Western Sicily birth centres within few years. PMID: 22277265 [PubMed - as supplied by publisher]

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