Advances in Otolaryngology The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Early versus Delayed Oral Feeding in Patients following Total Laryngectomy Sun, 28 Sep 2014 10:00:53 +0000 Objectives. To assess the effects of early oral feeding in laryngectomy patients versus delayed oral feeding. The outcomes used are mortality, pharyngocutaneous fistula rate, quality of life, hospital length of stay, and complications. Method. We performed searches within five major databases until June 2013. We considered randomised control trials (RCTs) and included nonrandomised studies for the assessment of harms. Results. We included four RCTs for assessment of benefits and three nonrandomised studies for assessment of harms (393 participants). There was no statistically significant difference detected in mortality at six months, pharyngocutaneous fistulae, or complications. The length of hospital stay was shorter in the early feeding group, MD −2.72 days [95% CI −5.34 to −0.09]. Conclusion. Early oral feeding appears to have similar incidence of complications and has the potential to shorten the length of hospital stay. Further well-designed RCTs are necessary because of weakness in the available evidence. Ashley Hay, Lisa Pitkin, and Kurinchi Gurusamy Copyright © 2014 Ashley Hay et al. All rights reserved. The Potential Use of Melatonin for Preventing Cisplatin Ototoxicity: An Insight for a Clinical Approach Mon, 18 Aug 2014 07:46:12 +0000 Cisplatin, one of the most effective and potent anticancer drugs, is used in the treatment of a wide variety of both pediatric and adult malignancies. However, the chemotherapeutic use of cisplatin is limited by its serious side effects, such as nephrotoxicity and ototoxicity. Ototoxicity produced by cisplatin is usually persistent, depending on the age of the patient, the cumulative number of doses, the number of chemotherapy cycles, the history of noise exposure, and deteriorating renal function. The mechanism of the ototoxicity caused by cisplatin is based on the generation of reactive oxygen species, which interfere with the antioxidant protection of the organ of Corti. Thus, protecting the cochlea with antioxidants ameliorates ototoxicity from cisplatin. In this context, melatonin appears as a therapeutic option for preventing the ototoxic effects of cisplatin, since the research in the last decade has proven its ability to be both a direct free radical scavenger and indirect antioxidant. In this sense, some of the evidence suggesting that melatonin is efficient for combating cisplatin-induced ototoxicity is summarized and discussed in this paper. Juliana Gusmão de Araujo, André Luiz Lopes Sampaio, Alessandra Ramos Venosa, and Carlos Augusto Costa Pires de Oliveira Copyright © 2014 Juliana Gusmão de Araujo et al. All rights reserved. Evaluation of Autogenous Engineered Septal Cartilage Grafts in Rabbits: A Minimally Invasive Preclinical Model Wed, 23 Jul 2014 11:01:49 +0000 Objectives. (1) Evaluate safety of autogenous engineered septal neocartilage grafts and (2) compare properties of implanted grafts versus controls. Study Design. Prospective, basic science. Setting. Research laboratory. Methods. Constructs were fabricated from septal cartilage and then cultured in vitro or implanted on the nasal dorsum as autogenous grafts for 30 or 60 days. Rabbits were monitored for local and systemic complications. Histological, biochemical, and biomechanical properties of constructs were evaluated. Results. No serious complications were observed. Implanted constructs contained more DNA () and less sGAG perDNA () when compared with in vitro controls. Confined compressive aggregate moduli were also higher in implanted constructs () and increased with longer in vivo incubation time (). Implanted constructs displayed resorption rates of 20–45 percent. Calcium deposition in implanted constructs was observe. Conclusion. Autogenous engineered septal cartilage grafts were well tolerated. As seen in experiments with athymic mice, implanted constructs accumulated more DNA and less sGAG when compared with in vitro controls. Confined compressive aggregate moduli were higher in implanted constructs. Implanted constructs displayed resorption rates similar to previously published studies using autogenous implants of native cartilage. Anton Kushnaryov, Tomonoro Yamaguchi, Kristen K. Briggs, Van W. Wong, Marsha Reuther, Monica Neuman, Victor Lin, Robert L. Sah, Koichi Masuda, and Deborah Watson Copyright © 2014 Anton Kushnaryov et al. All rights reserved. Benign Paroxysmal Positional Vertigo: An Integrated Perspective Thu, 17 Jul 2014 06:29:58 +0000 Benign paroxysmal positional vertigo (BPPV), the most common cause of dizziness, occurs in all age groups. It presents with vertigo on head movement, but in older patients presentation may be typical and thus accounting for a low recognition rate in the primary care setting. It may be recurrent in up to 50% of cases. BPPV is associated with displacement of fragments of utricular otoconia into the semicircular canals, most commonly the posterior semicircular canal. Otoconia are composed of otoconin and otolin forming the organic matrix on which calcium carbonate mineralizes. Otoconia may fragment with trauma, age, or changes in the physiology of endolymph (e.g., pH and calcium concentration). Presentation varied because otoconia fragments can be displaced into any of the semicircular canals on either (or both) side and may be free floating (canalolithiasis) or attached to the cupula (cupulolithiasis). Most cases of BPPV are idiopathic, but head trauma, otologic disorders, and systemic disease appear to be contributory in a subset. Positional maneuvers are used to diagnose and treat the majority of cases. In rare intractable cases surgical management may be considered. A strong association with osteoporosis suggests that idiopathic BPPV may have diagnostic and management implications beyond that of a purely otologic condition. Kourosh Parham Copyright © 2014 Kourosh Parham. All rights reserved. Retrospective Analysis of Pediatric Tracheostomy Thu, 26 Jun 2014 00:00:00 +0000 Purpose. This paper reviews analyses for tracheostomy within our patient population over the last 6 years. Methods. We conducted a retrospective chart review of consecutive patients undergoing tracheostomy at the tertiary Dicle University Medical hospital, Turkey, from January 2006 to December 2012. Patient age, sex, emergency, planned tracheostomy, indications, complications, and decannulation time were all assessed. Results. Fifty-six (34 male, 22 female) adult Pediatric patients undergoing tracheostomy between 2006 and 2013 were investigated. The most common indication for tracheostomy was upper airway obstruction (66.7%), followed by prolonged intubation (33.3%). Mean decannulation times after tracheostomy ranged between 1 and 131 days, the difference being statistically significant (). There was no significant difference in terms of mean age (; ). There was also no statistical difference between emergency and planned tracheotomies (). Conclusion. In our patient population, there was a significant decline in the number of tracheotomies performed for prolonged intubation and an increasing number of patient tracheostomy for upper airway obstruction. According to the literature, permanent decannulation rates were slightly higher with an increase in genetic diseases such as neuromuscular disease. Mehmet Akdag, Zeynep Baysal, Ayfer Gozu Pirinccioglu, Aylin Gul, Fazıl Emre Ozkurt, and Ismail Topcu Copyright © 2014 Mehmet Akdag et al. All rights reserved.