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Objectives (1) To compare the accuracy of 2 previously validated mobile-based hearing tests in determining pure tone thresholds and screening for hearing loss. (2) To determine the accuracy of mobile audiometry in noisy environments through noise reduction strategies. Study Design Prospective clinical study. Setting Tertiary hospital. Subjects and Methods Thirty-three adults with or without hearing loss were tested (mean age, 49.7 years; women, 42.4%). Air conduction thresholds measured as pure tone average and at individual frequencies were assessed by conventional audiogram and by 2 audiometric applications (consumer and professional) on a tablet device. Mobile audiometry was performed in a quiet sound booth and in a noisy sound booth (50 dB of background noise) through active and passive noise reduction strategies. Results On average, 91.1% (95% confidence interval [95% CI], 89.1%-93.2%) and 95.8% (95% CI, 93.5%-97.1%) of the threshold values obtained in a quiet sound booth with the consumer and professional applications, respectively, were within 10 dB of the corresponding audiogram thresholds, as compared with 86.5% (95% CI, 82.6%-88.5%) and 91.3% (95% CI, 88.5%-92.8%) in a noisy sound booth through noise cancellation. When screening for at least moderate hearing loss (pure tone average >40 dB HL), the consumer application showed a sensitivity and specificity of 87.5% and 95.9%, respectively, and the professional application, 100% and 95.9%. Overall, patients preferred mobile audiometry over conventional audiograms. Conclusion Mobile audiometry can correctly estimate pure tone thresholds and screen for moderate hearing loss. Noise reduction strategies in mobile audiometry provide a portable effective solution for hearing assessments outside clinical settings. [ABSTRACT FROM AUTHOR]

Objective: Determine the prevalence of asthma in children who underwent rigid bronchoscopy (RB) for a suspected foreign body aspiration (sFBA) in the tracheobronchial tree, and to identify characteristics of patients who could benefit from a trial of anti‐asthma treatment prior to undergoing a diagnostic bronchoscopy. Method: Retrospective chart review of children with sFBA in the tracheobronchial tree who underwent RB at the Montreal Children's Hospital (2001‐2009). Patient characteristics such as delay between initial choking episode and first otolaryngology evaluation, clinical findings, radiologic findings, bronchoscopic findings, and history of asthma were analyzed. Results: A total of 55 children underwent a RB for sFBA. Foreign bodies (FB) were found in 36 of these, one of which was asthmatic (2.78%, P <. 05). In the 19 children who had a negative bronchoscopy (no FB), four were asthmatics (21.1%, P <. 05). The mean time from the suspected initial choking event to the first otolaryngology evaluation was 27 days in asthmatics (range, 5 hours‐90 days; median, 14 days), whereas it was 7.2 days in nonasthmatics (range, 0.5 hours‐120 days; median, 16 hours). Otherwise, clinical and radiological findings were not significantly different in the asthmatic and non‐asthmatic groups. Conclusion: Asthmatic children with sFBA are significantly more likely to have a negative bronchoscopy than non‐asthmatics, especially when there is a delay between the suspected choking episode and the first otolaryngology evaluation. Therefore, a trial of anti‐asthma treatment prior to performing a diagnostic bronchoscopy in this subgroup of patients is justified. [ABSTRACT FROM AUTHOR]

The article offers information on a cohort study which suggests that there is no significant difference found in survival of laryngeal cancer patients with or without cartilage sclerosis after computerized tomography (CT) scan. It states the primary radiation therapy was used for the treatment of laryngeal cancer patients. It states that Kaplan-Meier survival analyses and Cox proportional-hazards regression were used for univariate and multivariate analyses during the study.

Objective: Recently, HPV has been associated with HNSCC. However its role in laryngeal SCC (LSCC) is unknown. The objective of this study is to 1) describe a novel HPV‐positive LSCC cell line and 2) report the prevalence of HPV‐positive LSCC in a select patient population. Method: Culture of an HPV‐positive LSCC primary tumor and derived cell‐line determined by p16 immunohistochemical (IHC) staining, HPV in‐situ hybridization (ISH), and HPV PCR‐MassArray using E6‐type‐specific primers. Retrospective analysis of the HPV‐status in 123 LSCC tissue micro array (TMA) patient specimens from 1985‐2000 as determined by p16‐IHC and HPV‐ISH staining. Results: A 51‐year‐old man with no tobacco or alcohol history was diagnosed with a T4N0M0 of the true vocal cord. Tumor location was confirmed by laryngoscopy and CT‐imaging. After total laryngectomy the tumor was cultured into a cell line (UM‐SCC‐105). The primary tumor specimen and LSCC derived UM‐SCC‐105 are HPV‐positive and contain HPV‐18 as established by p16 IHC, HPV‐ISH and PCR‐MassArray. In the TMA cohort, 19% (23/123) of tumors were positive for p16, and 3 were positive for HPV‐ISH. Based on p16 and ISH results, 2.4% (3/123) of tumor samples were determined to be HPV‐positive. Conclusion: In this cohort, prevalence of HPV in LSCC was 2.4%. Given the HPV‐induced HNSCC cancer epidemic, greater understanding for HPV in LSCC is warranted. UM‐SCC‐105 is the first HPV‐18 positive LSCC cell line described, and it will aid in future research to better understand the pathogenesis of HPV in LSCC. [ABSTRACT FROM AUTHOR]

Objective: The incidence of early squamous cell carcinoma of the oral tongue (SCCOT) is increasing, particularly among young patients. The development of loco‐regional recurrence is associated with poor survival. We sought to identify the predictors for nodal recurrence in early (T1/T2) SCCOT presenting with a radiologically N0 neck. Method: Retrospective chart review of 50 consecutive patients primarily treated for T1/T2‐N0 SCCOT at an academic tertiary institution between 1998 and 2007. N0 status confirmed by preoperative contrasted neck CT in all cases. Results: Twenty‐six men and 24 women with a median age of 61 years (range, 24‐90 years); 46% presented with a T1 and 54% with a T2. Depth of invasion >4 mm was present in 76%; positive margins in 8%; dysplasia at the margin 6%; perineural invasion 18%; and lymphovascular invasion 12%. Ipsilateral neck dissection was performed in 60% (20% microscopically positive) while adjuvant radiation was used in 32%. Twenty percent of the patients recurred in the neck, ipsilateral in all cases. It presented between 4 and 47 months and was associated with dysplasia at the margin (P =. 037) and local recurrence (P =. 002), while pathological T‐stage (pT2/pT1) trended (P =. 087). Conclusion: Pathological T‐stage, field cancerization and development of local recurrence are predictors for regional failure in patients with early SCCOT. Neck recurrence appears to be primarily determined by biological behavior rather than treatment modality in this subset of patients. [ABSTRACT FROM AUTHOR]

Objective: 1) To determine the incidence of pressure ulcers (PU) post‐prolonged head and neck surgery. 2) To determine the outcome of interventional strategies on PU development. Method: A prospective study between June 2008 and March 2011.Using the FOCUS‐PDCA model, an improvement plan was developed in KFMC for patients undergoing surgery of 4‐hour duration. A patient monitoring protocol was developed including a full demographic database, a preoperative risk assessment, an intraoperative prevention method with a skin integrity check list, and a postoperative skin assessment handover. The patients were monitored for signs of PU for the next 7 days. Possible risk factors along with pressure ulcer reduction interventions were evaluated. Results: During the study 230 H&N patients were monitored. The initial incidence of PU was 23.5%. After implementation of the specialty mattress, it decreased to 10%. With the use of additional mattresses, intra‐ and postoperative PU prevention documentation the incidence deceased to 5%. The PUs that developed were stage I or II; none of them progressed. Duration of surgery was the most important risk factor (P <. 05). The site of PU was in the back in 50% (scapula 29%) of patients. Increased length of stay was associated with PU development (P <. 05). Conclusion: Patients undergoing prolonged H&N surgery are at higher risk of developing PU than patients going for other types of surgeries. Downward trends in PU development were related to the implementation of interventional strategies. The high level of awareness and continuous monitoring prevented further progression of early stage PU. [ABSTRACT FROM AUTHOR]

Objective: 1) To retrospectively assess the usefulness of preoperative thyroglobulin (Tg) levels in predicting sentinel lymph node (SLN) biopsy (SLNB) status. 2) To evaluate the correlation between preoperative Tg levels and the overall number of positive SLNs. 3) To compare primary tumor (T) classification in patients according to SLNB outcome. Method: Data from patients operated for well‐differentiated thyroid carcinoma (WDTC) at the McGill University Thyroid Cancer Center were collected from January 2007 to January 2012. Statistical analyses were performed using a Mann‐Whitney‐Wilcoxon test, a Pearson correlation coefficient and a Pearson χ2 test. Results: Preoperative Tg levels and SLNB results were available in 74 patients (51 negative and 23 positive SLNBs). Mean preoperative Tg levels for negative and positive SLNB groups were 105.2 and 85.9 ng/mL, respectively, yielding no statistically significant difference (P =. 143). Moreover, no statistically significant correlation was found between Tg levels and the number of positive SLNs (P =. 515). While 82.4% of patients with negative SLNBs had a T1 or T2 class WDTC, 82.6% of patients with positive SLNBs had a T3 or higher class, yielding a statistically significant difference between the 2 groups (P <. 001). Conclusion: Preoperative Tg levels are not significantly different in patients with positive SLNBs as compared to negative SLNBs, and show no significant correlation with the number of positive SLNs. Thus, an elevated preoperative Tg is not a predictor of SLN status. Patients with positive SLNBs, however, have significantly worse T classifications. [ABSTRACT FROM AUTHOR]