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High‐capacity silicon (Si) materials hold a position at the forefront of advanced lithium‐ion batteries. The inherent potential offers considerable advantages for substantially increasing the energy density in batteries, capable of maximizing the benefit by changing the paradigm from nano‐ to micron‐sized Si particles. Nevertheless, intrinsic structural instability remains a significant barrier to its practical application, especially for larger Si particles. Here, a covalently interconnected system is reported employing Si microparticles (5 µm) and a highly elastic gel polymer electrolyte (GPE) through electron beam irradiation. The integrated system mitigates the substantial volumetric expansion of pure Si, enhancing overall stability, while accelerating charge carrier kinetics due to the high ionic conductivity. Through the cost‐effective but practical approach of electron beam technology, the resulting 500 mAh‐pouch cell showed exceptional stability and high gravimetric/volumetric energy densities of 413 Wh kg−1, 1022 Wh L−1, highlighting the feasibility even in current battery production lines. [ABSTRACT FROM AUTHOR]

This study aimed to compare surgical outcomes of transoral robotic thyroidectomy (TORT) and transoral endoscopic thyroidectomy vestibular approach (TOETVA), concurrently compared with conventional transcervical thyroidectomy (CTT). A network meta‐analysis, comprising 23 studies, was performed in this study. The operative time of the CTT group was significantly shorter than that of the TOETVA and TORT groups. The hospital stay of the TOETVA group was significantly longer than that of the CTT group. Rates of transient recurrent laryngeal nerve palsy and total complications were higher in association with TOETVA than with TORT. No significant differences were found between the three groups in intraoperative blood loss, retrieved lymph nodes, postoperative pain, and other complications. Cosmetic satisfaction was significantly superior with TORT and TOETVA than with CTT. Compared with CTT, TOETVA and TORT showed superior cosmesis but no significant difference in surgical outcomes except for operative time and hospital stay. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To evaluate the efficacy and safety of a slow-release form of bepotastine salicylate (HL151, Belion CR) in patients with perennial allergic rhinitis (PAR).Study Design: Double-blind, placebo-controlled multicenter comparative study.Methods: Two hundred seventy-two PAR patients (aged 19-65 years) were studied to determine the efficacy and safety of HL151 (20 mg once daily administration) relative to those of a placebo in terms of improvements in total and nasal symptom scores. The subjects were randomized to the placebo (n = 138) or HL151 group (n = 134, 20 mg orally once daily for 4 weeks), and reflective and instantaneous total nasal symptom scores (TNSS) were measured daily in comparison with baseline. Among 272 subjects, 229 subjects (119 in the placebo group, 110 in the HL151 group) who completed the study were included for efficacy analysis.Results: Instantaneous and reflective TNSS and nasal symptoms such as rhinorrhea, nasal itching, and sneezing at 2 and 4 weeks showed that HL151 was superior to the placebo (all P < .05). There were no significant differences in terms of adverse events and adverse drug reactions between the two groups. Regarding serious adverse events, there was only one case of acute hepatitis B, which was reported not to be associated with HL151.Conclusions: This multicenter trial showed that once-daily use of HL151 is efficacious and safe in adult patients with PAR and could improve compliance due to its convenience.Level Of Evidence: 1b Laryngoscope, 131:E702-E709, 2021. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: There is no study regarding intraoperative neural monitoring (IONM) of the external branch of the superior laryngeal nerve (EBSLN) during transoral thyroidectomy. The objective of this study was to evaluate the feasibility and success rate of electrical identification of the EBSLN during transoral robotic or endoscopic thyroidectomy. Study Design: Case series study. Methods: We studied a cohort of 76 patients (87 nerves at risk, (NARs)) who underwent transoral robotic or endoscopic thyroidectomy and simultaneous intermittent IONM between July 2017 and May 2019. We performed the standard IONM procedure plus routine neural monitoring of the EBSLN. IONM and surgical outcome data were prospectively collected. Results: Sixty‐one patients underwent the robotic procedure, and 15 patients underwent the endoscopic procedure. Thirty‐seven external branches of the superior laryngeal nerves at risk (42.5%) were electrically identified using electromyography signals (31 NARs, 35.6%) or cricothyroid muscle twitches (6 NARs, 6.9%). The mean pre‐(S1) and post‐dissection (S2) amplitudes of the EBSLN were 372 ± 147 and 351 ± 159 μV, respectively. The identification rates were not different between the robotic and endoscopic procedures. In comparing the early 20 NARs (18 patients) and the later 67 NARs (58 patients), the identification rate was higher in the later cases, although the difference was not statistically significant (25.0% vs. 47.8%, P =.079). Conclusion: IONM of the EBSLN is feasible and useful in identifying and preserving the nerve during transoral thyroidectomy, although the identification rate of the nerve is relatively low. Level of Evidence: 4 Laryngoscope, 131:E671–E676, 2021 [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the clinical implications of diabetes for the management of idiopathic sudden sensorineural hearing loss (ISSNHL).Study Design: Retrospective study.Setting: Tertiary referral center.Subjects and Methods: ISSNHL patients (N = 403) who received inpatient management between January 2015 and December 2018 were analyzed. All were managed by a uniform treatment protocol of high-dose steroid therapy and salvage intratympanic steroid injections. Treatment results were evaluated according to the American Academy of Otolaryngology-Head and Neck Surgery's criteria 3 months after the start of treatment. We compared the clinical parameters and treatment outcomes of ISSNHL with and without diabetes. We also evaluated the influence of diabetes on the prognosis of ISSNHL by propensity score matching.Results: Overall, of the 403 ISSNHL patients, 94 (23.3%) had diabetes, and 11 were newly diagnosed with diabetes. The patients with diabetes were older than those without diabetes (P < .001), and their initial hearing threshold was significantly higher (P < .001). The diabetic patients were hospitalized for a longer period, and their hearing recovery rate was lower. However, when age, sex, and initial hearing level were adjusted by propensity score matching, the diabetic patients and matched controls yielded similar treatment results.Conclusions: ISSNHL with diabetes usually presents with severe hearing loss and requires longer hospitalization. However, diabetes itself may not influence the prognosis of ISSNHL. Proper management must be provided in ISSNHL with diabetes. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to evaluate the frequency and pattern of central lymph node metastasis in isthmic papillary thyroid carcinoma (PTC). Methods We compared the clinical and pathological data of 45 patients with a single isthmic PTC and 149 patients with a single PTC located in the unilateral thyroid lobe, all of whom underwent total thyroidectomy and bilateral central neck dissection. Results The rates of clinical, pathologic, and occult central lymph node metastasis were higher in the isthmus group than the non-isthmus group. Central lymph node metastasis in the pretracheal and bilateral paratracheal lymph nodes was more frequent in the isthmic PTC group than in the non-isthmus group. On multivariate analysis, isthmic location of the tumor was an independent risk factor for central lymph node metastasis. Conclusion Complete bilateral central neck dissection should be considered for isthmic PTC because of the high rate of bilateral central lymph node metastasis, especially to pretracheal and bilateral paratracheal lymph nodes. © 2015 Wiley Periodicals, Inc. Head Neck 38: E412-E416, 2016 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis To evaluate clinical characteristics and possible associated factors of idiopathic sudden sensorineural hearing loss (ISSNHL) in children using univariate and multivariate analyses. Study Design A retrospective case series with comparisons. Methods From January 2007 to December 2013, medical records of 37 pediatric ISSNHL patients were reviewed to assess hearing recovery rate and examine factors associated with prognosis (gender; side of hearing loss; opposite side hearing loss; treatment onset; presence of vertigo, tinnitus, and ear fullness; initial hearing threshold), using univariate and multivariate analysis, and compare them with 276 adult ISSNHL patients. Results Pediatric patients comprised only 6.6% of pediatric/adult cases of ISSNHL, and those below 10 years old were only 0.7%. The overall recovery rates (complete and partial) of the pediatric and adult patients were 57.4% and 47.2%, respectively. The complete recovery rate of the pediatric group (46.6%) was higher than that of the adult group (30.8%, P = .040). According to multivariate analysis, absence of tinnitus, later onset of treatment, and higher hearing threshold at initial presentation were associated with a poor prognosis in pediatric ISSNHL. Conclusions The recovery rate of ISSNHL in pediatric patients is higher than in adults, and the presence of tinnitus and earlier treatment onset is associated with favorable outcomes. Level of Evidence 4 Laryngoscope, 125:2209-2215, 2015 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis To investigate the significance of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in vestibular neuritis. Study Design Retrospective, case-control study. Methods The study subjects were patients who received treatment for vestibular neuritis between January 2009 and December 2013, and a control group composed of 70 age- and sex-matched healthy subjects who received laboratory testing as part of a routine health checkup. The subjects underwent a complete blood cell count and counts of the various cell subtypes to compare NLR and PLR in the vestibular neuritis patients and controls. The associations between laboratory test results and values of the vestibular function test and clinical information were examined. In addition, a subgroup analysis according to the duration of spontaneous nystagmus was performed. Results The mean NLR and PLR values of the patient group were significantly higher than those of the control group. Although caloric test outcomes and hospitalization period were not significantly correlated with blood profiles, the duration of dizziness needing antivertiginous drugs was positively correlated with NLR and PLR ( P = .021, P = .020, respectively). In addition, NLR was negatively correlated with the length of time between symptom start and blood sampling ( P = .005). The NLR and PLR value of patients with nystagmus for more than 5 days were significantly higher than those of patients whose nystagmus ceased within 5days. Conclusions This is the first report to evaluate the significance of NLR and PLR in vestibular neuritis. NLR and PLR should be taken into consideration as simple and reliable parameters for predicting the cause and severity of the disease. Level of Evidence 3b Laryngoscope, 125:E257-E261, 2015 [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine the significance of laryngopharyngeal reflux (LPR) in benign vocal mucosal lesions. Study Design and Setting: A case-control study at the tertiary referral medical center. Subjects and Methods: From April 2003 to December 2006, we studied 110 patients with benign vocal mucosal lesions who had undergone 24-hour ambulatory double pH monitoring. The control group included 200 patients who had undergone ambulatory 24-hour double-probe pH monitoring due to laryngopharyngeal reflux–related symptoms without specific findings of benign vocal mucosal lesions. Reflux symptom index and reflux finding score were measured. We compared the prevalence of pathologic laryngopharyngeal reflux and various parameters of the pH monitoring such as total reflux number, fraction time of pH below 4 in various positions, and DeMeester scores. Results: The prevalence of pathologic laryngopharyngeal reflux was 65 percent in the control group, 66 percent in vocal nodule group, 75 percent in the vocal polyp group, and 90 percent in the Reinke''s edema group. Patients with Reinke''s edema had a significantly higher prevalence of pathologic laryngopharyngeal reflux than controls (P = 0.016). LPR was associated with a significantly increased risk of Reinke''s edema (odds ratio: 4.846, 95% confidence interval 1.093∼21.492). Total reflux number and DeMeester scores in the Reinke''s edema group and fraction time of pH below 4 in the supine position in the vocal polyp group were significantly higher than those in the control group. Conclusion: Laryngopharyngeal reflux might play a role as an etiologic factor in Reinke''s edema and vocal polyps. [Copyright &y& Elsevier]

Objectives: To evaluate the usefulness of acoustic parameters as an indicator of laryngopharyngeal reflux (LPR) treatment efficacy. Study Design: A prospective case series analysis. Materials and Methods: From January to September 2005, we prospectively analyzed 40 patients who were diagnosed with laryngopharyngeal reflux by 24-hour ambulatory double-probe pH monitoring. Laryngopharyngeal reflux patients were treated medically and voice analysis was conducted three times: before treatment, 1 to 2 months after treatment, and 3 to 4 months after treatment. Jitter, shimmer, and harmonic-to-noise ratio (HNR) were analyzed as the acoustic parameters. Pre- and posttreatment reflux symptom index and reflux finding score were documented. Results: Jitter, shimmer, and HNR had improved significantly at 1 to 2 months after treatment and were maintained at 3 to 4 months after treatment. Jitter was significantly correlated with reflux symptom index. Conclusion: Acoustic parameters can be used as indicators of treatment efficacy for laryngopharyngeal reflux disease. [ABSTRACT FROM AUTHOR]

Objectives: Although many bacteriology studies on tonsillar diseases have been completed, all have been confined to children and were characterized by a paucity of cases. The purpose of this study was to analyze the underlying bacterial pathogens in tonsillar disease. Methods: A retrospective study was performed on 824 patients who underwent elective tonsillectomy with or without adenoidectomy. We analyzed the differences between the bacterial pathogens in recurrent tonsillitis and tonsillar hypertrophy with regard to age, season, and antibiotic sensitivity. Results: Among 824 cases, 966 bacterial strains from the tonsil core were isolated. In recurrent tonsillitis, Staphylococcus aureus was the most common pathogen (30.3%), followed by Haemophilus influenzae (15.5%) and group A β-hemolytic Streptococcus ( Streptococcus pyogenes, 14.4%). In patients over 14 years of age, quite differently from other age groups, Klebsiella pneumoniae was isolated at a significantly higher percentage. In tonsillar hypertrophy, H. influenzae was isolated most commonly (31.4%) regardless of age, followed by S. pyogenes (24.2%), S. aureus (22.9%), and Streptococcus pneumoniae (12.6%). Furthermore, mixed infection was common because of its high resistance to penicillin. In both groups, S. pneumoniae was more common in younger patients, whereas K. pneumoniae was relatively common in adults. We found no differences in the detection rate by season; however, H. influenzae was frequently isolated in the tonsillar hypertrophy group regardless of seasonal variations. We also found no difference in the antibiotic sensitivity between the two groups; however, strains resistant to penicillin were relatively prevalent and showed a high sensitivity to third-generation cephalosporin. Conclusions: We observed some differences in the types of bacteria in the tonsillar core between the recurrent tonsillitis and tonsillar hypertrophy groups. Our study indicates that essential bacteria have been changing and, thus, we need to change our choice of antibiotics. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the necessity of preserving the posterior branch of the great auricular nerve during parotidectomy. Study Design and Setting: Forty-six patients undergoing parotidectomy were prospectively analyzed. Twenty-four patients had preservation of the posterior branch of the great auricular nerve; in the remaining 22 patients the nerve was sacrificed. A sensory index score was defined as the area involved multiplied by the intensity grade of sensory loss. Quality-of-life was evaluated with a questionnaire. Results: The sensory index score was significantly higher in the sacrificed group as compared with the preserved group at both 1 week (41.87 vs 62.11) and 1 month (24.91 vs 46.11) after parotidectomy. The sensory deficit improved over time in both groups, and after 12 months only minimal sensory loss remained. Quality-of-life was not significantly different between the groups. Conclusions: Irrespective of preservation of the posterior branch of the great auricular nerve, sensory deficit improved over time. Therefore, preservation of the posterior branch of the great auricular nerve might not be necessary during parotidectomy. [Copyright &y& Elsevier]

Objective: Intratympanic dexamethasone injection (ITDI) was generally used as salvage treatment for sudden sensorineural hearing loss (SSNHL) patients who failed initial systemic treatment or for patients who considered to have a hazard risk on systemic steroids. We investigated the effectiveness of combination therapy, early ITDI accompanied by systemic therapy on SSNHL. Method: We gathered the data of 151 SSNHL patients who were refractory to systemic treatment for 5 days. The injection group was administered systemic therapy and 4 times of ITDI within 2 weeks after break of SSNHL. The control group only received traditional treatment. We compared the last concrete hearing level and recovery rate. Results: Overall hearing improvement was observed in 47 of 104 (45.2%) control patients and in 30 of 47 (63.8%) injection patients (P =. 034). On the basis of Siegel criteria, 7 of 47 (14.9%) injection patients were recovered in Siegel criteria 1, and 10 of 47 (21.3%) and 13 of 47 (27.7%) injection patients were respectively recovered in Siegel criteria 2 and 3. In the control group, 15.4%, 8.7%, and 21.2% patients were recovered in Siegel criteria 1, 2, and 3, respectively. Depending on the degree of initial hearing loss, patients with severe hearing loss who were treated with ITDI showed significantly higher recovery rates than patients in the control group (83.8% vs 50.0%) (P =. 049). Conclusion: Early combination therapy of intratympanic dexamethasone injection within 2 weeks accompanied by initial systemic treatment is effective for patients with refractory sudden sensorineural hearing loss, especially for patients with severe hearing loss. [ABSTRACT FROM AUTHOR]

Objectives: Investigate the role of cochlear microphonics (CM) that could be simultaneously acquired in auditory brain stem response (ABR) test in neonatal hearing screening. Methods: From April 2013 to January 2014, hearing screening tests were performed on 51 newborns treated in neonate intensive care unit. The subjects underwent transient evoked otoacoustic emission (TEOAE) and auditory brain stem response (ABR). The amplitude of CM was acquired by applying 90 dB‐click sound of condensating and rarefacting polarity. Results: There were 68 ears with normal results in ABR, CM and OAE. Auditory neuropathy was suspected in 2 ears that had presence of CM and OAE with abnormal ABR waveform. Amplitude of CM correlated with reproducibility of OAE (p<.01) inversely correlated with latencies of wave I and III (P =. 016, P =. 010). The subjects with presence of OAE showed higher amplitude of CM than those with absent OAE (P <. 01). Mean CM amplitude of subjects with normal ABR threshold was higher than those with abnormal ABR, but there was no statistical significance. Five subjects who had normal ABR threshold showed no OAE response but CM was measured. Conclusions: Amplitude of CM had correlation with results of OAE and ABR test. CM might provide more stable information about cochlear hair cell than OAE test which could be easily influenced by condition of middle ear or external ear. We suggest CM as a useful supplementary tool for OAE test. [ABSTRACT FROM AUTHOR]

Objective: Robotic thyroidectomy and conventional endoscopic thyroidectomy have not been thoroughly compared. In this study, we compared the potential advantages of robotic versus endoscopic thyroidectomy. Method: We analyzed 218 consecutive patients who underwent endoscopic (105 cases) or robotic (113 cases) thyroidectomy using a gasless unilateral axillo‐breast (GUAB) or axillary (GUA) approach. Results: Because of the dexterity of robotic instruments and the improved surgical view, it was subjectively easier and took less time to perform a complete total thyroidectomy and central compartment neck dissections (CCND) in robotic thyroidectomy. In the case of unilateral lobectomy, endoscopic and robotic thyroidectomy had quite similar surgical outcomes. Cosmetic satisfaction was excellent in both groups. Conclusion: Robotic thyroidectomy is superior to endoscopic thyroidectomy for performing total thyroidectomy and bilateral CCND. However, in terms of cost‐effectiveness, endoscopic thyroidectomy is comparable to robotic thyroidectomy in patients who undergo unilateral lobectomy. [ABSTRACT FROM AUTHOR]

Objective: Nitric oxide (NO) is known to be an important mediator and inflammatory marker of airway. The purpose of this study is to analyze the distribution of nasal NO (nNO) and exhaled NO (eNO) in chronic sinusitis (CRS) with polyp and to predict clinical features of CRS with polyp by NO, which is easy to measure. Method: We used chemiluminescent analyzer to measure nNO and eNO between healthy individuals (32) and CRS with polyp patients (30), CRS with polyp and allergic rhinitis and compared it with a variety of clinical features of chronic sinusitis like sinus CT and symptoms. Results: The nNO were significantly lower in CRS with polyp (88.5 ± 54.7 ppb) compared with controls (241.0 ± 89.5 ppb), CRS with polyp and allergic rhinitis (167.0 ± 47.6 ppb) (pp < 0.009) with a positive relationship with the extent of sinus disease, and it was different from nNO. Conclusion: The nasal NO could be used to predict CRS with polyp, which eventually has to be treated with surgery. The upper airway disease could affect the lower airway inflammation, and it reflects, "One airway, one disease." [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to investigate how the expression of the RANK-RANKL-OPG system mediates the formation and differentiation of osteoclasts and causes bone resorption in cholesteatoma., Methods: An immunohistochemical analysis was carried out in 22 cholesteatoma tissues obtained during middle ear surgery and 15 normal postauricular skin tissues to examine the expression of RANKL and OPG., Results: All 22 cases of cholesteatoma and the 15 cases of normal postauricular skin expressed RANKL and OPG. The count and rate of RANKL-positive cells in cholesteatoma was significantly higher than in normal postauricular skin. The count and rate of OPG-positive cells in normal postauricular skin was significantly higher than in cholesteatoma. The ratio of the positive expression rates of RANKL and OPG in cholesteatoma was statistically higher than in normal postauricular skin., Conclusions: We provide evidence suggesting that RANKL, which activates osteoclasts, plays a significant role in the mechanism of bone destruction in cholesteatoma, and that the ratio of RANKL to OPG may be a reliable indicator of bone destruction in cholesteatoma.