Background:The endoscopic modified Lothrop procedure (EMLP) is used to manage ongoing refractory frontal sinusitis a er failed previous endoscopic sinus surgery (ESS), but this approach has a significant restenosis rate. We evaluated the potential benefits of mucosal gra s and pedicled flaps on the opening of the newly formed frontal ostium. Methods:Fi y patients with refractory frontal sinusitis or mucoceles a er ESS were randomized to undergo EMLP, either with (n = 27) or without (n = 23) mucosal gra s and pedicled flap reconstruction of the neo-ostium. The frontal neo-ostium was measured with Lindholm distending forceps, and anteroposterior (A-P) and lateral dimensions were measured intraoperatively, and then again at 6 weeks, 6 months, and 12 months postoperatively. Olfaction outcomes were assessed using the Taiwan Smell Identification Test (TWSIT) and a smell visual analog scale (VAS) score preoperatively and at 6 months postsurgery. Results:The initial intraoperative mean lateral and A-P dimensions were 23.2 ± 2.7 mm and 14.8 ± 2.3 mm and were significantly decreased at all time-points postoperatively. The mucosal gra s and pedicled flaps had greater lateral and A-P dimensions, and a greater percentage of intraoperative frontal neo-ostium area at all time-points postoperatively (all p < 0.05). At 6 months postoperatively, TWSIT (p = 0.027), but not the smell VAS score (p = 0.063), was significantly improved compared with baseline. TWSIT and smell VAS score changes did not differ between groups (p = 0.92 and p = 0.85, respectively). Conclusion:The use of mucosal gra s and pedicled flaps reduces stenosis of the frontal neo-ostium postsurgery and should be considered a er EMLP. C 2019 ARS-AAOA, LLC.

This paper focuses on machine learning based voice conversion (VC) techniques for improving the speech intelligibility of surgical patients who have had parts of their articulators removed. Because of the removal of parts of the articulator, a patient's speech may be distorted and difficult to understand. To overcome this problem, VC methods can be applied to convert the distorted speech such that it is clear and more intelligible. To design an effective VC method, two key points must be considered: 1) the amount of training data may be limited (because speaking for a long time is usually difficult for postoperative patients); 2) rapid conversion is desirable (for better communication). We propose a novel joint dictionary learning based non-negative matrix factorization (JD-NMF) algorithm. Compared to conventional VC techniques, JD-NMF can perform VC efficiently and effectively with only a small amount of training data. The experimental results demonstrate that the proposed JD-NMF method not only achieves notably higher short-time objective intelligibility (STOI) scores (a standardized objective intelligibility evaluation metric) than those obtained using the original unconverted speech but is also significantly more efficient and effective than a conventional exemplar-based NMF VC method. The proposed JD-NMF method may outperform the state-of-the-art exemplar-based NMF VC method in terms of STOI scores under the desired scenario. We confirmed the advantages of the proposed joint training criterion for the NMF-based VC. Moreover, we verified that the proposed JD-NMF can effectively improve the speech intelligibility scores of oral surgery patients. This paper focuses on machine learning based voice conversion (VC) techniques for improving the speech intelligibility of surgical patients who have had parts of their articulators removed. Because of the removal of parts of the articulator, a patient's speech may be distorted and difficult to understand. To overcome this problem, VC methods can be applied to convert the distorted speech such that it is clear and more intelligible. To design an effective VC method, two key points must be considered: 1) the amount of training data may be limited (because speaking for a long time is usually difficult for postoperative patients); 2) rapid conversion is desirable (for better communication). We propose a novel joint dictionary learning based non-negative matrix factorization (JD-NMF) algorithm. Compared to conventional VC techniques, JD-NMF can perform VC efficiently and effectively with only a small amount of training data. The experimental results demonstrate that the proposed JD-NMF method not only achieves notably higher short-time objective intelligibility (STOI) scores (a standardized objective intelligibility evaluation metric) than those obtained using the original unconverted speech but is also significantly more efficient and effective than a conventional exemplar-based NMF VC method. The proposed JD-NMF method may outperform the state-of-the-art exemplar-based NM...

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Similar to caloric and rotational chair tests, vHIT reflects the function of the entire semicircular canal VOR pathway but cannot identify whether a peripheral vestibular sensory organ or vestibular nerve is damaged. The diagnostic value of vHIT is high (sensitivity of 87.9% and specificity of 94.8%) for VN, and other types of acute vertigo and its positive predictive and negative predictive values have been reported as 85.3% and 95.8%, respectively. 9 vHIT, as a high-frequency measure tool, is a useful complement to caloric and rotational tests. | CONCLUSIONSThe present study showed that vHIT results were different in VN and SHLV groups, which may underlie different aetiologies of VN and SHLV; thus, further study will be necessary to confirm these results and determine the different aetiologies.The exclusive transcanal endoscopic tympanoplasty with tragal perichondrium is feasible, high success rate and good hearing results.This method also had the advantages of the minimised, better cosmetic results and free of suture. CONF LICT OF I NTERESTSNone to be declared. O R C I D Li-Chun Hsieh

4 Laryngoscope, 126:2399-2402, 2016.

Tympanoplasty is a technique that uses grafting materials to repair the tympanic membrane perforation through various approaches, including endaural, permeatal and retroauricular. Numerous grafting materials, such as autografts, allografts and xenografts, can be used. 1-3 Autografts, such as temporalis fascia, fat, loose connective tissue, perichondrium and cartilage, have been applied. 4-6 Additionally, al

Thyroglossal duct cysts are typically benign and usually asymptomatic. Malignant transformation is uncommon. Intralaryngeal extension is rare and results in dysphonia or dyspnea. There is no literature nowadays reporting the thyroglossal duct cyst carcinoma combining the clinical features of intralaryngeal extension. The authors present a case of progressive hoarseness and midline neck mass for 2 years. The laryngoscope and computed tomography revealed a 6-cm thyroglossal duct cyst containing ectopic thyroid tissue with intralaryngeal extension and causing airway obstruction. Complete excision with Sistrunk operation revealed papillary thyroid carcinoma. The patient resumed normal phonation after the surgery. There was no evidence of tumor recurrence and no hoarseness or dyspnea at 6 months follow up. This is the first reported case of a huge thyroglossal duct cyst carcinoma with intralaryngeal extension causing airway compromise. Complete excision of tumor is essential and vital to the symptom relief. A thyroglossal duct cyst carcinoma with endolaryngeal involvement should be considered in the differential diagnosis when the case has a massive midline neck mass with ectopic thyroid tissue and develops dyspnea or hoarseness concurrently.

Background External auditory canal (EAC) osteomas are rare, slow-growing benign neoplasms. Microscopic surgical excision had been reported for symptomatic osteomas. However, there was no study published on the feasibility of transcanal endoscopic ear surgery (TEES) for EAC osteoma. In this study, we propose two methods of TEES for symptomatic EAC osteomas and report the surgical outcomes of our patients. Methods Fifteen patients diagnosed with symptomatic EAC osteoma who underwent TEES were recruited at two otolaryngology referral centers. The extent of osteoma and degree of EAC stenosis was calculated based on high-resolution computed tomography (HRCT) imaging. We divided all the patients into two groups, solitary pedunculated osteoma or broad-based osteomas. The postoperative outcomes and complications were recorded for at least 6 months of outpatient follow-up. Results In this study, twelve patients with solitary osteoma underwent the first method, a direct transcanal removal procedure. In this approach, only a small bare bony area remained postoperatively, and it healed completely within 1 month. Three patients with broad based osteoma underwent the second method, a transcanal approach involving a skin flap. The degree of stenosis in all patients ranged from 29% to 90%. All of them could be treated completely through a transcanal endoscopic approach. No intraoperative or postoperative complications were noted during follow-up, and no canal stenosis and no recurrences were noted during at least 6 months of follow-up. Conclusions This endoscopic transcanal approach to EAC osteomas demonstrated good results for lesion removal without recurrence or intraoperative complications.