Rhytidoplasty: SMAS Imbrication Vector Comparison.

To determine if there are aesthetic differences in patients who have undergone a SMAS lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical vectors. To determine if there are aesthetic differences in the results of the neck using sutures placed in specific areas of the platysmal muscle versus randomly placed sutures for platysmal plication to the mastoid. Comparative, retrospective, blind, and randomized study. Evaluation of preoperative and postoperative photographs of 54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53 patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed by three external, unbiased facial plastic surgeons in a blind study. A 7-point scale was used to grade the improvement of the face and the neck. In the face, SMAS lifting with predominantly oblique-vertical vectors used during the procedure offer statistically better results (p ≤ 0.001) in comparison to predominantly oblique-horizontal vectors in the aesthetical improvement of the malar eminence, melolabial fold and jowls. In the neck, both techniques offer excellent results, but the sutures used for platysmal plication in specific areas offer no statistical differences in aesthetical results from those sutures that are randomly placed in the platysmal muscle. In our study of 107 patients, SMAS lifting using predominantly oblique-vertical vectors seem to have better results than using predominantly oblique-horizontal vectors. For the neck, we do not find statistical differences between randomly placed sutures for platysmal plication versus sutures placed in specific areas of the muscle.

«¿Solo se es profeta en su tierra?» ¿Citan los otorrinolaringólogos nacionales a otros otorrinolaringólogos españoles? / «Are we prophets only at home»? Do national otorhinolaryngologists cite papers by other Spanish ORL colleagues?

Introducción y objetivos: En los últimos años la revista Acta Otorrinolaringológica Española (Acta ORL) ha hecho un gran esfuerzo de difusión científica y mejoría de su calidad con la intención primordial de conseguir el factor de impacto otorgado por el Institute for Scientific Information (ISI). Para ello, resulta imprescindible que se incremente el número de veces que sus artículos son citados en otras revistas médicas indexadas en el ISI. El presente estudio analiza la citación de los artículos publicados por los otorrinolaringólogos nacionales en el Acta ORL (Abreviación: Acta Otorrinolaringol Esp), por parte de otros grupos nacionales. Material y métodos: Estudio retrospectivo descriptivo-bibliométrico, que analiza las publicaciones y las citaciones de los artículos publicados en el Acta ORL por los otorrinolaringólogos nacionales entre enero de 2004 y diciembre de 2008. Resultados: Se observa un bajo índice de publicación biomédica por parte de los grupos otorrinolaringológicos nacionales en el Acta ORL, donde solo se publica un 39,1% de la producción biomédica nacional. Se observa un bajo índice de citaciones provenientes de grupos nacionales (32%) y una importante tendencia a las autocitaciones (18,9%). Conclusión: Los autores nacionales citan escasamente a otros autores nacionales en sus propias publicaciones nacionales e internacionales. También observamos un bajo índice de producción biomédica en comparación con los pares europeos. Además, se constata que los artículos publicados en el Acta ORL poseen un bajo índice de citación en revistas indexadas en el ISI(AU)

Introduction: Over the last few years, the Acta Otorrinolaringológica Española (Acta ORL) has been working to improve its impact factor. A high citation rate in the Journals indexed at the Institute for Scientific Information (ISI) is needed to achieve this, particularly in the ones with a high impact factor. The objective of this study was to analyse the index of citation by other national research groups of the articles by Spanish otorhinolaryngologists published in the Acta ORL Esp. Material and methods: Retrospective descriptive-bibliometric study to analyse the publications and citations of original articles published in the Acta ORL between January 2004 and December 2008. Results: We observed that Spanish otolaryngologists had a low publication index in the Acta ORL, where only 39.1% of the Spanish biomedical production was published. Moreover, the original articles published in the Acta ORL had a low index (32%) of citation by other national authors or groups, displaying a strong self-citation tendency (18.9%). Conclusion: National otorhinolaryngologists or ORL research groups had a low tendency to cite other national (ORL) authors in their publications. In addition, national authors had low biomedical production compared with their European peers. The biomedical production and the articles published in the Acta ORL had a low citation index by ISI indexed journals(AU)

"Are we prophets only at home"? Do national otorhinolaryngologists cite papers by other Spanish ORL colleagues?

INTRODUCTION: Over the last few years, the Acta Otorrinolaringológica Española (Acta ORL) has been working to improve its impact factor. A high citation rate in the Journals indexed at the Institute for Scientific Information (ISI) is needed to achieve this, particularly in the ones with a high impact factor. The objective of this study was to analyse the index of citation by other national research groups of the articles by Spanish otorhinolaryngologists published in the Acta ORL Esp. MATERIAL AND METHODS: Retrospective descriptive-bibliometric study to analyse the publications and citations of original articles published in the Acta ORL between January 2004 and December 2008. RESULTS: We observed that Spanish otolaryngologists had a low publication index in the Acta ORL, where only 39.1% of the Spanish biomedical production was published. Moreover, the original articles published in the Acta ORL had a low index (32%) of citation by other national authors or groups, displaying a strong self-citation tendency (18.9%). CONCLUSION: National otorhinolaryngologists or ORL research groups had a low tendency to cite other national (ORL) authors in their publications. In addition, national authors had low biomedical production compared with their European peers. The biomedical production and the articles published in the Acta ORL had a low citation index by ISI indexed journals.

Type III tympanoplasty with titanium total ossicular replacement prosthesis: anatomic and functional results.

OBJECTIVE: To evaluate anatomical and functional results using titanium prostheses in cartilage palisade tympanoplasties. STUDY DESIGN: Retrospective clinical study. Data were collected from patients' charts and clinical review. SETTING: Tertiary referral center. INTERVENTION: Cartilage tympanoplasty with titanium total ossicular replacement prosthesis after tympanoplasty or tympanomastoidectomy in patients operated on between July 1998 and February 2006. MAIN OUTCOME MEASURES: Anatomical results (closure of the perforation, rate of retraction pockets, recurrent cholesteatoma, and extrusion and re-perforation rates) were clinically evaluated. Pure-tone averages of air and bone conduction were analyzed. A postoperative air-bone gap (ABG) of 20 dB or less was taken to represent successful hearing.The hearing outcomes of canal wall up (CWU), canal wall down (CWD), primary and revision surgeries, and 2 groups of a short-term (<12 mo) or long-term (>24 mo) follow-up (f-u) were assessed and compared. RESULTS: Ninety-four cases were observed during the visiting period: 43 (45.7%) underwent primary procedures and 51 (54.3%) underwent revision surgeries. Closure of the tympanic membrane was achieved in 98.9%.Postoperative ABG was 20 dB or lower in 62 (66%) of 93 cases, between 11 and 20 dB in 33 cases (35%), and 10 dB or lower in 29 cases (31%).All cases undergoing CWU had a mean +/- SD postoperative ABG of 14.59 +/- 11.28 dB. There were no statistically significant differences (independent-samples t test, p = 0.5) between these patients and those receiving CWD surgery (15.95 +/- 10 dB).Thirty-eight (68%) of 56 CWD and 24 (64%) of 37 CWU cases achieved a postoperative ABG between 0 and 20 dB (chi = 0.08, p = 0.7, correlation = 0.031).Thirty-three (64.7%) of 51 who underwent revision surgeries and 29 (69%) of 42 who underwent primary procedures had a postoperative ABG between 0 and 20 dB. The difference between the groups was not significant (chi = 0.3, correlation = 0.058, p = 0.5).The mean ABG in the short f-u group was 12.38 +/- 7.34. There was no significant difference regarding long-term f-u after 24 months (11.76 +/- 8.9; Wilcoxon signed-rank test, p = 0.7).We compared the mean postoperative ABG in low hearing frequencies (500 and 1,000 Hz) and high hearing frequencies (2,000 and 4,000 Hz). A better sound transmission was achieved in high frequencies (10.32 +/- 10.6 versus 20.61 +/- 13.73 dB, respectively); the difference was statistically significant (p < 0.001, paired-samples t test). CONCLUSION: Our results suggest that tympanoplasty with titanium total ossicular replacement prosthesis reconstruction offers a stable improvement of the ABG less than 20 dB in 66% of cases, in both short-term and long-term f-u. There were no differences in the results between CWU and CWD or between primary and revision surgery. The titanium prosthesis achieves the best acoustical results for sound transmission at high frequencies (2,000 and 4,000 Hz).

Effect of mitomycin in the surgical treatment of tracheal stenosis.

OBJECTIVE: To assess the capacity of high and low doses of the antimitotic drug mitomycin to prevent laryngeal stenosis in an animal model. METHODS: A prospective, randomized, double-blind, controlled study was carried out. End-to-end anastomosis was performed in 18 rabbits after tracheal annulus resection to produce inflammation. There were 3 treatment groups: topical saline (isotonic sodium chloride solution) and low-dose (0.2 mg/mL) and high-dose (0.5 mg/mL) topical mitomycin. RESULTS: A total of 107 procedures were performed: 54 surgical procedures, 35 fibrobronchoscopies, and 18 biopsies. The effect of mitomycin was dose related. In the high-dose mitomycin group, most rabbits progressed to stenosis with a percentage decrease in airway diameter that was significantly greater than in the other 2 groups (P <.001). The mean (SD) percentage of maximum stenosis in the high-dose group was 51% (22%). In the low-dose and saline groups, it was 18% (13%) and 16% (9%), respectively. No significant differences in tracheal stenosis between the low-dose mitomycin and saline groups were observed. Blinded histopathological analysis also showed no significant differences between the saline group and the low-dose mitomycin group. Compared with the other 2 groups, the high-dose mitomycin group had a significant increase in fibroproliferative tissue (P <.001). CONCLUSION: These results suggest that topical mitomycin is not effective for avoiding tracheal stenosis and may provoke the opposite effect if the dose is not carefully selected.