A four-year-old male presented with right-sided facial swelling near the angle of the mandible. D... more A four-year-old male presented with right-sided facial swelling near the angle of the mandible. Despite the presence of multiple dental carious lesions, the cervical lymphadenopathy did not appear to be of dental origin. Otolaryngology referral with subsequent excision of the affected lymph nodes confirmed the cervical lymphadenopathy to be due to a Mycobacterium avium intracellulare infection. A two-year follow-up showed successful resolution of the condition. The purpose of the present report was to describe a case with multiple dental carious lesions and cervical lymphadenopathy, with the latter attributed to a nondental etiology. A differential diagnosis of nondental etiologies of cervical lymphadenopathy in young children is described.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2014
The primary objective of this study was to compare the utility of high-speed video (HSV) to video... more The primary objective of this study was to compare the utility of high-speed video (HSV) to videostroboscopy (VS) in the assessment of adolescents with normal and abnormal larynges. A secondary objective was to evaluate the ease of assessment of adolescents with HSV. Case series with chart review. Tertiary academic health care center. This study involved a retrospective review of recordings of 7 adolescents assessed with both HSV and VS. The 14 recordings were randomized and presented to 4 groups of blinded evaluators: 2 fellowship-trained laryngologists, 2 speech language pathologists (SLP) with multiyear experience working in a voice clinic, 2 pediatric otolaryngologists, and 2 otolaryngology residents. Raters were asked to evaluate the videos using a standardized scoring tool. Raters also completed a questionnaire assessing their opinion of the HSV and VS recordings. Evaluators required more time to complete their assessment of VS recordings (2.95 min ± 2.41 min) than HSV recordi...
The mammalian ear has an extraordinary capacity to detect very low-level acoustic signals from th... more The mammalian ear has an extraordinary capacity to detect very low-level acoustic signals from the environment. Sound pressures as low as a few μ Pa (-10 dB SPL) can activate cochlear hair cells. To achieve this sensitivity, biological noise has to be minimized including that generated by cardiovascular pulsation. Generally, cardiac pressure changes are transmitted to most peripheral capillary beds; however, such signals within the stria vascularis of the cochlea would be highly disruptive. Not least, it would result in a constant auditory sensation of heartbeat. We investigate special adaptations in cochlear vasculature that serve to attenuate cardiac pulse signals. We describe the structure of tortuous arterioles that feed stria vascularis as seen in corrosion casts of the cochlea. We provide a mathematical model to explain the role of this unique vascular anatomy in dampening pulsatile blood flow to the stria vascularis.
Auriculocondylar syndrome is a rare craniofacial disorder comprising core features of micrognathi... more Auriculocondylar syndrome is a rare craniofacial disorder comprising core features of micrognathia, condyle dysplasia and question mark ear. Causative variants have been identified in PLCB4, GNAI3 and EDN1, which are predicted to function within the EDN1-EDNRA pathway during early pharyngeal arch patterning. To date, two GNAI3 variants in three families have been reported. Here we report three novel GNAI3 variants, one segregating with affected members in a family previously linked to 1p21.1-q23.3 and two de novo variants in simplex cases. Two variants occur in known functional motifs, the G1 and G4 boxes, and the third variant is one amino acid outside of the G1 box. Structural modeling shows that all five altered GNAI3 residues identified to date cluster in a region involved in GDP/GTP binding. We hypothesize that all GNAI3 variants lead to dominant negative effects.European Journal of Human Genetics advance online publication, 16 July 2014; doi:10.1038/ejhg.2014.132.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2013
Subglottic stenosis can result from endotracheal tube injury. The mechanism by which this occurs,... more Subglottic stenosis can result from endotracheal tube injury. The mechanism by which this occurs, however, is not well understood. The purpose of this study was to examine the role of angiogenesis, hypoxia and ischemia in subglottic mucosal injury following endotracheal intubation. Six Yorkshire piglets were randomized to either a control group (N=3, ventilated through laryngeal mask airway for corrosion casting) or accelerated subglottic injury group through intubation and induced hypoxia as per a previously described model (N=3). The vasculature of all animals was injected with liquid methyl methacrylate. After polymerization, the surrounding tissue was corroded with potassium hydroxide. The subglottic region was evaluated using scanning electron microscopy looking for angiogenic and hypoxic or degenerative features and groups were compared using Mann-Whitney tests and Friedman's 2-way ANOVA. Animals in the accelerated subglottic injury group had less overall angiogenic featur...
To investigate the timing and degree of angiogenesis following anterior costal cartilage graft la... more To investigate the timing and degree of angiogenesis following anterior costal cartilage graft laryngotracheoplasty in an animal model. Randomized controlled animal model. Twelve pigs were included in this study. Three control pigs were perfused with intravascular methyl methacrylate, and overlying tissue was corroded with potassium hydroxide and hydrochloric acid, leaving only a cast of vessels. Nine pigs underwent anterior costal cartilage graft laryngotracheoplasty and were survived for various lengths of time (3 for 48 hours, 3 for 10 days, 3 for 3 weeks) prior to corrosion casting. Transition zones between trachea and cartilage graft as well as the graft itself were analyzed for signs of angiogenesis (budding, sprouting, intussusception) and hypoxic or degenerative vessel features (extravasation, corrugation, circular constriction) using scanning electron microscopy. Angiogenesis peaked above control levels 48 hours after laryngotracheoplasty (P < .0001) and decreased 10 day...
Journal of the American Academy of Audiology, 2008
Children with multiple disabilities account for a small percentage of implantees in a cochlear im... more Children with multiple disabilities account for a small percentage of implantees in a cochlear implant program, but they remain the most challenging group for which to predict benefit from the implant and for cooperation with habilitation postoperatively. To assess the relationship of pre-implant functional disabilities with postoperative speech perception scores and determine the feasibility of predicting outcome with a cochlear implant in a multiply disabled pediatric population. Retrospective cohort study. Sixty-six children with a cochlear implant and at least one additional disability. We retrospectively examined the relationship between pre-implant Graded Profile Analysis (GPA) scores and postimplant speech perception scores. A pre-implant functional disability score (based on the Battelle developmental screen) was applied to the same cohort of patients and its association with postimplant speech perception scores was examined. The functional disability score significantly predicted high (k &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 24) and low (k &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 7) speech perception scores (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001) and had excellent discrimination ability (c statistic = 0.88 and 0.93 respectively). The GPA score was not significantly associated with speech perception scores (p = 0.519 and p = 0.146) and demonstrated no ability to discriminate postimplant speech perception scores in this implant population (c statistic = 0.49 and c = 0.57). Prediction of outcomes following cochlear implantation in multiply disabled children can be facilitated using this newly developed functional disability score as an adjunct to traditional candidacy assessments.
A four-year-old male presented with right-sided facial swelling near the angle of the mandible. D... more A four-year-old male presented with right-sided facial swelling near the angle of the mandible. Despite the presence of multiple dental carious lesions, the cervical lymphadenopathy did not appear to be of dental origin. Otolaryngology referral with subsequent excision of the affected lymph nodes confirmed the cervical lymphadenopathy to be due to a Mycobacterium avium intracellulare infection. A two-year follow-up showed successful resolution of the condition. The purpose of the present report was to describe a case with multiple dental carious lesions and cervical lymphadenopathy, with the latter attributed to a nondental etiology. A differential diagnosis of nondental etiologies of cervical lymphadenopathy in young children is described.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2014
The primary objective of this study was to compare the utility of high-speed video (HSV) to video... more The primary objective of this study was to compare the utility of high-speed video (HSV) to videostroboscopy (VS) in the assessment of adolescents with normal and abnormal larynges. A secondary objective was to evaluate the ease of assessment of adolescents with HSV. Case series with chart review. Tertiary academic health care center. This study involved a retrospective review of recordings of 7 adolescents assessed with both HSV and VS. The 14 recordings were randomized and presented to 4 groups of blinded evaluators: 2 fellowship-trained laryngologists, 2 speech language pathologists (SLP) with multiyear experience working in a voice clinic, 2 pediatric otolaryngologists, and 2 otolaryngology residents. Raters were asked to evaluate the videos using a standardized scoring tool. Raters also completed a questionnaire assessing their opinion of the HSV and VS recordings. Evaluators required more time to complete their assessment of VS recordings (2.95 min ± 2.41 min) than HSV recordi...
The mammalian ear has an extraordinary capacity to detect very low-level acoustic signals from th... more The mammalian ear has an extraordinary capacity to detect very low-level acoustic signals from the environment. Sound pressures as low as a few μ Pa (-10 dB SPL) can activate cochlear hair cells. To achieve this sensitivity, biological noise has to be minimized including that generated by cardiovascular pulsation. Generally, cardiac pressure changes are transmitted to most peripheral capillary beds; however, such signals within the stria vascularis of the cochlea would be highly disruptive. Not least, it would result in a constant auditory sensation of heartbeat. We investigate special adaptations in cochlear vasculature that serve to attenuate cardiac pulse signals. We describe the structure of tortuous arterioles that feed stria vascularis as seen in corrosion casts of the cochlea. We provide a mathematical model to explain the role of this unique vascular anatomy in dampening pulsatile blood flow to the stria vascularis.
Auriculocondylar syndrome is a rare craniofacial disorder comprising core features of micrognathi... more Auriculocondylar syndrome is a rare craniofacial disorder comprising core features of micrognathia, condyle dysplasia and question mark ear. Causative variants have been identified in PLCB4, GNAI3 and EDN1, which are predicted to function within the EDN1-EDNRA pathway during early pharyngeal arch patterning. To date, two GNAI3 variants in three families have been reported. Here we report three novel GNAI3 variants, one segregating with affected members in a family previously linked to 1p21.1-q23.3 and two de novo variants in simplex cases. Two variants occur in known functional motifs, the G1 and G4 boxes, and the third variant is one amino acid outside of the G1 box. Structural modeling shows that all five altered GNAI3 residues identified to date cluster in a region involved in GDP/GTP binding. We hypothesize that all GNAI3 variants lead to dominant negative effects.European Journal of Human Genetics advance online publication, 16 July 2014; doi:10.1038/ejhg.2014.132.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2013
Subglottic stenosis can result from endotracheal tube injury. The mechanism by which this occurs,... more Subglottic stenosis can result from endotracheal tube injury. The mechanism by which this occurs, however, is not well understood. The purpose of this study was to examine the role of angiogenesis, hypoxia and ischemia in subglottic mucosal injury following endotracheal intubation. Six Yorkshire piglets were randomized to either a control group (N=3, ventilated through laryngeal mask airway for corrosion casting) or accelerated subglottic injury group through intubation and induced hypoxia as per a previously described model (N=3). The vasculature of all animals was injected with liquid methyl methacrylate. After polymerization, the surrounding tissue was corroded with potassium hydroxide. The subglottic region was evaluated using scanning electron microscopy looking for angiogenic and hypoxic or degenerative features and groups were compared using Mann-Whitney tests and Friedman's 2-way ANOVA. Animals in the accelerated subglottic injury group had less overall angiogenic featur...
To investigate the timing and degree of angiogenesis following anterior costal cartilage graft la... more To investigate the timing and degree of angiogenesis following anterior costal cartilage graft laryngotracheoplasty in an animal model. Randomized controlled animal model. Twelve pigs were included in this study. Three control pigs were perfused with intravascular methyl methacrylate, and overlying tissue was corroded with potassium hydroxide and hydrochloric acid, leaving only a cast of vessels. Nine pigs underwent anterior costal cartilage graft laryngotracheoplasty and were survived for various lengths of time (3 for 48 hours, 3 for 10 days, 3 for 3 weeks) prior to corrosion casting. Transition zones between trachea and cartilage graft as well as the graft itself were analyzed for signs of angiogenesis (budding, sprouting, intussusception) and hypoxic or degenerative vessel features (extravasation, corrugation, circular constriction) using scanning electron microscopy. Angiogenesis peaked above control levels 48 hours after laryngotracheoplasty (P < .0001) and decreased 10 day...
Journal of the American Academy of Audiology, 2008
Children with multiple disabilities account for a small percentage of implantees in a cochlear im... more Children with multiple disabilities account for a small percentage of implantees in a cochlear implant program, but they remain the most challenging group for which to predict benefit from the implant and for cooperation with habilitation postoperatively. To assess the relationship of pre-implant functional disabilities with postoperative speech perception scores and determine the feasibility of predicting outcome with a cochlear implant in a multiply disabled pediatric population. Retrospective cohort study. Sixty-six children with a cochlear implant and at least one additional disability. We retrospectively examined the relationship between pre-implant Graded Profile Analysis (GPA) scores and postimplant speech perception scores. A pre-implant functional disability score (based on the Battelle developmental screen) was applied to the same cohort of patients and its association with postimplant speech perception scores was examined. The functional disability score significantly predicted high (k &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 24) and low (k &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 7) speech perception scores (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001 and p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001) and had excellent discrimination ability (c statistic = 0.88 and 0.93 respectively). The GPA score was not significantly associated with speech perception scores (p = 0.519 and p = 0.146) and demonstrated no ability to discriminate postimplant speech perception scores in this implant population (c statistic = 0.49 and c = 0.57). Prediction of outcomes following cochlear implantation in multiply disabled children can be facilitated using this newly developed functional disability score as an adjunct to traditional candidacy assessments.
Uploads
Papers by Evan Propst