bluuebunny/crossref_metadata_2025 huggingface dataset:
Posterior table fractures of the frontal sinus: I. an experimental study
Authors: Hybels Roger L. , Newman M. Haskell
Published: October 2006

Experiments using cats were performed to examine the natural history of posterior table fractures of the frontal sinus and the methods available for treatment. Elevation of depressed fractures and obliteration by either fat or osteoneogenesis and fibrosis were the modalities of treatment used. Comparisons were made with untreated controls. Fascia reinforcement of the dura and plugging of the nasofrontal duct were variables.

The nasofrontal duct is critical in the natural history of these injuries. All fractures of the posterior table heal if drainage into the nose is maintained. Fractures which are elevated heal by bony union with associated mucosal and dural healing. Loose fragments of the posterior table heal if left in place. Mucoceles form if the nasofrontal duct is obstructed, if mu‐cosa is inadequately removed during obliteration and, in some instances, where islands of mucosa are isolated by mucosal laceration. Viable adipose tissue in the sinus prevents significant ingrowth of mucosa from the nasofrontal duct. Growth of mucosa into fracture lines was not a problem. Both adipose transplants and intrasinus fascia reinforcement appeared to contribute to well defined posterior table healing.
Tympanic membrane keratoma (cholesteatoma) in children with no prior otologic surgery
Authors: Smith Ray , Moran Willard B.
Published: October 2006

Three children whose eardrums appeared normal upon previous examinations, one with the otomicroscope, apparently developed tympanic membrane cholesteatomas that penetrated the fibrous layer of the pars tensa. Their histories all included episodes of acute otitis media, but no otorrhea. No otologic surgical procedures, including myringotomy, had been performed. These cases are thought to provide clinical support for the basal epithelial migration theory of cholesteatoma genesis.

Rüedi's experiments suggest that cholesteatomas resulting from basal epithelial migration may not be visible for 18 to 30 days; thus, follow‐up evaluations after acute otitis media should probably include examinations one and two months after the infection. Pediatricians and family physicians should be urged to seek otologic consultation for patients with even minor eardrum abnormalities, particularly those following infection.
Sublabial mucosal flap: Repair of septal perforations
Authors: Tardy M. Eugene
Published: October 2006

The majority of perforations of the nasal septum, regardless of etiology, create little more than an annoyance to the patient. Perf orations commonly may be totally asymptomatic, discovered only on careful nasal examination. It is reasonable to assume, therefore, that only those septal defects creating important symptoms are deserving of repair and correction. Heavy crusting, recalcitrant bleeding and impending or actual loss of dorsal support are justifications for perforation closure.

Textbooks and journals abound with suggested varieties of techniques of repair, testifying to the non‐effectiveness of any one suitable approach. Local mucosal flaps, turbinate flaps, pedicle skin flaps, and free grafts of skin, dermis, perichondrium, cartilage, and fascia have all been employed with variable results. An inadequate blood supply and unfavorable scarred host bed commonly lead to failure of the above reconstruction methods.

In the past five years a horizontal mucosal flap derived from the under‐surface of the upper lip has proved reliable and expedient in septal perforation re‐epithelialization and closure. The reconstructive procedure is not technically difficult and leads to minimal patient discomfort.
Mycotic infections of the inner ear
Authors: Meyerhoff William L. , Paparella Michael M. , Oda Makoto , Shea Donald
Published: October 2006

Mycotic infections of the inner ear have only rarely been reported. In each reported case, involvement of the inner ear appeared to be secondary to overwhelming central nervous system disease. A review of specimens from the University of Minnesota temporal bone collection has identified three distinct routes of inner ear involvement by fungi suggesting the potential pathogenesis for this disease to be similar to that identified for bacterial labyrinthitis (tympanogenic, meningogenic, hematogenic).

The first case, a 48‐year‐old white male with leukemia, died of mucor meningoencephalitis. Temporal bone study revealed Mucor sp. in the arterioles of the temporal bone as well as fungal involvement of the perilymphatic space secondary to round window invasion, oval window invasion, and invasion through the internal auditory canal. The second case was a 69‐year‐old white male, diabetic, who died of Klebsiella septicemia. Post mortem temporal bone study revealed a focus of Candida sp. in the vestibule under the stapedial footplate without apparent involvement of the internal auditory canal. Case 3 was a 16‐year‐old male with lymphosarcoma who died of septicemia and candida meningoencephalitis. Candida sp. could be seen in the scala tympani adjacent to Rosenthal's canals presumably secondary to spread from the central nervous system. The fourth case, that of a 28‐year‐old white female with systemic candidiasis, had sequential ante mortem audiograms demonstrating progressive bilateral sensorineural hearing loss. Post mortem histologic examination of the temporal bones identified candida involvement of the inner ear which appeared to be hematogenic in origin.

These four cases demonstrate conclusive examples of inner ear involvement of fungal disease by the tympanogenic, meningogenic, and hematogenic routes.
Surgical management of brain tissue herniation into the middle ear and mastoid
Authors: Glasscock Michael E. , Dickins John R. E. , Jackson C. Gary , Wiet Richard J. , Feenstra Loow
Published: October 2006

In the well pneumatized temporal bone, the temporal lobe of the brain is separated from the middle ear and mastoid process by a thin layer of bone known as the tegmen. Congenital defects, infection, and trauma can alter this structure in such a way that cerebral tissue herniates into the ear. This unusual condition may precipitate numerous otologic problems such as hearing loss, trapped squamous epithelium, and the potential for meningitis or encephalitis.

The purpose of this paper is to define the problem as well as discuss the diagnosis and surgical management. The authors feel this should be a team effort, in many cases employing the assistance of a neurosurgeon, as the repair must often be intradural. Case histories and an extensive review of the literature are to be included.
Middle ear ventilation in conjunction with adenotonsillectomy
Authors: Leek Joseph H.
Published: October 2006

This report continues the evaluation of the use of a ventilation tube in the middle ear at the time of adenotonsillectomy. This series of 72 cases has been followed for 1 to 3 years. Each patient had bilaterally similar middle ear effusions. A myringotomy was performed in both ears. In one of the ears a ventilation tube was inserted, the other ear acting as a control.

In 3 out of 4 of the patients in this study, adenotonsillectomy and evacuation of the middle ear fluid were sufficient to clear the middle ear indefinitely, and the use of the ventilation tube was redundant.
Human laryngeal reinnervation: The Northwestern experience
Authors: Applebaum Edward L. , Allen George W. , Sisson George A.
Published: October 2006

Recent publications have reported impressive success with laryngeal reinnervation utilizing a nerve‐muscle pedicle. This innovative surgical procedure is claimed to be useful for unilateral and bilateral vocal cord paralysis. Although the surgical results reported by Tucker have been good, they have lacked corroboration from other centers. We have performed six laryngeal reinnervation procedures at Northwestern University Medical School. Four patients presented with bilateral vocal cord paralysis and two patients with unilateral paralysis. All six operations were successful in restoring vocal cord function. The technique, problems, and results are discussed. Our experience supports the initial reports of success with this new operation.
Fibrous histiocytoma of the parotid gland
Authors: Shapshay Stanley M. , Wingert Richard H. , Davis J. Scott
Published: October 2006

Fibrous histiocytomas are not uncommonly found in the head and neck region. These tumors, arising from the tissue histiocyte, generally behave in a benign fashion. An unusual case of a fibrous histiocytoma arising in the parotid gland is presented. The histopathology of these lesions as well as parotid neoplasms in children is reviewed. Wide local excision without sacrifice of important structures is the treatment of choice.
Experiences in middle turbinectomy
Authors: Morgenstein Karl M. , Krieger Myles K.
Published: October 2006

Rhinologists have long cautioned about removal of the middle turbinate, though exenteration of the ethmoid labyrinth including the middle turbinate has shown the structure can be sacrificed. The middle turbinate can be removed in the crowded nose often with septoplasty and partial inferior turbinectomy, to improve the nasal airway. A vasoactive middle turbinate which engorges and compresses against an often deviated nasal septum gives rise to the “four finger headache” patient for whom middle turbinectomy, often with septoplasty, is helpful. Point cocainization of the compressed site helps prognosticate the good candidate for surgical relief. Patients with purulent sinusitis have been excluded from the study. Results have been good to excellent with no long‐term adverse sequelae. There has been no crusting, drying, or infection as a result of our middle turbinectomies. Careful patient selection is critical.
Thin needle aspiration biopsy of the thyroid gland
Authors: Frable Mary Ann , Frable William Jackson
Published: October 2006

Between 1973 and December 1978, the authors performed 133 thin needle aspiration biopsies of the thyroid gland. Thin needle aspiration biopsy has proved valuable in this series and may save some patients the necessity of thyroid surgery. The procedure, performed quickly, results in a diagnosis usually available minutes later, and a definite patient disposition can be made promptly. At a time of medical cost containment, this procedure will become more important in patient care.

Review of our aspirations through 1977 revealed three false negative biopsies and two false positive reports.

Important differential characteristics between follicular neoplasm and nodular or ade‐nomatous goiter will be discussed. Neoplasms appear to represent a smaller percentage of cold thyroid nodules than reported elsewhere.
Epidermoid carcinoma of the nasal vestibule: Current treatment evaluation
Authors: Schaefer Steven D. , Hill Gary C.
Published: October 2006

Twelve cases of epidermoid carcinoma of the nasal vestibule with a median follow‐up of three years were reviewed to evaluate effectiveness of current treatment modalities. Patients were initially treated by surgery, irradiation, or a combination of both therapies. The authors conclude 1. epidermoid carcinoma of the nasal vestibule is an aggressive disease; 2. once metastases have occurred, they are poorly controlled by surgery and/or irradiation; and 3. initial therapy should be directed to both control of the primary and prevention of distant metastases.
Frey's syndrome: Incidence related to skin flap thickness in parotidectomy
Authors: Singleton George T. , Cassisi Nicholas J.
Published: October 2006

Symptomatic gustatory sweating and inflammation of the skin over the site of the parotidectomy occurs in from 5 to 25% of cases. In a series of 164 studied, 6 of 48 patients with thin flaps developed significant Frey's syndrome. These figures are significant at the 95% confidence level.
Multiple granular cell tumor
Authors: Jones John K. , Kuo Tseng‐Tong , Griffiths Ceri M. , Itharat Suphot
Published: October 2006

Eleven cases of granular cell tumor were reviewed. In two of the cases multiple sites of involvement were seen. The tumor occurred in the oral cavity in both of these cases and each was initially wrongly diagnosed as squamous cell carcinoma. The most common site was the subcutaneous tissue (nine patients) and the tongue was involved in three cases. In one patient the parotid gland was involved. Eight of the patients were females and three were males; seven were black and four were white. The importance of differentiating between squamous cell carcinoma and granular cell tumor is stressed, as is the need for a simple wide surgical excision.
Fibrous histiocytoma of the nasal cavity
Authors: Del‐Rey Enrique , De‐La‐Torre Fernando E.
Published: October 2006

The case of a 17‐year‐old female patient with a polypoid tumor in the right nasal fossa, diagnosed as fibrous histiocytoma and treated by polypectomy and maxillectomy, is reported. It represents a very unusual variety of nasal neoplasm, generally of unpredictable course. The clinical and morphological characteristics of seven previously published additional cases are also reviewed.
Early diagnosis in bell's palsy. A nerve conduction study
Authors: Joachims H. Z. , Bialik V. , Eliachar I.
Published: October 2006

In 100 consecutive patients affected by idiopathic facial palsy the final degree of recovery was found to be inversely related to the distal latency time (DLT) measured within 72 hours of the onset of the disease. Incomplete recovery occurred in 77% of patients in whom the DLT was prolonged more than 10.0 msec, while complete recovery was found in 92% of cases in whom the DLT was less than 6.0 msec. This inexpensive test is easily and quickly performed and does not depend on the subjective responses or the cooperation of the patients. It may fill the gap between the onset of the palsy and the period in which other electrodiagnostic tests can be usefully employed.
Issues in early identification of hearing loss.
Authors: Alberti Peter W. , Hyde Martyn L. , Corbin Hollis , Riko Krista A , Fitzhardinge Pamela M.
Published: October 2006

In a general hospital, an early detection research program based on a high risk register and brain stem electric response audiometry (BERA) using click and frequency‐specific stimuli identified 631 at‐risk neonates from the well baby nursery and the neonatal intensive care nursery (ICN). BERA tests were done before discharge and four months later; comparison of outcomes revealed substantial discrepancies. From the follow‐up test, 51 cases of mild to severe hearing loss were identified.

Experience from the research program has raised some issues relevant for establishment of service programs. Evaluation of all babies (general nursery and ICN) is justified on the basis of yield but is resource consuming; strategies for minimizing work load are discussed. Risk factor criterion levels affect case loading and yield. Frequency‐specific BERA identifies cases which would not be detected by click stimuli and which raise management questions. Deferral of testing to four months is feasible and desirable.
Industrial audiometry and the otologist.
Authors: Dobie Robert A.
Published: October 2006

The Hearing Conservation Amendment published by the Occupational Safety and Health Administration (OSHA) in 1983 requires hearing conservation programs to be provided for over 5 million workers whose daily noise exposures exceed 85 dBA time‐weighted average. The permissible exposure level is 90 dBA, above which the use of hearing protectors is mandatory. Current policies rely heavily on periodic audiometry to detect early threshold shifts due to inadequate use of hearing protection or to individual variation in susceptibility to noise induced hearing loss (NIHL).

Studies including over 1,000 noise exposed workers have shown that audiometry in the industrial setting is less reliable than clinical audiometry. Pure tone averaging markedly reduces test‐retest variability and should be incorporated into rules for decision‐making based on industrial audiometry. However, at least half of observed shifts are spurious. In addition, aging is an important confounding variable; in our data, about half of the population mean threshold shift seen was attributable to aging. Thus, only a minority of threshold shifts seen in industrial audiometry are due to NIHL. The large number of “false positive” shifts will inevitably eventually have the effect of a de facto lowering of the permissible exposure level to 85 dBA.

Otologic referral and major administrative action should be reserved for large or repeated threshold shifts. OSHA does not specify rules for otologic referral, but the criteria recommended by the American Academy of Otolaryngology‐Head and Neck Surgery are reasonable and should be supported. The necessity for otologic evaluation in the differential diagnosis of NIHL from other entities (particularly baseline audiometric abnormalities) is not universally appreciated; otolaryngologists need to educate their medical and nonmedical colleagues about this.
The immunocompromised human host: Diagnosis and treatment.
Authors: Sprinkle Philip M. , Mcclung James E. , James Paine A.
Published: October 2006

The immunocompromised human host may be subject to recurrent infection and/or malignant transformation. Signs and symptoms of depressed immunity generally reflect the degree of compromise. The laboratory diagnosis of the immune compromised host is presented. A review is given of the clinical manifestations and appropriate current therapy.
Idiopathic (bell's) facial palsy: Natural history defies steroid or surgical treatment.
Authors: May Mark , Klein Susan R. , Taylor Floyd H.
Published: October 2006

Idiopathic (Bell's) facial palsy is a self‐limiting, non‐life threatening, and spontaneously remitting disorder. The natural history of Bell's palsy is favorable: 84% of 1011 patients with Bell's palsy studied by one investigator recovered satisfactorily without treatment, and no valid clinical trials conducted to date have provided definitive evidence that treatment with steroids or surgery improves upon this figure. The authors studied 273 patients with Bell's palsy to evaluate the prognostic significance of evoked eleetromyography in predicting the possible benefit of transmastoid facial nerve surgical decompression. The results indicated that even when evoked electromyography was used to select those patients who might benefit most from transmastoid surgery, outcome in patients treated surgically was no better than can be expected to occur without treatment. Based upon these observations, transmastoid facial nerve surgery is not recommended to treat Bell's palsy because no benefits have been identified which outweigh the risks of surgery.
Mimetic surgery for the paralyzed face
Authors: Spector J. Gershon
Published: October 2006

One hundred ten patients with facial nerve paralyses were treated by various surgical methods. Eighty‐six patients had total facial nerve paralyses and 24 had segmental paralyses. In the total paralysis group, 62 patients had oncologic procedures or tumor induced paralysis. In the segmental paralysis group, 14 patients had malignancies. Two patients had idiopathic facial nerve paralysis.

In the total paralysis group, 59 had neural reconstructions, 7 neuromuscular pedicles, and 20 muscle‐fascia transpositions. The segmental paralysis group was divided into an upper facial palsy group (n= 11) and lower facial palsy group (n= 13). Five patients had neural transpositions, 5 had muscle‐fascia transpositions, and 14 had plastic reconstructions.

The results were analyzed by various methods and grading systems. The data indicate that neural repairs produce better results than muscle‐fascia transpositions or plastic reconstructions. Within the repairs, the procedures are listed in an hierarchical order of cosmetic and functional results.

The average follow‐up for the entire group was 2.8 years. The average follow‐up for the neural repair group was 3.2 years, and for the muscle fascia transpositions, 14.1 months.
Allergic fungal sinusitis: The Mayo clinic experience
Authors: Thane Cody D. , Bryan Neel H. , Ferreiro Jorge A. , Roberts Glenn D.
Published: October 2006

The diagnosis of allergic fungal sinusitis (AFS) is difficult to establish. The clinical presentation is not diagnostic. We define current criteria for diagnosis and the role of total and specific immunoglobulin E (IgE) and immunoglobulin G (IgG) levels in the disease process and review the clinical features of this disease.

Fifty‐one cases were identified in 44 patients who demonstrated characteristic allergic mucin. Thirty‐one of these cases satisfied rigid criteria for the diagnosis of AFS. Twenty of these cases were classified as AFS‐like syndrome.

The prevalence of strictly defined AFS was 4.0%. Dematiaceous fungi were the predominant agents cultured. All our patients had polyps, 23 (54%) had asthma, 12 (27%) had aspirin sensitivity, 20 (65%) had eosinophilia, and 9 (69%) had increased total IgE levels.
Juvenile nasopharyngeal fibroma: Androgen receptors and their significance for tumor growth
Authors: Hagen Rudolf , Romalo Gabriela , Schwab Burkard , Hoppe Florian , Schweikert Hans‐Udo
Published: October 2006

Since the publications of Martin, et al. (1948) and Schiff (1959), who were the first to report on the administration of sex hormones to juvenile nasopharyngeal fibroma (JNF) patients, several authors have described the different clinical effects and histologic changes after androgen and estrogen application. Since the mechanism of action of sex steroids in juvenile nasopharyngeal fibroma is almost unknown, the authors have studied androgen receptor binding in cultured tumor fibroblasts from three patients with JNF. Maximum androgen binding (Bmax) of the tumor fibroblasts approximated to that of genital skin fibroblasts, which served as a control androgen target tissue with high receptor density. Furthermore, in vitro experiments showed that the growth rate of tumor fibroblasts increased when testosterone was added to the culture medium, while the addition of two antiandrogens, cyproterone and flutamide, caused a reduction in growth rate.

It is concluded from these results that JNF is a hormone‐dependent tumor stimulated by testosterone whose growth rate may, at least in vitro, be reduced by antiandrogens such as cyproterone and flutamide.
Uvulopalatopharyngoplasty for snoring: Long‐term results
Authors: Levin Barry C. , Becker Gary D.
Published: October 2006

Uvulopalatopharyngoplasty (UPPP) has become a widely practiced procedure in the management of snoring. In a number of studies, all based on short‐term follow‐up, snoring was reduced or eliminated in 75% to 95% of patients. Because a declinein the initial success rate was casually observed, a formal analysis of the initial and long‐term results of UPPP for snoring was made in the present study. From 1985 to 1989, 69 patients with severe habitual snoring were retrospectively analyzed. A scoring system was devised for snoring, and each patient was interviewed regarding the effects of UPPP on his or her snoring 16 to 75 (mean 44) months after surgery. In 60 (87%) of 69 patients, snoring was initially significantly reduced or totally eliminated. After 13 months the success rate dropped to 46% (32 of 69 patients). Most failures occurred between 6 and 12 months of surgery, after which time the success rate remained relatively stable.

The authors' conclusion that the long‐term success rate of UPPP for snoring declines significantly with time has obvious implications regarding pre‐surgical patient counseling.
Scintigraphic assessment of swallow efficiency postlaryngectomy
Authors: Hamlet Sandra L. , Wilson Stephen , Stachler Robert J. , Salwen Walter A. , Muz Jaroslaw , Heilbrun Lance K.
Published: October 2006

There have been reports of a high incidence of hypopharyngeal stenosis in total laryngectomy patients when the surgery requires a partial pharyngectomy for pyriform sinus involvement. In this study, three groups were compared: total laryngectomy patients without partial pharyngectomy, total laryngectomy patients with partial pharyngectomy, and normal controls. All patients had received radiation therapy following surgery. All were maintaining oral nutrition, and none complained of dysphagia. Patients were tested between 1 and 7 months postradiation therapy, with a mean of 3 months. Measures of swallowing efficiency were based on scintigraphic data for a liquid swallow. Patients with partial pharyngectomy had abnormally long oropharyngeal transit times and low efficiency scores. For a subgroup of patients with partial pharyngectomy, swallowing data were available postsurgery and postradiation therapy. Postsurgery this patient group did not differ significantly from normal patients in swallowing efficiency, and swallowing efficiency deteriorated in postradiation therapy. This scintigraphic methodology is shown to be a sensitive method of assessing swallowing function in this patient population.
Changing patterns in pediatric supraglottis: A multi‐institutional review, 1980 to 1992
Authors: Senior Brent A. , Radkowski Diana , Macarthur Carol , Sprecher Robert C. , Jones Dwight
Published: October 2006

Supraglottitis is a rapidly progressive, life‐threatening airway emergency in pediatric patients typically caused by Haemophilus influenzae type B (HIB). With distribution of the first efficacious vaccine for HIB in April 1985, changing disease patterns have begun to emerge; however, certain characteristics have remarkably persisted.

The authors reviewed 252 pediatric patients with acute supraglottitis spanning the prevaccination and postvaccination years 1980 to 1992 at three major regional pediatric hospitals in Massachusetts, Ohio, and California, as well as at two community hospitals in Massachusetts. Findings include a decline in disease prevalence in all geographic areas with demographic, etiologic, and management evolution all seen. Children who had been immunized yet developed supraglottitis have been examined as predictive of future trends.
ras Mutations and expression in head and neck squamous cell carcinomas
Authors: Yarbrough Wendell G. , Shores Carol , Witsell David L. , Weissler Mark C. , Fidler Mary E. , Gilmer Tona M.
Published: October 2006

Mutational activation and overexpression of the family of ras proto‐oncogenes have been associated with many human tumors. The role of mutations of H‐ras, K‐ras, and N‐ras, as well as expression of the respective protein products (p21s) in normal mucosa, dysplastic mucosa, and squamous cell carcinomas (SCCs) of the head and neck has not been fully described. In our study, 51 tumors (40 paraffin embedded and 11 fresh frozen) were examined to determine if mutational activation of ras is an important molecular event in head and neck SCC. Analyses of codons 12, 13, and 61 of H‐ras, K‐ras, and N‐ras revealed no mutations, suggesting that mutational activation of ras is not important in the majority of head and neck SCCs.

Immunocytochemistry (ICC) was used to define the expression of H‐ras, K‐ras, and N‐ras in normal mucosa, dysplastic mucosa, and SCC of the head and neck and to determine if expression of ras family members correlated with early or late events in the development of SCC. Expression of p21N‐ras in nine samples of histologically normal head and neck mucosa revealed moderate staining in the basal proliferative layers with progressively less staining as cells matured. The most superficial layers of normal mucosa failed to express p21N‐ras. A low level of p21H‐ras was expressed in all layers of normal mucosa while K‐ras was not expressed. ICC of SCC tumor sections revealed cytoplasmic expression of N‐ras in nine of nine tumors, H‐ras in five of nine tumors, and K‐ras in one of nine tumors. Expression of H‐ras, K‐ras, and N‐ras in head and neck SCC was not related to histologic differentiation or TNM staging; however, p21N‐ras was overexpressed in seven of nine tumors. Furthermore, the pattern of N‐ras expression in dysplastic lesions revealed expression in all layers of the mucosa in contrast to normal mucosa, which expresses p21N‐ras primarily in the basal proliferative layer. The change in p21N‐ras expression pattern in dysplastic mucosa and its overexpression in the majority of tumors suggest that loss of control of N‐ras expression may be an early step in carcinogenesis of head and neck SCC.
Effect of artificial airway on ear complications from hyperbaric oxygen
Authors: Presswood Garron , Zamboni William A. , Stephenson Linda L. , Santos Perry M.
Published: October 2006

Hyperbaric oxygen treatment is associated with an increased risk of barotrauma to the tympanic membrane and middle ear. An artificial airway may compromise normal eustachian tube function and equilibration of middle ear pressures. This retrospective study was designed to evaluate the risk of middle ear complications in 267 patients receiving hyperbaric oxygen (HBO) therapy and to compare those with and without artificial airways. Charts of all patients were reviewed for middle ear and tympanic membrane complications and myringotomy tube placement. Eighteen of the 267 patients had artificial airways. Seventeen (94%) of these 18 patients developed middle ear or tympanic membrane complications, and 11 (61%) required tympanostomy tubes for pain, hemo‐tympanum, or serous otitis. In contrast, 114 (45.8%) of the 249 patients without airways developed ear complications, and 53 (21.3%) required tympanostomy tubes. These results suggest that patients with an artificial airway who are receiving HBO therapy are at greater risk for developing tympanic membrane and middle ear complications than nonintubated patients. Similarly, patients with artificial airways receiving HBO frequently require placement of tympanostomy tubes.
What more needs saying about imagination?
Authors: SPENCER MARGARET MEEK
Published: October 2006

This paper, delivered as a keynote address to the 19th World Congress in Reading, explains why the author chooses imagination as a core issue in children's learning to read and write. Drawing on literature, history, psychology, and other disciplines, the author explores how imagination grows and develops and contributes to comprehension and learning. (Please cite this paper as Spencer, M.M. (2002, July 29). What more needs saying about imagination? Paper presented at the 19th International Reading Association World Congress on Reading, Edinburgh, Scotland.)
Influence of an Erbium, Chromium‐Doped Yttrium, Scandium, Gallium, and Garnet (Er,Cr:YSGG) Laser on the Reestablishment of the Biocompatibility of Contaminated Titanium Implant Surfaces
Authors: Schwarz Frank , Nuesry Enaas , Bieling Katrin , Herten Monika , Becker Jürgen
Published: October 2006

Background: The aim of the present study was to evaluate the influence of an erbium, chromium‐doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG laser [ERCL]) on 1) the surface structure and biocompatibility of titanium implants and 2) the removal of plaque biofilms and reestablishment of the biocompatibility of contaminated titanium surfaces.

Methods: Intraoral splints were used to collect an in vivo supragingival biofilm on sand‐blasted and acid‐etched titanium disks for 24 hours. ERCL was used at an energy output of 0.5, 1.0, 1.5, 2.0, and 2.5 W for the irradiation of 1) non‐contaminated (20 and 25 Hz) and 2) plaque‐contaminated (25 Hz) titanium disks. Unworn and untreated non‐irradiated, sterile titanium disks served as untreated controls (UC). Specimens were incubated with SaOs‐2 osteoblasts for 6 days. Treatment time, residual plaque biofilm (RPB) areas (%), mitochondrial cell activity (MA) (counts per second), and cell morphology/surface changes (scanning electron microscopy [SEM]) were assessed.

Results: 1) ERCL using either 0.5, 1.0, 1.5, 2.0, or 2.5 W at both 20 and 25 Hz resulted in comparable mean MA values as measured in the UC group. A monolayer of flattened SaOs‐2 cells showing complete cytoplasmatic extensions and lamellopodia was observed in both ERCL and UC groups. 2) Mean RPB areas decreased significantly with increasing energy settings (53.8 ± 2.2 at 0.5 W to 9.8 ± 6.2 at 2.5 W). However, mean MA values were significantly higher in the UC group.

Conclusion: Within the limits of the present study, it was concluded that even though ERCL exhibited a high efficiency to remove plaque biofilms in an energy‐dependent manner, it failed to reestablish the biocompatibility of contaminated titanium surfaces.
Evaluation of Patient Perceptions After Frenectomy Operations: A Comparison of Carbon Dioxide Laser and Scalpel Techniques
Authors: Haytac M. Cenk , Ozcelik Onur
Published: October 2006

Background: A frenum that encroaches on the margin of the gingiva may interfere with plaque removal and cause tension. Frenectomy is the complete removal of the frenum that can be made by scalpels or with soft tissue lasers. The aim of this article was to compare the degree of postoperative pain, such as discomfort and functional complications (eating and speech), experienced by patients after two frenectomy operation techniques.

Methods: Forty patients requiring frenectomy were randomly assigned to have treatment either with a conventional technique or with a carbon dioxide (CO2) laser. The postoperative pain and functional complication ratings of each patient were recorded using a visual analog scale on days 1 and 7.

Results: The results indicated patients treated with the CO2 laser had less postoperative pain and fewer functional complications (speaking and chewing) (P <0.0001 each) and required fewer analgesics (P <0.001) compared to patients treated with the conventional technique.

Conclusions: This clinical study indicates that CO2 laser treatment used for frenectomy operations provides better patient perception in terms of postoperative pain and function than that obtained by the scalpel technique. Considering the above advantages, when used correctly, the CO2 laser offers a safe, effective, acceptable, and impressive alternative for frenectomy operations.
Immediate Restoration of Single Implants Placed Immediately After Tooth Extraction
Authors: Barone Antonio , Rispoli Lorena , Vozza Iole , Quaranta Alessandro , Covani Ugo
Published: October 2006

Background: Some of the original surgical protocols for implant surgery have been reassessed to satisfy the patient's continuously increasing expectation for shorter rehabilitation time, improved esthetics, and increased comfort. The aim of this study was to evaluate the 12‐month clinical success of 18 single‐tooth implants inserted immediately after tooth extraction and restored the same day with non‐functional loading.

Methods: A total of 18 patients (12 women and six men), 22 to 60 years old, were enrolled in this study. Eighteen single implants were inserted in fresh extraction sockets and immediately restored with temporary abutments and crowns. All experimental sites showed an absence of fenestrations or dehiscences of the bone walls and a residual gap between implant surfaces and surrounding bone walls ≤2 mm. All temporary prostheses were positioned the same day of surgery and were not in occlusal contact with opposing arches. The comparison between the baseline and 12‐month visits was performed with the Student t test for paired data (statistically significant at a level of α = 0.05).

Results: During the 12‐month follow‐up period, one fixture was removed 4 weeks after implant placement following an abscess. All remaining implants healed uneventfully with no complications and were assessed as stable and successful at the 12‐month checkup. No technical complications such as screw loosening, resin fracture, or pain during chewing were registered during the 12‐month period.

Conclusions: Within the limits of the data from this study, it can be suggested that immediate placement and restoration of a single implant can be a valid and successful option of treatment in the case of single compromised teeth. Moreover, this treatment protocol eliminates the need for removable provisional restoration and seems to maintain the preexisting architecture of soft and hard tissues in most cases. Nonetheless, further prospective and long‐term studies are required to obtain a better insight into the limitations of this protocol.
The Use of Celecoxib and Dexamethasone for the Prevention and Control of Postoperative Pain After Periodontal Surgery
Authors: Pilatti Gibson Luiz , André dos Santos Fábio , Bianchi Audilene , Cavassim Rodrigo , Tozetto Claudinéia W.
Published: October 2006

Background: Conventional non‐steroidal anti‐inflammatory drugs have been widely used in the control of postoperative pain, but sparse information is available on the efficacy of celecoxib, a selective cyclooxygenase‐2 inhibitor, or dexamethasone, a steroidal anti‐inflammatory drug, after periodontal surgeries. The purpose of the present study was to compare the use of celecoxib and dexamethasone in the management of pain after mucoperiosteal flap surgery.

Methods: A randomized double‐masked cross‐over clinical trial was conducted on 20 patients from 27 to 52 years old with generalized moderate to advanced chronic periodontitis. Mucoperiosteal flap surgeries for scaling and root planing were performed under local anesthesia on at least three quadrants, with a 4‐week interval between. Each quadrant was randomly assigned to one of the following medication protocols: placebo, 4 mg dexamethasone 1 hour before surgery and 8 hours after the first dose, and 200 mg celecoxib 1 hour before surgery and 12 hours after the first dose. Postoperative pain was accessed during the first 8 hours and on the following 3 days using the visual analog scale (VAS), the 101‐point numerical rate scale (NRS‐101), and the four‐point verbal rating scale (VRS‐4).

Results: Pain perception was statistically significantly lower in the celecoxib group than in the placebo group during the first 4 hours using VAS (P = 0.01) and at 1, 2, 3, 4, 6, and 7 hours using NRS‐101 (P = 0.03). The level of pain was lower in the dexamethasone group than in the placebo only at the 3‐hour period (P = 0.001). Statistically significant differences could be found among the groups at 1 hour (P = 0.015), 3 hours (P = 0.004), 4 hours (P = 0.02), and 7 hours (P = 0.05) using VRS‐4. There was no statistically significant difference between the celecoxib and dexamethasone groups.

Conclusion: The findings of this study suggest that the preemptive and postoperative use of celecoxib or dexamethasone were effective in the management of postoperative pain following open‐flap debridement.
The Effects of Interimplant Distances on Papilla Formation and Crestal Resorption in Implants With a Morse Cone Connection and a Platform Switch: A Histomorphometric Study in Dogs
Authors: Novaes Arthur B. , de Oliveira Rafael R. , Muglia Valdir A. , Papalexiou Vula , Taba Mário
Published: October 2006

Background: Implant esthetics have been the focus of attention for the last few years, and one of the most important points is the effect that interimplant distances can have on papilla formation and bone loss. The aim of this study was to evaluate the effect that distances of 1, 2, and 3 mm between implants after prosthetic restoration will have on crestal bone resorption (from the top of the implant to the bone crest [TI‐BC]) and bone resorption (from the top of the implant to the first bone‐to‐implant contact TI‐BIC) in two‐stage implants used in a submerged and non‐submerged protocol.

Methods: The mandibular bilateral premolars of seven dogs were extracted, and after 12 weeks, each dog received eight implants. The implants were placed so that three interimplant contact points were created, with 1‐mm (group 1), 2‐mm (group 2), and 3‐mm (group 3) distances constructed on each side. The sides and the position of the groups were randomly selected. After 12 weeks, the implants received metallic prostheses with 5 mm between the contact point and the bone crest. After 8 weeks more, the animals were sacrificed.

Results: The TI‐BC was 0.20 and 0.18 mm for group 1, 0.15 and 0.14 mm for group 2, and 0.15 and 0.15 mm for group 3 for non‐submerged and submerged implants, respectively. At the proximal region, the TI‐BC was 0.16 mm for non‐submerged and 0.16 mm for submerged implants. The TI‐BIC was 0.32 and 0.30 mm for group 1, 0.19 and 0.21 mm for group 2, and 0.30 and 0.24 mm for group 3 for non‐submerged and submerged implants, respectively. At the proximal region, the TI‐BIC was 0.26 mm for non‐submerged and 0.25 mm for submerged implants. There was no statistical difference for any of the parameters (analysis of variance [ANOVA]).

Conclusion: Distances of 1, 2, and 3 mm between implants do not result in statistically significant differences on TI‐BC and TI‐BIC around submerged or non‐submerged implants with a Morse cone connection and a platform switch.
William F. Ammons Jr., DDS, MSD
Authors: Johnson Robert H. , Tibbetts Leonard S. , Becker William
Published: October 2006

“If a man be endowed with a generous mind, this is the best kind of nobility.”

— Plato
Biological structure and health implications from tooth size at Mission San Luis de Apalachee
Authors: Stojanowski Christopher M. , Larsen Clark S. , Tung Tiffiny A. , McEwan Bonnie G.
Published: October 2006

This study analyzes dental metric variation to examine the biological structure of the native population at Mission San Luis de Apalachee, a late 17th century mission located in the Apalachee Province of Spanish colonial Florida. Three topics are addressed: (1) comparison of tooth sizes among adult and subadults, (2) analysis of the bio‐spatial structure of skeletons within the church area, and (3) comparison of phenotypic profiles of individuals interred within coffins in the ritual nucleus of the church: the altar region. Analyses indicate that subadults had smaller average tooth sizes than adults for the posterior dentition that was particularly evident in mandibular nonpolar molars and premolars. This disparity, also documented in two other mission populations, likely represents ontogenetic stress and resulting increased mortality among those most at risk for early death. Analysis of the spatial structure of graves failed to document biological structuring by side of the aisle or by burial row, although some gross differences were evident when front, middle, and rear church burials were compared. Individuals buried in coffins within the same row were phenotypically similar to one another. However, inter‐row comparisons indicated lack of phenotypic similarity among all coffin interments. These analyses suggest maintenance of kin‐structured burial for elites alone within the San Luis community. Am J Phys Anthropol, 2007. © 2006 Wiley‐Liss, Inc.
Stability of Lithium in α‐Rhombohedral Boron
Authors: Hayami Wataru , Tanaka Takaho , Otani Shigeki
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
M1‐x[W2O2X6] with M: K+, Tl+, Ag+, Hg2+, Pb2+; X: Cl, Br — A Class of Mixed Valence Tungsten(IV,V) Compounds with Layered Structures, W—W Bonds and High Conductivity.
Authors: Beck Johannes , Kusterer christian , Hoffmann Rolf‐Dieter , Poettgen Rainer
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Mn5Si3‐Type Host‐Interstitial Boron Rare‐Earth Metal Silicide Compounds RE5Si3: Crystal Structures, Physical Properties and Theoretical Considerations.
Authors: Roger Jerome , Ben Yahia Mouna , Babizhetskyy Volodymyr , Bauer Joseph , Cordier Stephane , Guerin Roland , Hiebel Kurt , Rocquefelte Xavier , Saillard Jean‐Yves , Halet Jean‐Francois
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Preparation, Crystal Structure and Chemical Bonding Analysis of the New Binary Compounds Rh4Ga21 and Rh3Ga16.
Authors: Bostroem Magnus , Prots Yurii , Grin Yuri
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
“Unusual” Phase Transitions in CeAlO3.
Authors: Fu W. T. , IJdo D. J. W.
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Gas‐Phase Reactions of Atomic Lanthanide Cations with Sulfur Hexafluoride: Periodicity in Reactivity.
Authors: Cheng Ping , Bohme Diethard K.
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
The First Structural Characterization of a Binary P—N Molecule: The Highly Energetic Compound P3N21.
Authors: Goebel Michael , Karaghiosoff Konstantin , Klapoetke Thomas M.
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
First Synthesis of Group‐14 Polyanions by Extraction of a Binary Alloy with dmf and a Novel Conformation of the (Ge9—Ge9)6‐ Dimer: Crystal Structures of [K6(Ge9—Ge9)](dmf)12, [Rb6(Ge9—Ge9)](dmf)12 and [K2.5Cs3.5(Ge9—Ge9)] (dmf)12.
Authors: Nienhaus Anke , Hoffmann Stephan D. , Faessler Thomas F.
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Barrelane‐Like Germanium Clusters in Eu3Ge5: Crystal Structure, Chemical Bonding and Physical Properties.
Authors: Budnyk Sergij , Weitzer Franz , Kubata Christof , Prots Yurii , Akselrud Lev G. , Schnelle Walter , Hiebl Kurt , Nesper Reinhard , Wagner Frank R. , Grin Yuri
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
A Novel Mo(V) Oligophosphate Built‐Up of Di‐ and Triphosphate Groups: Cs(MoO)4(P2O7)2 (P3O10)
Authors: Leclaire Andre , Raveau Bernard
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Polymer‐Supported Chiral Schrock Catalysts Immobilized via the Arylimido Ligand.
Authors: Wang Dongren , Kroell Roswitha , Mayr Monika , Wurst Klaus , Buchmeiser Michael R.
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Magnesium Bistrifluoromethanesulfonimide as a New and Efficient Acylation Catalyst.
Authors: Chakraborti Asit K. , Shivani Shivani
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Deprotection of Heteroaromatic Carbamates via a Base‐Catalyzed Methanolysis.
Authors: Shieh Wen‐Chung , Xue Song , McKenna Joe , Prasad Kapa , Repic Oljan , Blacklock Thomas
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
A New Route to the Synthesis of Long‐Chain Methyl α‐Chlorooxoalkanoates.
Authors: Rauf Abdul , Ahmad Shabana
Published: October 2006

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.