bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Intubation Devices Affect Middle Ear Pressure Dynamics?
Authors: Torun Mümtaz Taner , Kuşderci Hatice Selçuk , Öterkuş Mesut 
Published: March 2019

Abstract
Our study aimed to investigate the effects of different intubation devices on middle ear pressure (MEP) dynamics by evaluating MEP during stages of anesthesia.
Sixty-one consecutive patients were randomly assigned to 2 groups: the classical endotracheal intubation group and the Baska Mask (a new laryngeal mask [LMA]) group. All patients received the same anesthesia protocol. The right and left MEP values of the patients were measured and recorded preoperatively, during the induction of anesthesia, at the time of intubation and at 5th minute of anesthesia.
In group 1, the pressure values measured in the right ear during anesthesia induction, at the time of intubation and at 5th minute of anesthesia were 10.97 ± 27.06, 16.77 ± 29.40, and 21.64 ± 90.31, respectively, compared to left ear values of 8.61 ± 26.39, 18.77 ± 37.84, and 38.61 ± 56.96 daPa, respectively. In group 2, MEP values measured in the right ear during anesthesia induction, at the time of intubation, and at 5th minute of anesthesia were 9.53 ± 20.43, 22.30 ± 41.50, and 20.60 ± 46.85 daPa, respectively, compared to left ear values of −4.26 ± 25.17, 6.20 ± 26.56, and 30.30 ± 65.17 daPa, respectively. MEP was statistically significantly increased in the classical endotracheal intubation group compared to the LMA group.
We found that the increase in pressure is lower in patients receiving LMA compared to classical endotracheal intubation. The Baska Mask LMA is recommended in selected patients to prevent complications of MEP elevation.
Craniofacial Approaches to Pediatric Orbital Tumors
Authors: Kaderbhai Jameel , Lo William , Rodrigues Desiderio , White Nicholas , Evans Martin , Nishikawa Hiroshi , Dover Michael Stephen 
Published: March 2019

Abstract
Primary pediatric orbital tumors requiring surgery are uncommon and often require multidisciplinary management. Commonly used surgical approaches to the orbit include transconjunctival, transcutaneous (eyelid), transcranial, or extracranial osteotomies. This paper reviews a 10-year experience of cases that required a transcranial or extracranial surgical approach at the Birmingham Children's Hospital. A total of 9 patients were identified between the years 2008 to 2017. Pathologies included rhabdomyosarcoma, juvenile ossifying fibroma, optic nerve glioma, and retinoblastoma. Surgical approaches to the orbit included supraorbital bar osteotomy (transcranial) or lateral orbitotomy (extracranial). Surgical team members included neurosurgery, craniofacial surgery, and ophthalmology. This study aims to review the role of surgery in management as well as the specific indications for performing transcranial or extracranial osteotomies. It also highlights the excellent access achieved with the use of these osteotomies in certain cases, especially when compared with transconjunctival or transcutaneous approaches.
A Static Facial Sling Technique Restoring Nasolabial Sulcus in Facial Paralysis
Authors: Dornhoffer James , Vural Emre 
Published: March 2019

Abstract
Static facial sling techniques are useful rehabilitation modalities where dynamic rehabilitation methods are not feasible in the management of facial paralysis. The authors present their technique as an alternative static sling method, which may give the patient a more natural nasolabial sulcus restoration in addition to suspension of the oral commisure.
Introducing A Family With Tens of Rare Craniofacial Clefts
Authors: Kalantar-Hormozi Abdoljalil , Abbaszadeh-Kasbi Ali , Shalbaf Shervin , Davai Nazanin Rita 
Published: March 2019

Background:
Craniofacial clefts are one of the rarest congenital malformations. When it comes to genetic inheritance patterns of craniofacial clefts, there are few studies on this subject due to the rarity and sporadic nature. In this study an extended family whose members have multiple craniofacial clefts has been introduced.

Methods:
The authors haphazardly found a family whose members have craniofacial clefts, either Tessier no. 0 or both Tessier nos. 0 and 14, and, consequently, they were categorized into 3 groups based on the severity of clefts.

Results:
Forty-two craniofacial clefts were noticed within the family. Twenty-two (52.3%) of patients were females and 20 (47.6%) were males. Twenty-three (54.8%) members had isolated Tessier no. 0 cleft, whereas 19 (45.2%) members had both Tessier nos. 0 and 14. Of all 42 patients, 18 (42.8%), 3 (7.1%), and 21 (50%) patients had severe, intermediate, and mild clefts, respectively.

Conclusion:
The present study reveals that in some patients genetic background is likely to be the cause of clefts.
Hydrocephalus Due to Idiopathic Fourth Ventricle Outflow Obstruction
Authors: Bai Jianfeng , Yu Qingqing , Sun Xiaoyu , Xiao Huaming , Wang Kai , Sun Feng , Sui Qiangbo 
Published: March 2019

Abstract
The fourth ventricle outlet obstruction (FVOO) is a rare but well-established cause of obstructive tetra-ventricular hydrocephalus, characterizing with dilatation or large cerebrospinal fluid collection of the foramina of Magendie and Luschka. In children, it is usually the consequence of posterior cerebral fossa malformations; while in adult, the occlusion is rather acquired than congenital, mostly linked to an inflammatory process, intraventricular hemorrhage, head trauma, brain tumors or Arnold-Chiari malformation. However, idiopathic FVOO is extremely rare, and only 6 such cases have been reported in the English literature. Hereby, we described an extraordinarily rare case of idiopathic FVOO in a 15-year-old patient successfully treated with direct microsurgical excision of the obstruction membrane. Furthermore, the clinical characteristics and treatment for this rare disease were investigated and reviewed.
A Life Threatening Subglottic and Mediastinal Hemangioma in an Infant
Authors: Onder Serap Sahin , Gergin Ozgul , Karabulut Burak 
Published: March 2019

Abstract
Subglottic and mediastinal hemangioma are rare benign vascular tumors of childhood. They cause potentially life threatening condition which requires intervention. Several therapeutic options have been described in the literature with varying degrees of success and complications. We report a case of a stridulous 2-month old female infant with mediastinal and subglottic hemangioma. The child was treated with propranolol without the need for tracheostomy or any other surgical intervention, and with no reported side effects. Propranolol is an effective, non-invasive treatment for life threatening infantile hemangiomas compressing the airway, should be used as a firstline treatment for subglottic hemangiomas when intervention is required.
The Superficial Temporal Artery Island Flap: An Option for Moustache Reconstruction
Authors: Fatma Bilgen , Alper Ural , Mehmet Bekerecioglu 
Published: March 2019

Abstract
Vascular anomalies are a group of lesions originating from blood vessels and lymphatics with varying histology and clinical behavior. They form the most common congenital anomalies in infants and children. The reconstructive method for the facial region defects varies depending on the size and position of the defect, as well as the patient's age, health status and aesthetic concerns. In this case, the authors present a male patient who underwent a wide resection of his mustache area because of vascular malformation and reconstructed with hair-bearing temporal artery island flap.
A 42-year-old male patient presented with swelling and ongoing color change in the cheek and lip area on the left side of the face. His examination revealed a vascular malformation extending from the preauricular region to the left side of the nose, to the upper lip and to the medial canthal region. Superficial temporal artery island flap was designed to reconstruct the upper lip area while full thickness skin graft planned for the defect on nose and cheek.
STA island flap has been applied in many areas such as forehead, eyebrow, eyelid, cheek, and nose reconstruction due to its advantages such as providing good color and texture harmony, reliable and constant pedicle, simple and fast dissection, wide rotation arc and low donor area morbidity. Superficial temporal artery island flap should be considered as a favorable reconstruction option in upper and middle face region for moderate and small sized defects
The Frontalis Muscle Flap: As a Salvage Procedure for Upper Eyelid in a Burn Patient
Authors: Iğde Murat , Tapan Mehmet , Ergani Hasan Murat , Yaşar Burak 
Published: March 2019

Abstract
The ugly face of civil war shows itself in the desperate patients and their extreme sequellae. The options for reconstruction of patients with late-term serious sequellae decrease and their treatments also become more difficult. A 31-year-old male patient was injured 18 months ago due to a bomb explosion and received long-term treatment through local wound care in his country. A patient who is referred to us with such late-term ectropion and lagophthalmos is likely to have both morphologic and functional deterioration. A frontal muscle flap was planned for this patient. The frontal muscle flap has been used for a long time in ptosis surgery and was used in the treatment of the patient to repair both lagophthalmos and ptosis. Satisfactory results were obtained at the end of a 6-month period during which the patient was monitored.
Computer-Aided Design/Computer-Aided Manufacturing Milling of Allogeneic Blocks Following Three-Dimensional Maxillofacial Graft Planning
Authors: Gialain Ivan Onone , Pinhata-Baptista Otavio Henrique , Cavalcanti Marcelo Gusmão Paraíso , Cortes Arthur Rodriguez Gonzalez 
Published: March 2019

Abstract
Despite the advent of stereolithography in craniofacial surgery for creating surgical guides and custom synthetic scaffolds, little is known about the feasibility of computer-aided design/computer-aided manufacturing (CAD/CAM) milling of freeze-dried allogeneic bone blocks following previously designed volumetric graft plans. The aim of this technical report is to present a methodology for CAD/CAM milling to achieve the volume and shape of allogeneic bone blocks as estimated by using a virtual planning software. To perform the current methodology, an ex vivo simulation was performed. The milled allogeneic block presented satisfactory dimensional accuracy as compared with the respective three-dimensional virtual model.
Novel Simple Strategy for Cartilage Tissue Engineering Using Stem Cells and Synthetic Polymer Scaffold
Authors: Uz Uzdan , Gunhan Kivanc , Vatansever Seda , Kivanc Mujde , Yuceturk Ali Vefa 
Published: March 2019

Abstract
Cartilage created by tissue engineering is a promising new development in facial reconstructive surgery. The purpose of this study was to evaluate the histological results of implantation of synthetic polymer scaffold with chondrocytes differentiated from adipose-derived mesenchymal stem cells. Adipose tissue obtained from Wistar albino rats was dissociated, incubated and placed in culture medium. After a sufficient level of stem cell proliferation, the differentiation phase was started. Cells were collected on the 7th and 21st day of culture for chondrogenic characterization. After the 21st day of the differentiation phase of chondrocytes, they were transferred onto poly(dl-lactide-epsilon-caprolactone) synthetic polymer and culture continued for 24 hours. The scaffold with chondrocytes was then implanted into a subcutaneous area of skin on the back of the neck of the rat. Six weeks after implantation, all rats were sacrificed and the implantation areas were analyzed. Chondrocytes derived from adipogenic mesenchymal stem cells were stained positively with collagen II, aggrecan and Sox-9 after the differentiation stages. Histological examination of the excised material showed that chondrocytes were present, and the scaffold had been completely absorbed. The results of this study indicate that the differentiation method from mesenchymal stem cells to chondrogenic lineage was straightforward and scaffold with cells was easily accessible. This technique may be a good option for cartilage tissue engineering.
Adipogenic Mesenchymal Stem Cells and Hyaluronic Acid as a Cellular Compound for Bone Tissue Engineering
Authors: Boeckel Daniel Goncalves , Sesterheim Patrícia , Peres Thiago Rodrigues , Augustin Adolpho Herbert , Wartchow Krista Minéia , Machado Denise Cantarelli , Fritscher Guilherme Genehr , Teixeira Eduardo Rolim 
Published: March 2019

Abstract
This study investigates the applicability of adipose mesenchymal stem cells (mADSCs) and hyaluronic acid (HA) as a cellular compound for bone tissue engineering. A critical bone defect was created on each femur of 25 rats in vivo, receiving the following 5 graft treatments: I—Control-defect; II—HA; III—mADSCs; IV—mADSCs+HA; and V—previously osteoinduced mADSCs+HA. Evaluation using microcomputed tomography, histomorphometry, and RT-PCR analysis was performed 23 days after implantation. Microcomputed tomography analysis indicated higher means of bone contact surface (BCS) and bone surface density (BSD) for the mADSCs+HA group compared with Control and the HA groups (P < 0.05). Histomorphometric findings showed higher means of bone regeneration in the mADSCs+HA compared with HA and Control groups (P < 0.05). The RT-PCR ratios showed no difference in type 1 collagen (Col1A) gene expression or osteopontin (OP) gene expression, whereas for the osteonectin gene (ON) higher means were found in the HA and mADSCs osteoin+HA groups (P < 0.05). These results suggest that a combination of HA and mADSCs without prior osteoinduction might be applicable for bone tissue regeneration.
Indocyanine Green Sentinel Node in Merkel Cell Carcinoma of the Cheek
Authors: Gabriele Guido , Aboh Ikenna Valentine , Cascino Flavia , Zerini Federico , Amadi Jude Ugochukwu , Del Frate Rossella , Xu Junfeng , Gennaro Paolo 
Published: March 2019

Abstract
Merkel cell carcinoma (MCC) is a rare malignant tumor with a neuroendocrine phenotype. The authors report a case of MCC of the left cheek region in an 85-year-old Caucasian woman who also received sentinel node biopsy using both Technectium-99m-labeled (99mTc) lymphoscintigraphy and indocyanine green lymphography.
External Jugular Vein Aneurysm in a Child With Hemophilia A
Authors: Lee Dong Hoon , Baek Hee Jo , Yoon Tae Mi , Lee Joon Kyoo , Lim Sang Chul 
Published: March 2019

Abstract
An external jugular vein (EJV) aneurysm is an extremely rare disease. Ultrasonography with color doppler methods is considered the criterion standard for diagnosis of a venous aneurysm. The treatment of choice for an EJV aneurysm is surgical excision. Herein, we report an unusual case of an EJV aneurysm in a child with hemophilia A. Because the incidence of an EJV aneurysm is low, it is important to distinguish it from other neck lesions, including congenital disease. In addition, it should be noted that in hemophilia patients, an EJV aneurysm may occur in a spontaneous or small trauma.
The Relationship Between Ocular Protrusion and Craniofacial Structures
Authors: Gulsen Ayse , Uzuner Fatma Deniz , Sibar Serhat 
Published: March 2019

Objective:
This study aimed to evaluate the relationships between ocular protrusion and other craniofacial structures.

Methods:
The lateral cephalograms of 124 nonsyndromic white adults were assessed. Two orbital and 13 craniofacial parameters were measured. Subgroups were constructed according to sex, anteroposterior position of maxilla, and mandibular plane angle values.Anatomical parameters and their relationships were statistically analyzed by analysis of variance and multivariate stepwise regression analysis.

Results:
There were no significant differences in ocular protrusion distances between sexes, and between individuals with different maxillary anteroposterior position and mandibular plane angle values. Ocular protrusion distances, the distance between the eyeball apex and the lateral orbital margin (Eyeball apex—LOr: OP1) and inferior orbital margin (Eyeball apex—IOr: OP2), were found to be 20.6 ± 2.8 and 16.5 ± 3.1, respectively. However, regression analysis showed that the ocular protrusion distances had weak correlation with a few craniofacial structures. The OP1 had a low negative relationship with the maxillary anteroposterior position (N-Aperp) (r: −0.289) (P < 0.05). The OP2 had a low negative relationship with the palatal plane angle (FH/PP) (r: −0.291) (P < 0.01) but had a positive relationship with the cranial base angle (BSN) (r: 0.304) (P < 0.01) and posterior facial height (SGo) (r: 0.299) (P < 0.01).

Conclusions:
Ocular protrusion distances did not differ by sex, maxillary anteroposterior position, and amount of mandibular plane angle and showed weak correlation with a few craniofacial structures. Ocular protrusion amounts can be used for diagnosis and treatment plan in craniofacial syndromic or nonsyndromic anomalies.
A Patient With Toxoplasmosis as a Cause of Submental Lymphadenopathy
Authors: Sireci Federico , Bruno Rocco , Martines Francesco , Freni Francesco , Cicciù Marco , Galletti Francesco 
Published: March 2019

Abstract
Submental mass secondary to toxoplasmosis is a rare condition and physicians rarely consider its diagnosis. The presented case reports a 43-year-old woman referred with a constant, painless, edema located in the submental area for 2 weeks. Diagnosis of toxoplasmosis was established by the positive serological finding after an accurate medical history of the infectious disease specialist (the patient had eaten raw meat). The patient underwent antimicrobial therapy with resolution of lymphadenopathy. According to review of literature, the article aims to remind clinicians, maxillofacial surgeons, and otolaryngologists that a neck mass can be related to the infectious cause with involving of lymph node like as toxoplasmosis. Therefore, a serological diagnosis should be considered before moving to needle biopsy or excisional biopsy of neck mass.
Regional disparities in access to verified burn center care in the United States
Authors: Carmichael Heather , Wiktor Arek J. , McIntyre Robert C. , Lambert Wagner Anne , Velopulos Catherine G. 
Published: March 2019

BACKGROUND
Burn injuries result in 50,000 annual admissions. Despite joint referral criteria from the American College of Surgeons (ACS) and American Burn Association (ABA), many severely injured patients are not treated at verified centers with specialized care. Only one prior study explores regional variation in access to burn centers, focusing on flight or driving distance without considering the size of the population accessing that center. We hypothesize that disparities exist in access to verified centers, measured at a population level. We aim to identify a subset of nonverified centers that, if verified, would most impact access to the highest level of burn care.

METHODS
We collected ABA data for all verified and nonverified adult burn centers and geocoded their locations. We used county-level population data and a two-step floating catchment method to determine weighted access in terms of total beds available locally per population. We compared regions, as defined by the ABA, in terms of overall access. Low access was calculated to be less than 0.3 beds per 100,000 people using a conservative estimate.

RESULTS
We identified 113 centers, 59 verified and 54 nonverified. Only 2.9% of the population lives in areas with no verified center in 300 miles; however, 24.7% live in areas with low access. Significant regional disparities exist, with 37.3% of the population in the Southern Region having low access as compared with just 10.5% in the Northeastern Region. We identified 8 nonverified centers that would most impact access in areas with no or low access.

CONCLUSION
We found significant disparities in access to verified center burn care and determined nonverified centers with the greatest potential to increase access, if verified. Our future directions include identifying barriers to verification, such as lack of fellowship-trained burn surgeons or lack of hospital commitment.

LEVEL OF EVIDENCE
Epidemiological, level III.
Diagnostic Yield of 2-Hour EEG Is Similar With 30-Minute EEG in Patients With a Normal 30-Minute EEG
Authors: Mahuwala Zabeen , Ahmadi Saumel , Bozoky Zoltan , Hays Ryan , Agostini Mark , Ding Kan 
Published: March 2019

Purpose:
Current literature suggests that longer duration of EEG recording increases the yield of detecting interictal epileptiform discharges. However, optimal duration for a repeat study in patients with initially normal 30-minute EEG is not clear. Thus, the purpose of this study is to determine whether a 2-hour EEG has a diagnostic advantage over a routine 30-minute EEG in detecting epileptiform abnormalities in patients who had a first normal 30-minute EEG.

Methods:
This is a single-center, retrospective study done at UT Southwestern Medical Center at Dallas and Parkland Memorial Hospital. The data from 1997 to 2015 were extracted from the existing EEG report database for patients who had a first normal 30-minute EEG recording. EEG was interpreted by board-certified clinical neurophysiologists, who classified each EEG as normal or abnormal, with relevant subsequent subclassification.

Results:
Over 18 years, a total of 12,425 individual 30-minute EEGs were performed. Of these, 1,023 patients had at least one repeated EEG after the first normal EEG. Among these patients, 763 had a 30-minute EEG as the second study and 260 had a 2-hour EEG as the second study. The yield of epileptiform discharges was 3.3% in the 30-minute EEG group and 4.2% in the 2-hour EEG group (P = 0.5) in the repeating studies.

Conclusions:
Two-hour EEG has a similar yield as 30-minute EEG to detect epileptiform discharges in patients with a normal 30-minute EEG.
Effects of Diurnal Intermittent Fasting on Daytime Sleepiness Reflected by EEG Absolute Power
Authors: Almeneessier Aljohara S. , BaHammam Abdulrahman A. , Olaish Awad H. , Pandi-Perumal Seithikurippu R. , Manzar Md Dilshad , BaHammam Ahmed S. 
Published: March 2019

Purpose:
We hypothesized that diurnal intermittent fasting would not increase slow frequency EEG waves, which reflect increased sleepiness. Therefore, this study aimed at performing a quantitative EEG analysis of young healthy volunteers with and without diurnal intermittent fasting while controlling for potential confounders.

Methods:
Eight young healthy volunteers (mean age: 24.4 ± 3.7 years) reported to the laboratory during the following five occasions: (1) adaptation, (2) 4 weeks before Ramadan while performing diurnal intermittent fasting (fasting from dawn to sunset) for 1 week (fasting outside Ramadan), (3) 1 week before Ramadan (nonfasting baseline), (4) during the second week of Ramadan while fasting (Ramadan), and (5) 2 weeks after Ramadan (recovery). Frontal, central, and occipital EEG signals were monitored four times (09:15, 11:15, 13:15, and 15:15 for 15 minutes each time) while the participants were awake to assess EEG spectral power of the delta, theta, alpha, and beta frequency bands.

Results:
During wakefulness, no difference in EEG slowing was observed between nonfasting baseline and fasting during and outside Ramadan. There were no differences in the mean absolute power of each band in any studied brain region in any of the four study periods. Moreover, there was no difference in EEG absolute powers in the delta, theta, alpha, and beta frequency bands for any individual brain region during the four study periods.

Conclusions:
Spectral analysis of EEG power indicates that diurnal intermittent fasting does not increase sleepiness. Future larger studies are needed to confirm the current findings.