bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhaled Triamcinolone with Proton Pump Inhibitor for Treatment of Vocal Process Granulomas: A Series of 67 Granulomas
Authors: Hillel Alexander T. , Lin Li-Mei , Samlan Robin , Starmer Heather , Leahy Kevin , Flint Paul W. 
Published: May 2017

ObjectivesWe sought to analyze the outcomes of vocal process granulomas treated with proton pump inhibitors and inhaled triamcinolone acetonide.MethodsWe reviewed the medical records of patients with a diagnosis of contact granuloma or vocal process granuloma between 1995 and 2008. Data included age, gender, intubation history, reflux history, lesion location, previous treatment methods, treatment course, and recurrence. All patients were treated with daily or twice-daily protein pump inhibitors and inhaled triamcinolone acetonide (300 μg 3 times a day).ResultsSixty-seven granulomas were diagnosed in 54 patients: 13 bilateral and 41 unilateral. Twenty patients, including all 11 women, had a recent history of intubation. Sixty-two granulomas in 50 patients were treated with triamcinolone and a proton pump inhibitor. Of the 57 granulomas that completed treatment, 5 (9%) did not respond (mean follow-up, 50 weeks; range, 30.3 to 78.3 weeks), 13 (22%) partially responded (mean follow-up, 11 weeks; range, 3 to 30 weeks), and 40 (69%) completely responded (mean follow-up, 21 weeks; range, 5.9 to 84.6 weeks). Three cases had recurrence: 2 nonresponders and 1 complete responder. One patient developed oral thrush.ConclusionsIn this study, vocal process granulomas occurred more frequently in men, whereas women developed granulomas only after intubation. The anti-inflammatory action of inhaled triamcinolone combined with antireflux proton pump inhibitors successfully treats most vocal process granulomas with low rates of side effects and recurrence.
Modified Extracorporeal Septoplasty Technique in Rhinoplasty for Severely Deviated Noses
Authors: Jang Yong Ju , Kwon Minsu 
Published: May 2017

Objectives Secure fixation of the reimplanted septum is critical for successful long-term aesthetic and functional outcomes following extracorporeal septoplasty (ECS). We describe the results of our modified ECS technique. Methods This retrospective study involved 27 patients with a deviated nose who underwent our modified ECS method in rhinoplasty between June 2006 and January 2009. Anthropometric changes were assessed from preoperative and postoperative facial photographs. Patient satisfaction was evaluated, and nasal obstruction improvement was assessed on a visual analog scale. Results Postoperative correction of the external nose deviation angle was statistically significant. Twenty-four patients (89%) were satisfied with the cosmetic outcome, and all 23 patients with moderate to severe preoperative nasal obstruction were satisfied with the postoperative improved nasal breathing. Conclusions Our modified ECS fixation technique was easy to perform and effective in septorhinoplasty for severe septal deviation.
Furosemide Administered before Noise Exposure can Protect the Ear
Authors: Adelman Cahtia , Perez Ronen , Nazarian Yoram , Freeman Sharon , Weinberger Jeffrey , Sohmer Haim 
Published: May 2017

Objectives We assessed the effect of furosemide administration on noise-induced hearing loss. This drug reversibly elevates the auditory threshold by inducing a temporary reduction of the endocochlear potential and thereby suppresses the cochlear amplifier and active cochlear mechanics. Methods Mice were given a single injection of furosemide 30 minutes before exposure to 113 dB sound pressure level broadband noise. Control animals received saline solution. Furosemide was administered in other mice after the noise exposure. Auditory threshold shifts were assessed by recording auditory nerve brain stem evoked response (ABR) thresholds to broadband clicks. Results The mean ABR threshold in the group injected with furosemide and exposed to temporary threshold shift (TTS)-producing noise was elevated by 20.4 ± 12.3 dB, and that in the saline control group was elevated by 35.4 ± 18.3 dB (p < 0.02). The mean threshold elevations in the group injected with furosemide and exposed to permanent threshold shift (PTS)-producing noise and in the PTS saline control group were 15.0 ± 10.3 dB and 27.0 ± 12.7 dB, respectively (p < 0.01). Similar results were obtained when the PTS was assessed with an 8-kHz tone burst ABR. There was no significant difference in the PTS between mice given a single injection of furosemide and those given saline solution after the noise; this finding shows that furosemide is not acting as an antioxidant. Conclusions It appears that reversible hearing threshold elevation as a result of furosemide administration before noise exposure can reduce the TTS and PTS. This finding provides insight into the mechanism of noise-induced hearing loss.
High-Resolution Manometry of Pharyngeal Swallow Pressure Events Associated with Head Turn and Chin Tuck
Authors: Mcculloch Timothy M. , Hoffman Matthew R. , Ciucci Michelle R. 
Published: May 2017

Objectives We quantified the effect of swallowing maneuvers on pharyngeal pressure events using high-resolution manometry. Methods Seven subjects swallowed multiple 5-mL water boluses in 3 different postural conditions: neutral, head turn, and chin tuck. Pressure and timing events were recorded with a 36-sensor high-resolution manometry catheter. We analyzed the regions of the velopharynx and the base of the tongue for maximum pressure, rate of pressure increase, pressure gradient, and duration of pressure above baseline. In the region of the upper esophageal sphincter (UES), we analyzed the duration of pressure declination, minimum pressure during UES opening, and maximum pressures before and after UES opening. Results The maneuvers did not have a significant effect on maximum pressure, rate of pressure increase, or pressure gradients in the velopharyngeal or tongue base regions. The duration of pressure above baseline was significantly longer in the velopharynx for head turn. The preswallow maximum UES pressure was significantly greater for neutral swallows than for head turn, and the postswallow maximum pressure was significantly lower for chin tuck. Both maneuvers appeared to prolong UES pressure declination duration, but neither prolongation reached significance. Conclusions High-resolution manometry allows for optimal spatial and temporal resolution during recording of pressure events along the length of the pharynx, and revealed previously undetected task-dependent pressure and timing differences during chin tuck and head turn in healthy adults. These maneuvers appear to influence the UES to a greater degree than the velopharynx or the tongue base. Further studies designed to quantify the effect of other maneuvers and bolus consistencies on the generation of pharyngeal pressure events both in normal and in disordered subjects may lead to hypothesis-driven, optimal, individualized swallowing therapies.
Effect of Nitric Oxide Synthase Inhibitor on Increase in Nasal Mucosal Blood Flow Induced by Sensory and Parasympathetic Nerve Stimulation in Rats
Authors: Ogawa Fumio , Hanamitsu Masakazu , Ayajiki Kazuhide , Aimi Yoshinari , Okamura Tomio , Shimizu Takeshi 
Published: May 2017

ObjectivesNeural control of nasal blood flow (NBF) has not been systematically investigated. The aim of the present study was to evaluate the effect of electrical stimulation of both sensory and parasympathetic nerves innervating the nasal mucosal arteries on NBF in rats.MethodsIn anesthetized rats, nasociliary (sensory) nerves and postganglionic (parasympathetic) nerves derived from the right sphenopalatine ganglion were electrically stimulated. We measured NBF with a laser-Doppler flowmeter.ResultsThe nerve stimulation increased NBF on both sides and increased the mean arterial blood pressure. The increase in NBF was larger on the ipsilateral side than on the contralateral side. Hexamethonium bromide, a ganglion blocker, abolished the stimulation-induced pressure effect and the increase in NBF on the contralateral side, but did not abolish the increase in NBF on the ipsilateral side. The remaining increase in NBF was abolished by NG-nitro-L-arginine, a nitric oxide synthase inhibitor. Histochemical analysis with nicotinamide adenine dinucleotide phosphate-diaphorase showed neuronal nitric oxide synthase-containing nerves that innervate nasal mucosal arteries.ConclusionsNitric oxide released from parasympathetic nitrergic nerves may contribute to an increase in NBF in rats. The afferent impulses induced by sensory nerve stimulation may lead to an increase in mean arterial blood pressure that is partly responsible for the increase in NBF.
Neck Surface Electromyography as a Measure of Vocal Hyperfunction before and after Injection Laryngoplasty
Authors: Stepp Cara E. , Heaton James T. , Jetté Marie E. , Burns James A. , Hillman Robert E. 
Published: May 2017

Objectives The goal of this preliminary study was to determine whether neck surface electromyography (sEMG) is sensitive to possible changes in vocal hyperfunction associated with injection laryngoplasty, particularly with respect to alterations in the degree of vocal hyperfunction. Methods Thirteen individuals undergoing office-based injection laryngoplasty for glottal phonatory insufficiency were prospectively studied with a battery of acoustic, aerodynamic, endoscopic, and anterior neck sEMG assessments before the procedure and approximately 1 week afterward. Results Anterior neck sEMG values were not significantly reduced (p < 0.05) after the procedure; however, perceptual ratings of strain and false vocal fold compression were both significantly reduced, reflecting a decrease in vocal hyperfunction. Conclusions The results do not support the use of anterior neck sEMG measures to assess vocal hyperfunction, and place into question the use of some other measures (estimates of anterior-posterior supraglottic compression, quantitative measures of anterior-posterior and false vocal fold supraglottic compression, and acoustic vowel rise times) that have been considered reflective of vocal hyperfunction.
Elastic Fibers in Reinke's Edema
Authors: Sakae Flavio Akira , Imamura Rui , Sennes Luiz Ubirajara , Tsuji Domingos Hiroshi , Mauad Thais , Nascimento Saldiva Paulo Hilário 
Published: May 2017

Objectives We describe the distribution of elastic system fibers in the superficial layer of the lamina propria of Reinke's edema, as compared with normal vocal folds. Methods Weigert's resorcin-fuchsin stain after oxidation with 10% oxone was used to study the arrangement of elastic fibers. The findings were categorized and afterward compared with the severity of Reinke's edema. Results Analysis of 20 specimens of vocal folds with Reinke's edema showed that the network of thin elastic fibers in Reinke's space lost their undulated appearance and had a tangled aspect. In addition, these fibers were no longer parallel to the epithelial basement membrane, but had a random distribution scattered throughout Reinke's space. The elastic fiber network immediately below the epithelial basement membrane also appeared more fragmented in Reinke's edema because of some alteration in organization combined with the 5-μm-thick histologic sectioning plane. No significant difference in the degree of elastic system fiber disarrangement was observed between severity grades II and III (p = 0.382). Large areas of disarrangement were predominant (80% of cases). Conclusions The disarrangement of elastic fibers in Reinke's edema may cause insufficient tissue resistance and resilience, contributing to the hypermobility observed in Reinke's edema.
Prevalence of Acoustic Neuroma Associated with Each Configuration of Pure Tone Audiogram in Patients with Asymmetric Sensorineural Hearing Loss
Authors: Suzuki Masaaki , Hashimoto Sho , Kano Shigeyuki , Okitsu Takuji 
Published: May 2017

Objectives The criteria have not yet been established for identifying the configuration of a pure tone audiogram constituting abnormal results that warrant further investigation. The purpose of this study was to determine the prevalence of acoustic neuroma associated with each configuration of the pure tone audiogram in patients with asymmetric sensorineural hearing loss (SNHL). Methods We performed a retrospective chart review of 500 patients 15 years of age or older who had asymmetric SNHL and had undergone magnetic resonance imaging. Results The prevalence of acoustic neuroma in these patients was 2.6% (13 of 500). The prevalence of acoustic neuroma in each audiometric configuration was as follows: 7.1% (3 of 42) for a basin-shaped loss (odds ratio [OR] versus overall prevalence, 2.88; p =0.23; 95% confidence interval [CI], 0.79 to 10.54),4.7% (5 of 107) for a flat loss, 3.4% (2 of 58) for total deafness, 2.9% (l of 34) for a high-frequency sloping audiogram, and 2.5% (2 of 81) for a high-frequency steep audiogram. The prevalence in patients with nonimproving idiopathic sudden deafness was 8.1% (OR, 3.29; p = 0.06; 95% CI, 1.13 to 9.55). Conclusions In conclusion, 2.9% to 8.1% of patients with a characteristic configuration of the pure tone audiogram and symptoms of nonimproving or progressive idiopathic sudden deafness may have acoustic neuroma.
Balloon Dilation for Recurrent Stenosis after Pediatric Laryngotracheoplasty
Authors: Bent John P. , Shah Maulik B. , Nord Ryan , Parikh Sanjay R. 
Published: May 2017

Objectives We assessed the safety and efficacy of balloon dilation as treatment for recurrent stenosis after pediatric laryngotracheoplasty. Methods We studied a retrospective case series at an academic tertiary care children's hospital. We included all patients under the age of 18 years with subglottic or tracheal stenosis treated at our institution with balloon dilation between June 2007 and April 2009. The records were analyzed for patient demographics, presenting symptoms, surgical technique, and airway description. The outcome measures were airway diameter, postoperative symptoms, tracheotomy status, and complications. Results Ten patients (9 with subglottic stenosis and 1 with tracheal stenosis) underwent 20 balloon dilation procedures without complication. The average age at the time of the procedure was 17 months (range, 3 months to 9 years). The patient presenting symptoms were stridor in 7 cases and tracheotomy in 3 cases. Vascular balloons (diameter range, 6 to 12 mm; length, 20 mm) were inflated to 10 to 12 cm H2O pressure for an average of 40 seconds (range, 10 to 120 seconds). Each procedure consisted of 1 to 3 dilation cycles. The immediate postdilation airway area increased by an average factor of 4.9 (range, 1.9 to 9). Six patients had repeat procedures with an average interval between dilations of 67 days (range, 6 to 337 days). Stridor was eliminated or greatly improved in all patients on the first postoperative day; 7 patients sustained this benefit, with an average follow-up time of 10 months (range, 4 to 23 months). Six of the 10 patients had undergone previous laryngeal reconstruction (age range, 3 months to 4 years). Of these 6, 3 have no tracheotomy, with a mean follow-up of 12.5 months. The 3 children who benefited the least from dilation were noted to have more diffuse and chronic inflammation of the larynx in comparison to the responders. Conclusions This case series suggests that balloon dilation is a relatively safe and effective procedure. It may be particularly well suited to recent stenosis after laryngotracheal reconstruction.
Value of Barium Swallow Studies in Predicting the Response to Rabeprazole in Elderly Patients with Laryngopharyngeal Reflux Disease and Nonerosive Reflux Disease in Particular
Authors: Kimura Yurika , Sugiura Mutsumi , Kato Tomofumi , Makino Nao , Ohmae Yukio , Kishimoto Seiji 
Published: May 2017

Objectives Laryngopharyngeal reflux disease (LPRD) is an important cause of throat discomfort in the elderly. Our objective was to investigate the usefulness of barium swallow studies for the diagnosis of LPRD. Methods The subjects were 59 patients at least 60 years of age with LPRD suspected on laryngoscopy findings. We evaluated esophageal clearance using a barium swallow study and the upper gastrointestinal tract endoscopic findings of gastroesophageal reflux disease according to the revised Los Angeles classification, and correlated these findings with the effect of rabeprazole, a proton pump inhibitor. Results Among subjects with positive reflux findings in the esophageal phase of the barium swallow, rabeprazole was significantly effective (p = 0.0025). To identify nonerosive reflux disease, we analyzed the 50 cases with a negative Los Angeles classification of upper gastrointestinal tract endoscopic findings. Rabeprazole was again significantly effective in patients with positive findings for esophageal reflux (p = 0.0025). Conclusions Among elderly patients with suspected LPRD, there was a positive correlation between impaired esophageal clearance on the barium swallow study and the effectiveness of rabeprazole. The barium swallow study could be a screening test for LPRD in elderly patients with throat discomfort.
Sphenoid Sinus Pneumatization and Its Relation to Bulging of Surrounding Neurovascular Structures
Authors: Cho Jae Hoon , Kim Jin Kook , Lee Jeung-Gweon , Yoon Joo-Heon 
Published: May 2017

Objectives We investigated the bulging and dehiscence of neurovascular structures in the sphenoid sinus and their relationships to the pneumatization of the sphenoid sinus. Methods One hundred sagittally hemisected cadaveric heads were examined. The degree of pneumatization of the sphenoid sinus was determined. Bulging and dehiscence of the internal carotid artery (ICA), optic nerve, maxillary nerve, and vidian nerve were examined, and the distances between these structures and the anterior or superior wall of the sphenoid sinus were measured. Additionally, the degree of bony thickness over these structures was determined. Results The prevalences of bulging of the optic nerve, segments 1 and 3 of the ICA, and the maxillary and vidian nerves were 56%, 34%, 65%, 41%, and 52%, respectively. The greater the degree of pneumatization, the more frequently did the structures bulge into the sphenoid sinus. The optic nerve was found to be in close proximity to the anterior and superior walls of the sphenoid sinus. The bone over the surrounding structures was very thin, especially for the complete sellar type. Conclusions The prevalence of bulging of the optic nerve, the ICA, and the maxillary and vidian nerves increased in proportion to the degree of sphenoid sinus pneumatization.
Bilateral Peritonsillar Abscesses: Our Experience and Clinical Features
Authors: Watanabe Tetsuo , Suzuki Masashi 
Published: May 2017

Objectives This study analyzed the incidence and characteristics of bilateral peritonsillar abscesses (PTAs) that were treated with immediate tonsillectomy. Methods The study analyzed 409 patients with PTAs treated between 1984 and 2008. The patients included 304 male and 105 female patients between 2 and 85 years of age (median age, 30 years). Immediate tonsillectomy was performed in 371 of the PTA patients (90.7%). The incidence of bilateral PTAs and candidate predictive factors for bilateral PTAs were reviewed, including age, duration of PTA symptoms, history of recurrent tonsillitis, history of PTAs, deviation of the uvula, body temperature on admission, white blood cell count on admission, and C-reactive protein level on admission. Results Bilateral PTAs were found in 24 of 371 patients (6.5%). Younger age, absence of a deviated uvula, and a higher C-reactive protein value were the clinical features associated with bilateral PTAs in multivariate analysis. Conclusions The occurrence of bilateral PTAs was not rare; this fact has to be taken into consideration in discussing therapeutic concepts. The clinical features of bilateral PTAs suggested that bilateral PTAs might be a part of the natural history of PTAs, and that they occur in cases in which there is a delay in diagnosis and treatment. Further study is necessary to confirm the causation of bilateral PTAs.
Childhood Hearing and its Relationship with Tinnitus at Thirty-Two Years of Age
Authors: Dawes Patrick J. D. , Welch David 
Published: May 2017

ObjectivesTinnitus is associated with hearing loss in adulthood, often resulting from noise or age, but it is not known whether children's hearing and/or middle ear health predispose them to tinnitus in adulthood.MethodsThe participants were members of the Dunedin Multidisciplinary Health and Development Study, born in Dunedin, New Zealand, between April 1972 and March 1973. The base sample consisted of 1,037 children. Otitis media was assessed at 5, 7, and 9 years of age; audiometry and tympanometry findings were recorded at 11 years of age, and a detailed description of the tympanic membrane was made at 15 years of age. At 32 years of age, 970 of the 1,015 living study members (96%) answered questions about tinnitus.ResultsChildren who had otitis media and a raised audiometric threshold went on to experience more tinnitus in adulthood than did those without middle ear disease or those who had otitis media without a raised threshold. In those who had recovered from otitis media, audiometric threshold elevation at lower and higher frequencies was associated with experiencing tinnitus in adulthood. Neither childhood otitis media alone nor elevated thresholds alone predicted adult tinnitus.ConclusionsChildhood otitis media with an associated hearing loss in the low and high frequencies was associated with a greater probability of experiencing tinnitus in adulthood.
Ki-67 Proliferation Rate as a Prognostic Marker in Major Salivary Gland Carcinomas
Authors: Vacchi-Suzzi Martino , Bocciolini Corso , Bertarelli Claudia , Dall'olio Danilo 
Published: May 2017

Objectives The study was performed to evaluate the prognostic relevance of cell proliferation associated with Ki-67/Mib-1 immunostaining in malignant tumors of the major salivary glands. Methods Cell proliferation was evaluated by Mib-1 antibody against Ki-67 antigen in 41 patients with cancer of the parotid or submandibular glands, including 14 acinic cell carcinomas, 12 ductal carcinomas, 7 mucoepidermoid carcinomas, 5 carcinomas ex pleomorphic adenoma, 1 adenoid cystic carcinoma, 1 undifferentiated carcinoma, and 1 polymorphous low-grade adenocarcinoma. Results Patients with Ki-67 values of more than 15% and those with Ki-67 values of 15% or less differed both in disease-free survival (p < 0.001) and in overall survival (p < 0.001). We evaluated the association between Ki-67 and time to recurrence in correlation to age, sex, ductal histotype, and N stage; the Cox regression model was significant (p = 0.013). In the group of patients with T1 and T2 cancers, those with Ki-67 values of 15% or less had better survival rates than did those with Ki-67 values of more than 15% (p = 0.004). In the group of patients with NO cancers, those with Ki-67 values of 15% or less had a better survival than did those with Ki-67 values of more than 15% (p < 0.001). Conclusions To our knowledge, this is the first study to stratify different risk classes in early T1–T2 or NO malignant tumors of the major salivary glands that identified aggressive lesions with elevated Ki-67 expression at an initial stage.