bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic Transantral and Transnasal Repair of Orbital Floor Fracture with the Ballooning Technique, and Classification and Characterization of Orbital Floor Fractures
Authors: Park Il-Ho , Lee Heung-Man , Yanagi Kiyoshi 
Published: December 2015

Background The level of difficulty during an endoscopic approach for an inferior orbital fracture depends on the fracture pattern and the presence of a ruptured membrane (orbital periosteum and sinus mucosa). The purpose of our study was to examine fracture patterns according to age group and to determine the relationship between the type of fracture and the type of membrane injury. Methods We reviewed the records of 30 patients who, from 2006 to 2010, underwent endoscopic transantral and transnasal approach with a balloon catheter technique to repair orbital floor fracture. The procedure was done through middle or inferior meatal antrostomy and two small antrostomies made in the anterior wall of the maxillary sinus by using an endoscope and specially designed curved dissectors. Results There were 3 linear, 20 trapdoor-type and 7 blowout fractures. There was a tendency toward a higher incidence of linear fractures at younger ages and of blowout fractures in older patients. All linear fractures had rupture of both membranes, whereas both membranes were intact in 15 of the 20 patients with trapdoor fractures. Among blowout fractures, there was no membrane rupture in five and both membranes were ruptured in two patients. No patient reported diplopia after fracture repair. Conclusions Rupture of the periosteum, which makes visualization and reduction of orbital tissue difficult for the surgeon during endoscopic repair of the orbital floor fracture, was observed in 3 of 3 linear fractures and 5 of 20 trapdoor fractures. We found that linear fractures were more common in pediatric patients. Care of pediatric orbital floor fracture requires particular caution.
The Orbital Floor is a Surgical Landmark for the Asian Anterior Skull Base
Authors: Wuttiwongsanon Chairat , Chaowanapanja Pattraporn , Harvey Richard J. , Sacks Raymond , Schlosser Rodney J. , Chusakul Supinda , Aeumjaturapat Songklot , Snidvongs Kornkiat 
Published: December 2015

Background Surgical landmarks for defining the level of the skull base during endoscopic sinus and skull base surgery (ESBS), e.g., the middle turbinate, may be distorted by tumor or previous surgery. The orbital floor is a valid fixed anatomic landmark for the white population, but it is not known if its use is useful for an Asian population. Objectives To define fixed anatomic landmarks for ESBS in an Asian population and to compare the level of the skull base and its relation with anatomic landmarks between Asian and white populations. Methods Computed tomographies performed on paranasal sinuses of Thai patients were retrospectively assessed. The distance between the nasal floor to four structures, the orbital floor, sphenoid planum, cribriform, and ethmoid roof, were measured. The level of skull base related to the orbital floor of an Asian population was compared with data of a white population from a previously published study. Results A total of 150 Thai patients (300 paranasal sinus systems) were assessed and compared with 150 white patients. The orbital floor was always below the skull base (600 sides [100%]). When compared with white patients, the Asian patients had significantly higher mean (standard deviation [SD]) values: orbital floor (35.2 ± 3.4 mm versus 33.9 ± 3.0 mm; p < 0.001), ethmoid roof (49.3 ± 3.8 mm versus 48.4 ± 4.5 mm; p = 0.01), cribriform (46.4 ± 3.6 mm versus 44.0 ± 3.7 mm; p < 0.001), and sphenoid roof (45.7 ± 3.7 mm versus 44.9 ± 3.7 mm; p = 0.01). The Asian population had a mean (SD) longer distance from the orbital floor to the cribiform (11.2 ± 2.5 mm versus 10.1 ± 2.7 mm; p < 0.001), a shorter distance to the sphenoid roof (10.5 ± 3.3 mm versus 11.0 ± 2.9 mm; p = 0.03), and a similar distance to the ethmoid roof(14.1 ± 3.1 mm versus 14.5 ± 3.5 mm; p = 0.09). Conclusion Although a statistical difference exists between racial groups, clinically, the orbital floor is a useful fixed anatomic landmark for ESBS for both Asian and white populations.
Association of Body Mass Index and Other Factors with Histamine Skin Reactivity in Adults with Allergic Nasal Symptoms
Authors: Park Do Yang , Kim Yoo Suk , Kim Jeong Hong , Kang Ju Wan 
Published: December 2015

Background The skin-prick test is the most commonly used method to diagnose allergy. In addition, histamine skin reactivity is used as a positive control for the skin-prick test. However, there is individual variation in histamine skin reactivity. The factors that influence individual variation in histamine skin reactivity remain unknown. Objectives We aimed to investigate the factors associated with histamine skin reaction. Methods Ninety-seven subjects who underwent a skin-prick test to diagnose allergic rhinitis were enrolled in this study. The skin-prick test was performed with six common allergens. The wheal size of the histamine skin reaction was analyzed; other variables included age, sex, body mass index (BMI), atopy, smoking history, and the testing season. Results The wheal size in the histamine skin test was significantly associated with age and BMI. The association between histamine skin reactivity and BMI was also present in multivariate analysis, adjusted for age, sex, atopy, smoking history, and season. Conclusion Histamine skin reactivity increased with BMI (degree of obesity). This association should be considered for better interpretation of the skin-prick test. Further studies regarding the mechanism for this association are needed.
Reduction of Adhesions and Antrostomy Stenosis with Topical Vitamin a after Endoscopic Sinus Surgery
Authors: Fang Kai-Min , Wang Chi-Te , Chen Ya-Wen , Huang Tsung-Wei 
Published: December 2015

Background Prevention of adhesion formation and restoration of mucociliary mucosa are major determinants of the success of endoscopic sinus surgery (ESS). Vitamin A (VA) can promote mucociliary differentiation of respiratory epithelium. However, whether topical VA can promote sinonasal wound healing or reduce adhesion formation after ESS in humans remains unexplored. Objective To investigate the effect of topical VA on sinonasal wound healing and adhesion formation after ESS. Methods This is a within-subject control study. Patients with chronic rhinosinusitis were included. Each patient underwent ESS, and topical VA was applied over the sinonasal wound. Postoperative outcomes were assessed by using the Lund-Kennedy score, and the antrostomy size was measured. In vitro wound healing assay of fibroblasts with or without VA was evaluated. Restoration of ciliated epithelium was examined by using scanning electron microscopy. Results Thirty patients were enrolled. The mean (standard deviation {SD}) scores for scarring/adhesion in the VA-treated side at 3 and 12 months after surgery (0.20 ± 0.40 and 0.23 ± 0.42, respectively) were significantly lower than those in the controls (0.47 ± 0.50 and 0.53 ± 0.62, respectively). The mean (SD) antrostomy size in the VA treated side at 1, 3, and 12 months after surgery (0.85 ± 0.30 cm2, 0.7 ± 0.30 cm2, and 0.70 ± 0.27 cm2, respectively) were significantly larger than those in the controls (0.79 ± 0.26 cm2, 0.60 ± 0.25 cm2, and 0.57 ± 0.24 cm2, respectively). Wound healing assay revealed that VA significantly inhibited the proliferation and migration of fibroblasts. Scanning electron microscopy showed mature ciliated cells in the VA-treated side. Conclusion Topical VA is a promising agent for sinonasal wound healing after ESS because it can promote mucociliary reepithelization, reduce adhesion, and prevent antrostomy stenosis.
How I do It: The Sphenoethmoidectomy: With Illustration and Video
Authors: Gudis David A. , Karnezis Tom K. , Soler Zachary M. , Schlosser Rodney J. 
Published: December 2015

Background Several techniques for performing the sphenoethmoidectomy have been described. We present a safe, effective, and efficient technique. Objective We present text, images, and video to demonstrate our preferred technique for performing a sphenoethmoidectomy. Methods A description of the technique without prospective or retrospective data, whereby a Kerrison rongeur and microdebrider were used to perform a total sphenoethmoidectomy by skeletonizing the skull base and lamina papyracea. Results In our hands, the Kerrison rongeur and microdebrider allowed for a reliably safe and efficient sphenoethmoidectomy for chronic sinusitis with or without polyposis or skull base approaches. Conclusion The technique described can be added to the armamentarium of the endoscopic sinus surgeon.
The Radiologic Evaluation of Osteitis Type and Formation in Chronic Rhinosinusitis with and without Nasal Polyposis
Authors: Emre Ismet Emrah , Celebi Irfan , Ercan Ibrahim 
Published: December 2015

Objective To evaluate the amount and type of osteitis observed in chronic rhinosinusitis with nasal polyposis (CRSwNP) and compare it with that of chronic rhinosinusitis without nasal polyposis (CRSnNP). Setting Sisli Etfal Research and Education Hospital, Istanbul, Turkey. Study Design Prospective, single-blind, cohort study. Methods Three different patient groups, designated as the CRSwNP, CRSnNP, and control groups, were included in the study. Forty patients who had CRSnNP and/or CRSwNP confirmed with a paranasal sinus computerized tomography (CT) study were included for the study group, and 20 individuals were included in the control group. Paranasal sinus CTs were evaluated and compared for osteitis. Results Hounsfield units obtained from the right and left agger nasi walls and the medial maxillary sinus wall in the control group were significantly different from the entire group. Similarly, values for the anterior ethmoid wall were statistically significant for the CRSwNP group compared with all the subjects. When the groups were compared to one another, there were significant differences in both the right and left agger nasi walls and the frontal sinus wall. Conclusion Differentiating and acknowledging osteitis induced by CRSwNP rather than CRSnNP may aid in preoperative planning and indicate where to be more aggressive when excising bony structures. This may help in reducing recurrence and in increasing quality of life.
Computed Tomographic Analysis of Frontal Recess Cells in Pediatric Patients
Authors: Al-Qudah Mohannad , Mardini Diala 
Published: December 2015

Objective To describe the prevalence of frontoethmoid cells and superior uncinate process attachment in pediatric patients with sinonasal symptoms. Method Fifty high-resolution computed tomographies of the paranasal sinuses for pediatric patients were evaluated for the presence of frontoethmoid cells and uncinate process insertion. The computed tomographies were randomly collected for patients with sinonasal symptoms (age range, 4-15 years) at our clinic. The prevalence of these cells was compared against age group and type of uncinate process. Results The prevalence of each structure was agger nasi cell (97%), type 1 frontal cell (39%), type 2 frontal cell (27%), type 3 frontal cell (11%), type 4 frontal cell (1%), supraorbital ethmoid cell (38%), suprabullar cell (57%), frontal bullar cell (9%), and interfrontal septal cell (16%). When excluding the agger nasi cell, 48 patients (96%) had at least one type of frontoethmoid cell and 43 (86%) had at least one frontal cell. The frequency of these cells did not significantly differ based on sex or uncinate process insertion, but it did with age. Lamina papyracea was the most common site of superior uncinate process attachment. Conclusion Our results indicated a high frequency of frontoethmoid cells in the pediatric age group. The prevalence of these variations changes during childhood development. As in adults, lamina papyracea is the most common site of superior uncinate process attachment. Recognition of these variations in the frontal recess can provide useful information for safe and efficient endoscopic dissection in the frontal recess region.
The Effect of Compound Nasal Surgery on Obstructive Sleep Apnea Syndrome
Authors: Hisamatsu Ken-ichi , Kudo Itsuhiro , Makiyama Kiyoshi 
Published: December 2015

Background Nasal surgery often fails to ameliorate the symptoms of obstructive sleep apnea syndrome (OSAS). We developed a compound nasal surgery (CNS) method that consists of septoplasty combined with submucosal inferior turbinectomy and posterior nasal neurectomy to ensure low nasal resistance during sleep. Objective To clarify the effect of CNS on OSAS, pre- and postoperative changes in sleep-related events were studied by using polysomnography, the Epworth sleepiness scale (ESS), the visual analog scale for snoring, and health-related quality of life (QOL). Methods Forty-five consecutive patients with OSAS and with nasal problems underwent CNS. Three months later, the postoperative effect on OSAS was assessed by using polysomnography findings, daytime sleepiness by the ESS, nasal allergy symptoms, and health-related QOL. Snoring was assessed by the family by using a visual analog scale. Results The indices of apnea, apnea-hypopnea, oxygen desaturation, and arousal; the ESS; allergic symptom score; health-related QOL; and snoring on a visual analog scale were all significantly improved. Conclusions CNS improves OSAS events without any pharyngeal surgical procedure in selected patients. If high nasal resistance associated with OSAS is present, then CNS should thus be considered.
Recurrent Asystole as an Electrocardiographic Artifact during Microdebrider use in Functional Endoscopic Sinus Surgery
Authors: Patadia Monica , Bartindale Matthew , Caballero Nadieska 
Published: December 2015

Introduction Electrocardiographic (EKG) artifacts can lead to unnecessary treatment and costly diagnostic workup. Two previous studies reported a ventricular tachycardia artifact as a result of microdebrider malfunction. In this study, we report the first case of EKG artifacts that mimick asystole from microdebrider use during functional endoscopic sinus surgery (FESS). Case A healthy 19-year-old woman presented with chronic rhinosinusitis, nasal polyposis, and a deviated nasal septum. She was scheduled for a bilateral FESS and septoplasty. During surgery, the microdebrider was changed after 1 hour. While using the second microdebrider, the EKG monitor showed three distinct asystolic events, all lasted approximately 3 seconds. The EKG tracing returned to normal sinus rhythm every time the microdebrider was stopped. The patient's oxygen saturation remained at 100%, and blood pressure remained stable during the episodes. The procedure was aborted, and an extensive cardiology workup was performed, which returned negative results. Biomedical engineering investigated the microdebrider and found a far greater than expected chassis leak, which likely caused electrical interference. Six months later, the patient underwent a right-sided FESS and revision left frontal FESS. There were no EKG abnormalities during the second surgery. Discussion Although other EKG artifacts have been reported in the literature, this is the first case report of an artifact that mimicked asystole that stemmed from microdebrider use. Improved awareness of this potential EKG artifact for both the surgeon and the anesthesiologist may prevent an unnecessary costly workup.
Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors
Authors: Syrengelas Dimitrios , Kalampoki Vassiliki , Kleisiouni Paraskevi , Manta Vassiliki , Mellos Stavros , Pons Roser , Chrousos George P. , Siahanidou Tania 
Published: December 2015

Abstract

Background
Only a few studies have been conducted with the objective of creating norms of the Alberta Infant Motor Scale (AIMS) for the assessment of gross motor development of preterm infants. The AIMS performance of preterm infants has been compared with that of the Canadian norms of full-term infants, but not with that of full-term infants of the same nationality. Moreover, the possible impact of prematurity-related morbidity factors on AIMS performance is unknown.

Objectives
The aims of this study were: (1) to evaluate AIMS trajectory in a large population of Greek preterm infants and create norms, (2) to compare it with the AIMS trajectory of Greek full-term infants, and (3) to examine the possible influence of neonatal morbidity on AIMS scores in the preterm sample.

Design
This was a cross-sectional study.

Methods
Mean AIMS scores were compared, per month (1–19), between 403 preterm infants (≤32 weeks of age, corrected for prematurity) and 1,038 full-term infants. In preterm infants, the association of AIMS scores with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) of grade ≤III, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and sepsis was assessed by hierarchical regression analysis.

Results
Alberta Infant Motor Scale scores were significantly lower in preterm infants than in full-term infants. Mean AIMS scores in preterm infants were significantly associated with RDS (b=−1.93; 95% CI=−2.70, −1.16), IVH (b=−0.97; 95% CI=−1.69, −0.25), and ROP (b=−1.12; 95% CI=−1.99, −0.24) but not with BPD or sepsis in hierarchical regression analysis.

Conclusions
Alberta Infant Motor Scale norms were created for Greek preterm infants. This study confirms that AIMS trajectories of preterm infants are below those of full-term infants of the same nationality. The influence of morbidity factors, including RDS, IVH, and ROP, should be taken into account when administering the AIMS in preterm infants.
Biplanar Proximal Phalanx Closing Wedge Osteotomy for Hallux Rigidus
Authors: Hunt Kenneth John , Anderson Robert B. 
Published: December 2015

Background: Many procedures have been described for surgical treatment of symptomatic hallux rigidus. Dorsal cheilectomy of the metatarsophalangeal joint combined with a dorsal-based closing wedge osteotomy of the proximal phalanx (i.e., Moberg procedure) has been described as an effective procedure. For patients with hallux rigidus and clinically significant hallux valgus interphalangeus, the authors previously described a dorsal cheilectomy combined with a biplanar closing wedge osteotomy of the proximal phalanx, combining a Moberg osteotomy with an Akin osteotomy. The purpose of this study was to describe the clinical results of this procedure. Methods: This article is a retrospective review of prospectively gathered data that reports the clinical and radiographic results of dorsal cheilectomy combined with a biplanar oblique closing wedge proximal phalanx osteotomy (i.e., Moberg–Akin procedure) for patients with symptomatic hallux rigidus and hallux valgus interphalangeus. Consecutive patients were followed and evaluated for clinical and radiographic healing, satisfaction, and ultimate need for additional procedure(s). Thirty-five feet in 34 patients underwent the procedure. Results: All osteotomies healed. At an average of 22.5 months of follow-up, 90% of patients reported good or excellent results, with pain relief, improved function, and fewer shoe wear limitations following this procedure. Hallux valgus and hallux interphalangeal angles were radiographically improved. Other than one patient who requested hardware removal, no patients required additional surgical procedures. Conclusions: Dorsal cheilectomy combined with a Moberg-Akin procedure was an effective and durable procedure with minimal morbidity in patients with hallux rigidus combined with hallux valgus interphalangeus. Level of Evidence: IV, Retrospective Case Series
Novel Surgical Technique and Early Kinesiotherapy for Acute Achilles Tendon Rupture
Authors: Jielile Jiasharete , Sabirhazi Gulnur , Hu Geyang , Chen Jiangtao , Aldyarhan Kayrat , Zheyiken Jangannuer , Zhao Qin , Bai Jingping 
Published: December 2015

Background: This prospective study was performed to investigate the contribution of early kinesiotherapy, the active exercise and movement of the ankle and knee joints, following a novel surgical technique for reconstruction of the acutely ruptured Achilles tendon and the underlying mechanisms involved. Materials and Methods: One hundred and seven patients with an acute Achilles tendon rupture received postoperative early kinesiotherapy treatment following the novel “Pa-bone” surgical technique. Clinical outcomes were evaluated using the Achilles tendon rupture score, a score for measuring outcomes related to symptoms and physical activity, and bilateral ultrasonographic examination of the Achilles tendon. Results: Range-of-motion recovery equal to the intact side averaged 7 weeks. Double-legged heel rises and sustained single-leg heel rise exercises were possible at an average of 1 week and 60 ± 2 days, respectively. All patients could perform single-leg heel rise of the injured foot for 60 ± 23 seconds at an average of 12 weeks. No rerupture was observed. In addition, ultrasonographic examination revealed that the cross-sectional areas of the ruptured tendon were significantly larger than those of the healthy side. Overall reconstruction of the Achilles tendon was obtained for most of the patients. Conclusion: Postoperative early kinesiotherapy treatment following Pa-bone surgical technique resulted in excellent clinical outcomes and contributed to the overall reconstruction of the Achilles tendon. Level of Evidence: IV, Retrospective Case Series
Validation of Foot and Ankle Outcome Score for Hallux Valgus
Authors: Chen Lan , Lyman Stephen , Do Huong , Karlsson Jon , Adam Stephanie P. , Young Elizabeth , Deland Jonathan T. , Ellis Scott J. 
Published: December 2015

Background: Patient-reported outcome questionnaires such as the Foot and Ankle Outcome Score (FAOS) are useful in evaluating results after orthopedic interventions. However, despite being frequently used in the literature, its validity has not been established for forefoot disorders. Our study aimed to validate the FAOS for use in assessing outcomes of hallux valgus surgery. Methods: From 2006 to 2009, 195 patients with nonarthritic hallux valgus were included in the construct validity portion of the study. Patients had a SF-36 and a FAOS completed. Forty additional patients, both preoperative and postoperative, were given questionnaires to assess the relevance of each of the FAOS questions as it pertained to their bunions. Patients were also given the FAOS 1 month after the first to assess FAOS reliability. Responsiveness of the FAOS was included with 40 patients who had both preoperative and postoperative FAOS scores. Results: Four out of five FAOS subscales demonstrated acceptable correlation with the SF-36. The FAOS symptoms subscale showed the least correlation with SF-36, demonstrating the foot-specific nature of the questions. Both preoperative and postoperative patients rated the FAOS quality of life questions as the most relevant. All five subscales achieved acceptable test-retest reliability. The FAOS sports and recreation subscale was the least responsive. Conclusion: Patient-based assessments have become increasingly important in evaluating treatment effectiveness. This study has shown that the FAOS has acceptable construct validity, reliability, and responsiveness in hallux valgus patients and is a useful patient-based tool in assessing these patients.