bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcanal Endoscopic Tympanoplasty with Tragal Perichondrium Graft by the under‐over Technique
Authors: Valdivia Victor , Venegas Monica M. H. , Morante Juan C. C. 
Published: August 2013

Objectives:Evaluate the anatomical and audiological results of the endoscopic tympanoplasty with tragal perichondrium graft.Methods:A case series in patients with chronic otitis media, treated with transcanal endoscopic tympanoplasty by the under‐over technique. Patients were followed six months post treatment with clinical and audiometric evaluations in the Department of Otolaryngology, National Hospital Arzobispo Loayza, Lima ‐ Peru between 2007 and 2011.Results:Of a total of 64 patients, 31 met the inclusion criteria. 20 were males (64.5%) and the mean age was 27.5 years. The left ear was the most affected with 61.3%. Only 12.9% had retraction pocket. Perichondrium graft was used in 87.1%, and tragal cartilage with perichondrium with the others. There was complete closure of the perforation in 93.5% and only 2 complications, infection and perforation. The difference of the mean of the audiometries by air previous (39.1 ± 5.8) and posterior (30.2 ± 7.2) of surgery was significant (P = 0.0001). The difference of the air‐bone gap previous (13.1 ± 4.9) and posterior (4.3 ± 2.3) of the surgery was significant (P = 0.0001).Conclusions:The endoscopic tympanoplasty improves the audiometric levels and the gap in post‐surgery patients, and allows the complete closure of the perforations with less complications, in the present series.
Kawasaki Disease Resembling a Retropharyngeal Abscess: Clinical Analyses in 9 Cases
Authors: Yagi Masao , Yun Yasutaka , Osumi Yasunori , Tomoda Koichi 
Published: August 2013

Objectives:Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology mostly affected children younger than 5 years of age. Although KD is characterized by prolonged fever (more than 5 days duration) plus 4 of the following 5 signs: conjunctivitis, skin rash, changes in the mouth and extremities, and cervical lymphadenopathy; cervical lymphadenopathy is the least common. Some of the unusual neck presentations reported in KD included deep neck infection like peritonsillar abscess and retropharyngeal abscess. Although it is important for patients with KD to receive early diagnosis and intravenous immunoglobulin (IVIG), unusual presentation of KD presents a dilemma for clinicians.Methods:We retrospectively analyzed clinical data from nine cases that were unresponsive to antibiotic therapy as retropharyngeal abscess/cellulitis later found to be the symptoms of KD from 2007 April to 2013 Feb. There were 5 boys and 4 girls, aged from 8 months to 9 years.Results:The mean white blood cell count in one study was 16000, with a range of 11200‐21300. The mean C‐reactive protein level was 11.1 (6.43 to 21.7). All patients had marked cervical lymphadenopathy with head rotation failure because of severe neck pain. Neck computed tomographic scan demonstrated widening of the retropharyngeal space with a central hypodense region in all cases. Dramatic clinical improvement was seen after a 2‐day course of IVIG treatment in all cases.Conclusions:These cases emphasize that KD should be considered in children with suspected cervical lymphadenitis or retropharyngeal abscess with a poor response to empiric antibiotic therapy.
Severity of CMV Hearing Loss due to the Innate Immune Response in Mice
Authors: Park Albert H. , Duval Melanie , Wang Yong , Firpo Matthew A. 
Published: August 2013

Objectives:Demonstrate the role of the innate immune response in a mouse model for Cytomegalovirus (CMV) induced sensorineural hearing loss (SNHL).Methods:Forty C57BL/6 and BALB/c mice underwent intracranial injection at postnatal day 3 with 200 pfu of green fluorescent protein (GFP) expressing murine (m) CMV; 10 controls received either saline or no injection. Hearing thresholds were assessed using distortion product otoacoustic emission (DPOAE) and auditory brain stem response testing (ABR). Temporal bones were harvested and sectioned for histologic analysis. A subset of BALB/c and C57B/6 temporal bones were harvested for histologic analysis 3 and 7 days after inoculation.Results:Fifty‐five percent of the BALB/c mice had profound hearing loss (≥80 dB) at 4 weeks of age, while 45% initially showed moderate hearing loss that progressed to profound hearing loss by 6 weeks. The green fluorescent protein (GFP)‐labeled virus was abundant in the spiral ganglion and adjacent to the scala tympani at 7 days post‐injection and absent by 4 weeks. In contrast to what was seen in BALB/c mice, the C57/B6 mice showed mild hearing loss. Moreover, temporal bone histology also showed no evidence of mCMV infiltration of the cochlea 3 and 7 days post‐inoculation when peak mCMV infection was expected.Conclusions:Since C57BL/6 mice have been shown to possess a Ly‐49H receptor that triggers natural killer cell activation which is not present in BALB/c mice, these results suggest that CMV mediated hearing loss severity may be influenced by the innate immune response.
Stability Measurements of the Baha System in Children
Authors: Felton Mark , Feltham Penny , Andrew Rachel , Bruce Iain 
Published: August 2013

Objectives:Bone conduction implant (eg, Baha®) stability can objectively be measured over time using radio‐frequency analysis (RFA). Adult studies suggest that the Cochlear Baha BI300 Implant® may be loaded as soon as the soft tissue wound is healed. We aim to discuss implant stability in children using RFA measurements.Methods:Consecutive children having a Cochlear Baha BI300 Implant had RFA measurements taken peri‐operatively, 1 week post‐surgery, within 3 months of surgery, and then subsequently at least 3 monthly. RFA measurements were measured at loading of the hearing processor and at 1 week post‐loading. Standard practice has been to load the implant at 3‐6 months postoperatively.Results:Nine children had 10 Cochlear Baha BI300 implants® (8 unilateral and 1 bilateral) with a mean age of 9 years 4 months (4 years 9 months to 13 years 5 months). The mean time to loading of the hearing processor was 3.3 months (3 to 5 months, n = 9). Mean follow‐up was 9 months (6 weeks to 23 months). Peri‐ and postoperative RFA measurements will be discussed with 6 children having RFAs sufficiently high for hearing processor loading much earlier post‐implantation. Implant stability was maintained after loading with the hearing processor.Conclusions:This study indicates that a larger study is warranted to evaluate both the role of sequential RFA measurements in the timings of Baha hearing processor loading and the possibility of loading at 4‐6 weeks in selected children. Subsequently RFA measurements may also be used to decide between single‐ and two‐stage surgery.
Systematic Review of Endoscopic Balloon Dilation of Pediatric Subglottic Stenosis
Authors: Lang Michael , Brietzke Scott E. 
Published: August 2013

Objectives:1) Critically assess the literature reporting on the outcomes of endoscopic balloon dilation (EBD) of pediatric subglottic stenosis.Methods:Adhering to PRISMA principles, a systematic review of pediatric EBD was performed using the PUBMED (MESH) and EMBASE databases. Inclusion criteria consisted of sample size of five or greater pediatric patients, and primarily EBD without adjuvant procedures such as laser ablation or prolonged stenting. Meta‐analysis was performed with random effects modeling and meta‐regression.Results:Eleven studies were identified on the initial search. Cross‐checking references led to identification of 2 additional studies. After detailed review and application of the inclusion/exclusion criteria, 6 studies were included in the final dataset with 145 total subjects. All studies were case series (level 4 evidence). The average sample size was 16 (range = 8‐37). Grand mean age was 29.3 months (range = 4.8‐60 months). EBD treatment success was defined as avoidance of more definitive procedures (airway reconstruction, tracheostomy). The random effects model estimate of the overall treatment success was 64.8% (95% CI = 56.5‐73.1%, P < 0.001, Q test for heterogeneity = 31.0, P < 0.001, I squared = 74.2%). Follow‐up was inconsistently reported but averaged 5.0 months (range =. 25‐12.5 months) in studies that did report it. Only one study reported significant complications (one death, two tracheal lacerations). Meta‐regression results did not indicate that age, Cotton‐Myer stage (1, 2, or 3) or primary versus secondary treatment significantly affected the odds of EBD treatment success.Conclusions:EBD is successful in the majority of patients over short‐term follow‐up, and reported complication rates are low. Factors predictive of treatment success have not been conclusively determined.
A Case of Recurrent Postoperative Aseptic Meningitis after Craniopharyngioma Resection
Authors: Lam Allen C. , Mamanov Marlen , Curry William T. , Holbrook Eric H. 
Published: August 2013

Objectives:1) Describe a case of aseptic meningitis following craniopharyngioma resection. 2) Review of literature and pathophysiology surrounding aseptic meningitis secondary to cranipharyngioma resection. 3) Recognize diagnostic and management difficulties regarding this phenomenon.Methods:This is a case report of a 65‐year‐old female with a compressive craniopharyngioma who underwent endoscopic trans‐sphenoidale resection followed by aseptic meningitis, regrowth, open re‐resection, and recurrence of meningitis.Results:The patient was found to have a cranoiopharyngioma on magnetic resonance imaging after presentation with 2‐months of diplopia. She underwent trans‐sphenoidale resection with improved vision post‐operatively. However, she presented to the emergency department (ED) with fatigue and fever concerning for meningitis. Cerebrospinal fluid (CSF) analysis demonstrated elevated leukocytes and total protein, and normal glucose levels consistent with meningitis. Cultures returned sterile. She was discharged on long‐term antibiotics. Unfortunately, her craniopharyngioma regrew requiring open craniotomy re‐resection. She did well post‐operatively but presented to the ED with altered mental status, emesis, and fever. Again, CSF analysis was sterile with elevated leukocytes and total protein. She was treated with another course of long‐term antibiotics. After radiation therapy, repeat MRIs found no regrowth of her craniopharyngioma.Conclusions:Aseptic meningitis after craniopharyngioma resection is a rare phenomenon but can introduce a diagnostic and management conundrum. This case highlights the importance of awareness for chemical‐induced meningitis following craniopharyngioma resection. While symptomatic relief is important, the course of antibiotic coverage is controversial. Coordinated multi‐team efforts are necessary to provide optimal care for these patients.
The Effect of PM10 on the Symptoms of Allergic Rhinitis during Spring
Authors: Baek MinKwan , Jung JuHyun , Jang Taeyoung , Kim Suntae , Ko Kwangpil , Kim YoungHyo 
Published: August 2013

Objectives:Clarify the effect of PM10 (particulate matter less than 10 Î¼m), which is the major component of air pollution, on the symptoms of allergic rhinitis patients during spring.Methods:We investigated changes in allergic symptoms (rhinorrhea, sneezing, nasal obstruction and sleep disturbance) and nasal obstruction level as measured using a portable peak nasal inspiratory flowmeter (PNIF) in 108 allergic patients. Forty‐seven control subjects were also included. Spring pollen counts and PM10 concentrations in Incheon city were also evaluated. We conducted long‐term observation of the effect of PM10 on allergic symptoms for 120 days from February to May and compared the changes in symptom scores before and after the 2 days when PM10 concentration was 100Î¼g/m3 (short term).Results:The highest concentration of PM10 during the study period was <150 mg/m3. No significant correlations between PM10 and nasal obstruction (P = 0.0670), rhinorrhea (P = 0.1485), sneezing (P = 0.3991), itching (P = 0.2044), sleep disturbance (P = 0.4413) and the sum of all symptoms (P = 0.0816) were identified. However, the variation in nasal obstruction, as assessed by PNIF, was significantly correlated with the PM10 level (P = 0.0410). There was also a significant correlation between outdoor activity duration and the sum of clinical symptoms (P < 0.001). Neither frequency of drug use nor PNIF values were affected by the short‐term changes in PM10 levels.Conclusions:Our data suggest that PM10 concentration during spring influences nasal obstruction as determined by PNIF; this nasal obstruction was also influenced by the duration of outdoor activity.
Endoscopic Anatomy Variation of the Medial Pterygopalatine Fossa Structures and Its Surgical Applications
Authors: Polev Georgy 
Published: August 2013

Objectives:Describe the endoscopic anatomy variability of the medial Pterygopalatine Fossa (PPF) structures during cadaveric dissection, and analyze the relationship of the neurovascular structures in this region.Methods:20 non‐injected fresh cadaveric specimens were dissected bilaterally via the endonasal endoscopic approach.40 medial PPF regions are described. The distances between the vidian canal (VC) and palatovaginal canal (PVC) orifices are measured and the mean length of the PVC is estimated. Also we measured the distances between VC orifice and foramen rotundum (FR) to estimate the risk of maxillary nerve lesion during the transnasal vidian neurectomy. The 3‐D relationship between the greater palatine neurovascular bundle (GPB) and the aforesaid structures has been analyzed.Results:The mean distance between PVC and VC orifices equaled 2.6 mm and the mean length of the PVC was 6.4 mm. The mean length of the palatine bone sphenoid process is 7.2 mm, which is always approximately equal to the distance between the GPB and the PVC cranial orifice. The mean distance between the VC orifice and FR is 4.6 mm.Conclusions:Based upon this study, modified “retrograde” approach to the VC orifice from the choanal arch behind the middle turbinate tail via the palatine bone sphenoid process along the PVC is proposed. The peculiarity of this approach is the preservation of the PPF contents and sphenopalatine neurovascular bundle, which are moved aside laterally during the dissection. Further investigation is needed to establish the feasibility of this approach in vivo.
Ethmoid Adenocarcinoma: Systematic Associated Skull Base Resection Improves Disease‐Free Survival
Authors: Durand Nicolas , Espitalier Florent , Ferron Christophe , Cassagnau Elisabeth , Bord Eric , Langlois Emanuelle M. , Malard Olivier 
Published: August 2013

Objectives:Ethmoid adenocarcinoma is an occupational tumor affecting woodworkers with prognosis correlated to the local control of the disease. Since 1998, we have developed a technique of skull base resection with reconstruction by exclusive transfacial approach. This method allows a resection of the cribriform plate and dura mater associated with the removal of the tumor with simplified postoperative features compared with mixed approach.Methods:We performed a retrospective analysis of 89 patients presenting with ethmoid adenocarcinoma from 1998 to 2010 (144 months). All patients treated with surgical removal and postoperative adjuvant radiotherapy were included. Postoperative features and oncologic outcomes were analyzed.Results:89 patients were treated by surgical removal of the ethmoid tumor associated or not with skull base resection by a transfacial approach. The median age was 67.6 years, and 91% were occupational woodworkers. Among these 89 patients, 71 benefited from skull base resection by transfacial approach. Disease free survival was significantly better in the skull base removal group (P = 0.009) and decreased for T4 stages (P = 0.008). Overall survival was not influenced by the surgical technique. This method provided less morbidity than mixed approach and good results of 5‐years specific survival (85 %).Conclusions:Prognosis of ethmoid adenocarcinomas is related to local control. In our experience the transfacial approach for systematic skull base resection associated with tumor removal and reconstruction is safe, efficient, and improves local control with a low morbidity, allowing a curative treatment for a larger number of patients.
Improvement in Eustachian Tube Function after Endoscopic Sinus Surgery for Polypoid Chronic Rhinosinusitis
Authors: Yu Vivian M. , Yu Jeffrey W. 
Published: August 2013

Objectives:1) Discuss the evidence for polypoid chronic rhinosinusitis causing Eustachian tube dysfunction and the role of endoscopic sinus surgery. 2) Demonstrate a case report of a patient with otologic complaints of Eustachian tube dysfunction showing that Functional Endoscopic Sinus Surgery (FESS) results in both symptomatic and objective improvement on tympanogram with Toynbee maneuver.Methods:A patient with polypoid chronic rhinosinusitis was assessed with two runs of tympanometry: a run before and after a Toynbee maneuver. The same test was repeated at 12 and 22 weeks after surgery.Results:Preoperatively, there was no shift in the tympanogram in either ear after the Toynbee maneuver. At the first post‐operative visit, our patient demonstrated a shift in the tympanogram curve after a Toynbee maneuver in the left ear. At the second visit the patient demonstrated a shift in both ears. The patient also described subjective improvement in symptoms of Eustachian tube dysfunction.Conclusions:This case study demonstrates that endoscopic sinus surgery in patients with chronic rhinosinsitis can improve symptoms of Eustachian tube dysfunction. Improvement in Eustachian tube function can be demonstrated by vigorous testing by shifts in the tympanogram curve after pressurization using the Toynbee maneuver. This suggests that a large prospective study should be performed using subjective and objective measures of Eustachian tube function in patients with otologic complaints and chronic rhinosinusitis. We feel that this unique test is clinically relevant and uses equipment readily available in a standard office rather than more extensive that are restricted to research laboratories.
The Influence of Body Mass Index and Other Patient Factors on Parotidectomy Complications
Authors: Thorpe Eric , Teng Stephanie , Greenbaum Evan , Borrowdale Richard W. , Marzo Sam J. , Leonetti John P. 
Published: August 2013

Objectives:1) Determine if body mass index (BMI) influences the outcome of patients undergoing a parotidectomy. 2) Identify other factors that influence patients undergoing a parotidectomy. Study Design: Chart review. Setting: Tertiary care academic hospital. Subjects: Three hundred and sixty‐five surgical cases were reviewed from 2005‐2011. A total of two hundred and fifty‐five met inclusion criteria. Cases were excluded if other procedures were completed at the same time as the parotidectomy.Methods:BMI categories were separated. Outcomes reviewed included nerve weakness, hematoma/seroma formation, infection, and other noted complications. Complications were broken down into early (less than 30 days) and late (more than 30 days). Other variables assessed include age, gender, diabetes, surgeon, and superficial vs. total parotidectomy.Results:Fisher's exact test was used to identify variables associated with post‐operative complications. BMI was shown to not have a statistically significant effect on complications. Patients undergoing a total parotidectomy had significantly more early complications and nerve weakness early and late (P = 0.0293). Diabetic patients had significantly more nerve weakness early and late (P = 0.0148).Conclusions:BMI does not influence post‐operative complications in patients undergoing parotidectomies and should not prevent elective parotidectomies in patients. Patients with diabetes and those undergoing total parotidectomies have significantly more complications.
Is There a Relationship between Epistaxis and Staphylococcus aureus Colonization in the Nasal Vestibule?
Authors: Ulusoy Seçkin , Babaoğlu Gülçin , Cingi Cemal 
Published: August 2013

Objectives:Although epistaxis is still very common in children and adults, its cause in most non‐traumatic cases remains unknown. We aimed to find out if nasal colonization with Staphylococcus aureus leads to inflammation, crusting, and new vessel formation and ends with epistaxis in association. We also wanted to investigate the relationship between positive cultures and seasons.Methods:One hundred twenty‐nine patients were recruited for the study group (86 had crusting in the nasal vestibule while 43 did not) and compared with 40 healthy control subjects. A microbial swab was taken from the anterior nasal cavity of each subject. The same procedure was repeated at each season.Results:S aureus was found to be more common in the epistaxis group when compared with the control group, with a percentage of 37% and 19% respectively. There was no difference in the prevalence of S aureus between crust and noncrust groups. When positive cultures were grouped and compared according to season, we observed that the positive culture with epistaxis was much higher (44.82 %) in autumn.Conclusions:A positive correlation between nasal colonization with S aureus with epistaxis highlights the importance of healthcare and preventive care. Further studies should be performed to decrease epistaxis by diminishing the colonization of S aureus. Special attention should be given in autumn.
Surgical Treatment for Paranasal Mucoceles: Usefulness of Preoperative MRI and Computer‐Aided Surgery
Authors: Hashimoto Shigehisa , Takahashi Sugata 
Published: August 2013

Objectives:Surgical procedures for paranasal mucoceles are associated with different levels of difficulty depending on the sites and the number of mucoceles, because the walls of mucoceles are excised and opened into the nasal cavity. We examined the usefulness of magnetic resonance imaging (MRI) in addition to computed tomography (CT) and also that of computer‐aided surgery.Methods:The study involved 70 patients undergoing surgical treatment for paranasal mucoceles. Preoperative CT and MRI were carried out, and mucoceles were opened into the nasal cavity by endoscopic sinus surgery (ESS) using computer‐aided surgery. Mucosal flaps were created within the nasal cavity and inserted into the mucoceles by sliding them down.Results:CT confirmed bone defect sites, and tumor differentiation was performed using MRI preoperatively. Multilocular mucoceles could be confirmed intraoperatively in 19 patients and on preoperative MRI in 18 cases (94.7%). Preoperative nasolacrimal ducts and orbital cavities were marked on the monitor by computer‐aided surgery so that they could be avoided while the walls of mucoceles were excised and widely opened into the nasal cavity. There were no postoperative complications or residual mucocele, and only one patient (1.4%) showed re‐closure of the opened site 6 months after the operation.Conclusions:Evaluation of the mucoceles by preoperative MRI was useful to accurately grasp the number of mucoceles and their sites. Because concomitant use of computer‐aided surgery allows the mucoceles to be opened as safely and widely, it can be considered to be useful for reducing the rate of postoperative re‐closure.