bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Papillomavirus in Sinonasal Diseases
Authors: Suzuki Mikio , Hasegawa Masahiro , Deng Zeyi , Maeda Hiroyuki , Kiyuna Asanori , Uehara Takayuki 
Published: February 2015

ObjectiveThis study investigated prospectively the role of human papillomavirus (HPV) in various sinonasal diseases.MethodHPV presence and viral load and physical status of HPV‐16 were examined by polymerase chain reaction‐based methods using fresh frozen samples obtained from 13 patients with IP (IP group), 11 with squamous cell carcinoma in the maxillary sinus (SCC group), and 39 with chronic inflammatory lesions (inflammatory group).ResultsThe presence of the HPV genome was detected in 46.1%, 27.3%, and 7.6% of patients in the IP, SCC and inflammatory groups, respectively. The IP group showed significantly higher HPV‐positive rates than the inflammatory group. All types of HPV detected were high‐risk HPV, especially HPV‐16. The relative HPV‐16 copy numbers varied from 2.5 to 1524.1 per 50 ng genomic DNA. Viral load was higher in the IP and SCC groups than in the inflammatory group. In the IP group, no significant relationship was found between HPV‐16 viral load and clinical characteristics, or between physical status and clinical characteristics.ConclusionHPV infection is involved in the pathogenesis of IP, and high viral load and integration of HPV have an important role in malignant lesion in association with IP.
Image‐Guided Sphenoidotomy
Authors: Jiang Rong‐San , Wu Shang‐Heng , Liang Kai‐Li 
Published: February 2015

ObjectiveTo study the efficacy of image‐guided surgery (IGS) in the fenestration of the sphenoid sinus in patients with chronic rhinosinusitis who received functional endoscopic sinus surgery (FESS).MethodA group of 205 patients who received FESS incorporating IGS were enrolled. Another group of 178 patients who underwent FESS before an imaging‐guided system was available and chosen for comparison. The fenestration rate of the sphenoid sinus was compared between different groups of patients with and without IGS.ResultsThe fenestration rates of the sphenoid sinus were 93.3% for patients without nasal polyps, 94.2% for patients with nasal polyps, and 91.2% for revision FESS when operated with IGS, were 100% for patients without nasal polyps, 98.1% for patients with nasal polyps, and 91.3% for revision FESS when operated with IGS, and were 89.8% for patients without nasal polyps, 88.62% for patients with nasal polyps, and 68.6% for revision FESS when operated without IGS. The fenestration rate of the sphenoid sinus in revision FESS without IGS was significantly lower than others.ConclusionOur results showed IGS improves the successful fenestration rate of the sphenoid sinus in revision FESS.
Inverted Papilloma Ooriginating from the Opticocarotid Recess
Authors: Srinivasan Ramya , Portillo Elyse , Takashima Masayoshi 
Published: February 2015

Objective1) Understand the relationship of the opticocarotid recess with the surrounding structures. 2) Explain the pathophysiology and natural history of an inverting papilloma (IP) in the sphenoid sinus. 3) Examine the significance of a neoplasm originating from the anterior clinoid.MethodThis case report was conducted in a tertiary hospital setting in June 2011. The subject, a 49‐year‐old woman, presented with an inverting papilloma originating from the opticocarotid recess causing optic nerve dehiscence. The intervention was endoscopic excision. Outcome was measured by clinical examination, and follow‐up patient analysis is ongoing.ResultsThe patient was found to have an inverting papilloma (IP) of the sphenoid sinus. During endoscopic sinus surgery, the inverted papilloma was visualized originating from the sphenoid sinus and causing bony erosion in the area of the opticocarotid recess. An area of optic nerve dehiscence was identified, and the sheath of the optic nerve was clearly visualized once the tumor was peeled off the optic canal. Pathology confirmed the diagnosis of inverting papilloma and was negative for carcinoma. Follow‐up clinical examination of the patient revealed that endoscopic excision effectively removed the neoplasm without local complications or recurrence.ConclusionInverting papillomas originating from the region of the opticocarotid recess are an atypical entity and have the potential to cause rare, but serious, complications. The authors are unaware of any reported cases of an IP originating from this area. Early, effective management is crucial given the vital structures at risk.
Controlled Nasolabial Angle Treatment
Authors: Hermann Diego R. , Balsalobre Leonardo , Pascoto Gabriela R. , Stamm Raquel , Stamm Aldo E. C. 
Published: February 2015

ObjectiveTo evaluate the nasolabial angle (NLA) treatment with the septal‐columellar strut suture in a controlled and precise technique.MethodTwelve patients of both sexes (8 women and 4 men), who had nasolabial angle not compatible with sex (we consider the angle between 90° and 95° suitable for men and 95° to 100° for women) underwent open approach rhinoplasty. A special ruler protractor type (developed for this purpose) was used to indicate how much the caudal septum should be resected to maintain these angles accurately. Then the columellar strut was fixed to the caudal septum with 2 sutures (one superior and another one inferior). Patients were evaluated using digital photography before surgery, immediately postoperatively (PO), and 6 months after surgery. Patients were followed prospectively.ResultsIn those 8 women evaluated, the ANL was between 95° and 100° in the immediate postoperative period. The 6‐month postoperative evaluation revealed that 5 had a variation of 3°, and 3 of them had variations between 3° and 5°. Of the 4 evaluated men, all had ANL between 90° and 95°, and their 6‐month postoperative evaluations revealed variations of 3° in 2 patients and variations between 3° and 5° in the other 2.ConclusionThe nasolabial angle can be treated in a controlled and precise way, using a special ruler protractor and the columellar strut‐septal suture.
Impact of Long‐term Diving on Otolaryngology
Authors: Gurpinar Berk 
Published: February 2015

Objective1) Determine the negative effects of diving in otolaryngology. 2) Review the literature and give a brief description of pathologies related to diving.MethodBetween May 2011 and February 2012, 90 male subjects were prospectively examined in Kasimpasa and Golcuk Military Hospitals. The study group consisted of 45 military divers, and the rest, nondivers, were determined as the control group. The data included the age, sex, and experience of diving in terms of years. Detailed otolaryngologic examination, including endoscopy, was performed. Continuous data were displayed as mean ± standard deviation (SD). The Mann‐Whitney U test was used to determine statistically significant variances.ResultsIn the study group, the mean age was 30.71 ± 5.932 years, and total time in diving was 7.289 ± 6.083 years. In the control group, the mean age was 32.21 ± 4.784 years. In the study group 26 of 45 subjects had exocytosis (57.7%), and 34 had inferior turbinate hypertrophy (75.5%). Correlation of exocytosis and the inferior turbinate hypertrophy between the 2 groups was statistically significant (P <. 0001). Age was not statistically correlated between the 2 groups, implying the 2 groups were identical (P =. 831)ConclusionAlthough the negative effect of cold water on the external ear canal is studied thoroughly, inferior turbinate hypertrophy in long‐term divers was not familiar up to now. This study shows that diving has negative effects on external ear anatomy and the nasal cavity.
Maxillary Sinus Septation Causing Chronic Sinusitis
Authors: Sullivan Corbin , Conley Stephen , Sewell Steven 
Published: February 2015

Objective1) Report a unique case of a complete maxillary sinus septation (MSS) obstructing the ostio‐meatal complex with resulting chronic unilateral maxillary and ethmoid sinusitis. 2) Report a novel treatment of a MSS with dual approach via Caldwell‐Luc and endscopic maxillary antrostomy. 3) Perform a literature review of MSS.MethodThis is an individual case report of a pediatric patient treated in 2010 for chronic right maxillary and ethmoid sinusitis resulting from an obstructive complete MSS. Initial treatment was medical, followed by a unique combined surgical approach. The patient was followed clinically and with computed tomography (CT).ResultsThe patient did not have recurrence of sinusitis either clinically or on imaging during the follow‐up period.ConclusionThis is a unique case of MSS causing chronic sinusitis. There is scant mention of MSS in otolaryngology literature, with most mentions coming from oral and maxillofacial surgery literature. This may present an area for future investigation in relation to both imaging findings and surgical approach to rhinosinusitis.
Recurrent Massive Allergic Fungal Sinusitis in Children
Authors: Arora Vipin , Singh P. P. 
Published: February 2015

Objective1) To evaluate the clinical and radiological profile of massive allergic fungal sinusitis (AFS) in children. 2) To evaluate the efficacy of external open sinus surgery for recurrent massive AFS in children.MethodRetrospective review of clinical and radiological records at tertiary care university hospital. Twelve pediatric patients (age 9‐15 years, mean 13.2 years) of recurrent massive AFS who had skull‐base erosion, intracranial extension with unilateral or bilateral intraorbital involvement on CT scan were included in study. All patients had undergone multiple unsuccessful endonasal operations (range, 3‐5; mean, 3.8). Patients were operated by bilateral lateral rhinotomy and transfrontal approaches (3), transantral endoscopic approach (7), and combined lateral rhinotomy and transnasal approach (2). All patients received postoperative antibiotics and steroids. Postoperative follow‐up was done, and symptoms were evaluated (range, 14‐24 months; mean 17.5 months).ResultsNasal obstruction and discharge were the most common presenting complaints. Aspergillus flavus was the most common fungus isolated. All the patients had subjective improvement of symptoms following surgery. Noncontrast CT scan done at least 1 year following surgery showed recidivism of disease in 8.3% cases.ConclusionIndividualized external open sinus surgery for massive AFS is effective management for patients who have undergone repeated unsuccessful endonasal procedures. Rate of recidivisim (8.3 %) is less compared to that reported for endonasal procedures (10‐100%). Morbidity, complications and cost of single external procedure for massive AFS is less as compared to repeated endonasal procedures.
Use of HRCT‐MRI Fusion Imaging in the Detection of Cerebrospinal Fluid Leaks
Authors: Agbetoba Abib A. , Delman Bradley , Bederson Joshua , Govindaraj Satish 
Published: February 2015

Objective1) Determine the accuracy of high resolution computed tomography and magnetic resonance fused imaging in detecting skull base cerebrospinal fluid leaks. 2) Develop a comprehensive algorithm for the diagnostic workup of anterior skull base cerebrospinal fluid leaks.MethodWe retrospectively reviewed 16 cases of patients who underwent HRCT‐MRI fusion studies with intraoperative fluorescein localization for the evaluation and repair of CSF leaks during a 3‐year period between 2008 and 2011 at the Mount Sinai Medical Center.ResultsSixteen HRCT‐MRI fusion studies were evaluated from 16 different patients suspected of having CSF leaks. Eleven out of the 16 subjects had a confirmed diagnosis of CSF leak on intraoperative nasal endoscopy. HRCT‐MRI fusion imaging accurately identified the CSF leak and its location in each of the 11 subjects yielding a sensitivity of 100%. Three of the 16 patients were found to have no signs of active leak or skull base defect on intraoperative nasal endoscopy, 2 of which correlated with negative findings on fusion imaging.ConclusionHRCT‐MRI fusion is an excellent imaging modality that not only provides accurate identification and localization of CSF leaks but also acts as a great adjunct for intraoperative localization and repair. HRCT‐MRI fusion should be incorporated into the diagnostic algorithm for management of CSF leaks.
Allergic Rhinitis and Changing Nasal Congestion after Continuous Positive Airwary Pressure
Authors: Skirko Jonathan R. , James Kathryn T. , Levine Corinna G. , Shusterman Dennis , Weaver Edward M. 
Published: February 2015

ObjectiveAmong continuous positive airway pressure (CPAP) users, self‐reported allergic rhinitis has been associated with relative worsening of subjective nasal congestion. This study’s aims were to test the associations between objective allergic rhinitis status and 1) change in objective nasal congestion after CPAP initiation, or 2) objective CPAP use.MethodObjective allergic rhinitis status was established by skin‐prick test of 17 region‐specific aeroallergens in CPAP patients with baseline turbinate hypertrophy. Objective nasal congestion was measured by acoustic rhinometry (combined bilateral minimal cross‐sectional area, MCA) at baseline and 3‐months later in subjects using CPAP. Objective CPAP use was measured at 12 months.ResultsThis cohort study included n = 81 subjects from a larger parent trial on turbinate hypertrophy in CPAP patients. In this cohort, MCA did not change significantly in subjects with allergic rhinitis (n = 51, paired t‐test P =. 18) or in controls (n = 30, paired t‐test P =. 67) after initiation of CPAP, and there was no significant difference in change between groups (t‐test P =. 28). CPAP use in allergic rhinitis subjects (1.9 ± 2.7 h/night) was not significantly different from controls (2.4 ± 3.0 h/night; Mann‐Whitney U test, P =. 28), but statistical power was limited for the observed difference (power 12%).ConclusionAllergic rhinitis did not predict worsening of objective nasal congestion with CPAP initiation or decreased CPAP use, but confounding, eligibility criteria, limits of objective nasal measurements, and insufficient statistical power may have blunted a true effect. Further studies are needed.
Application of a Novel Bioabsorbable Tonsil Patch
Authors: Melder Patrick C. 
Published: February 2015

Objective1) To learn if application of a novel bioabsorbable material is feasible for use as a posttonsillectomy patch. 2) To determine, based on the limited number of cases, if there is subjective evidence of decreased pain and quicker return to normal diet. 3) To determine if further research is warranted.MethodThe current study was a nonrandomized clinical study in a private practice. Biodesign 4‐layer tissue grafts (COOK Medical) were placed in the tonsillar fossa after tonsillectomy. Patients were then questioned on postoperative pain, need for narcotic use, and days to return to normal diet.ResultsThe main objective to determine feasibility of placement of a bioabsorbable patch was achieved in all 10 cases. The average placement time per side was 10 minutes, adding 20 minutes/case. Patients were seen at either postopeartive days 2 and 10, and patients were questioned about expected level of pain, need for narcotics, and return to normal diet. All patients on average were noticing significant decreases in pain at days 3 and 4, noted with decreased narcotic intake and return to normal diets. No adverse events were noted with the Biodesign® material.ConclusionFirst, the study demonstrates the feasibility of using Biodesign as a bioabsorbable patch after tonsillectomy. Second, the initial results of this pilot study are very encouraging in providing evidence that a non‐energy–based device can provide consistent postoperative pain reduction. Further study is warranted to better measure outcomes.
Changes of Site of Obstruction in Obstructive Sleep Apnea According to Position
Authors: Kim So Young , Lee Woo Hyun , Rhee Chae‐Seo , Lee Chul Hee , Won Tae‐Bin 
Published: February 2015

ObjectiveTo evaluate the changes of site of obstruction in obstructive sleep apnea (OSA) patients according to sleep position.MethodFrom December 2010 to December 2011, 113 OSA patients underwent drug‐induced sleep endoscopy in the supine and lateral positions. Obstruction site was classified as soft palate (SP), tongue base (TB), lateral wall (LW), larynx (LX), and no obstruction (NO). Patients with a nonsupine RDI above 10 were classified as nonpositioners (NP) and below 10 as positioners (PR).ResultsThere were 85 men and 28 women with a mean age of 42.7 years. Mean BMI was 27.1, and mean RDI was 37.5. The PR (position responder) group was 49 patients, which accounts for 43.36% of all enrolled OSA patients (113 patients). Their site of obstruction in supine position was TB (20), SP(13), LW(11), and LX(5). In the lateral position 32 showed no obstruction, 8 showed obstruction at the LW, and the remaining 9 patients showed obstruction at SP. In the NP group (64, 57%), site of obstruction in the supine position was TB (20), SP (11), LW (26), and LX (7). In the lateral position, obstruction was observed at the LW (39), SP (16), TB (5), and LX (4).ConclusionSite of obstruction according to sleep position was evaluated for the first time. TB obstruction showed marked improvement when sleep position changed from supine to lateral. Obstruction in the lateral position was mostly due to obstruction at the LW, and position dependency is mostly determined by LW collapsibility.
Comparing Ways of Assessing Tongue Base Obstruction in Obstructive Sleep Apnea
Authors: Koh Lynn , Mok Paul Kan‐Hwei 
Published: February 2015

ObjectiveTo determine if awake clinical evaluation methods like Friedman’s Tongue Position (FTP), endoscopic assessment of the hypopharynx using Mueller maneuver (MM), and during end expiration (EEPBOT) to assess tongue‐base obstruction correlate well with tongue‐base obstruction seen during drug‐induced sleep endoscopy (DISE).MethodPilot prospective study of 16 patients with moderate to severe OSA recruited over 1 year at a tertiary care center. These patients were evaluated in the clinic with the flexible nasendoscope and subsequently underwent full PSG and DISE with midazolam.ResultsThe 16 patients studied had a mean AHI of 65 (range, 18.8 to 129). Fifteen out of 16 patients (93.7%) were found to have multi segment obstruction on DISE according to the original grading proposed by Pringle and Croft. Comparing the various awake dynamic maneuvers against DISE as a gold standard, MM was found to have sensitivity of 53%, FTP had a sensitivity of 80%, and EEPBOT had a sensitivity of 93%. Because of the skewed nature of the results (only 1 out of 16 patients [6.3%] was classified as not having obstruction), specificity results had no statistical value.ConclusionThis small pilot study showed a good correlation between EEPBOT, FTP, and DISE. A poorer correlation between MM and DISE is seen. Our results suggest that EEPBOT and FPP are superior to MM in evaluating tongue‐base obstruction in OSA; however, further research is required to support these findings.
da Vinci System for Treatment of Sleep Apnea Syndrome
Authors: Baptista Peter M. , Alcalde Juan , de Abajo Jorge , Gallegos Vivian 
Published: February 2015

ObjectiveTongue base hypertrophy is frequently related with sleep apnea‐hypopnea syndrome (OSAHS). The objectives were: 1) To determine which patients are candidates for tongue base resection by means of trans ral robotic Surgery (TORS). 2) To evaluate the clinical results of this technique associated or not with other treatments.MethodAll patients were diagnosed with OSAHS with obstructing tongue base through polysomnography, office endoscopy, and drug‐induced sleep endoscopy (DISE). Ten patients with OSAHS and obstructive tongue base were surgically treated with TORS using the Intuitive da Vinci system and traditional surgical techniques for OSAHS between August and December 2011.ResultsThe mean preoperative apnea‐hyponea index (IAH) was 40.67 (22.26‐78.21). Patients did not require tracheotomy, and no major complications were observed during or after surgery. Tongue base and epiglottis were managed securely, and no problems with hemostasis were observed. Swallowing pain was present a mean of 10 days after surgery with satisfactory response to therapy with corticoesteroids and nonsteroidal anti‐inflammatory drugs. One of the patients presented an epidermoid tumor in the right side of the tongue base causing the obstructive syndrome; it was resected with no affected margins using the TORS technique.ConclusionThe DISE technique is a useful test to determinate which patients are candidates for tongue base surgery. All patients archived a significant improvement of their IAH and Epworth Sleepiness Scale (ESS). The Intuitive da Vinci system provides excellent visualization and tissue management with low morbidity.
Daytime Sleepiness and Sleep in Allergic Rhinitis
Authors: Chiba Shintaro , Ando Yuji , Watanabe Subaru , Kimura Akihiro , Moriwaki Hiroto 
Published: February 2015

ObjectiveOver 20 million people in Japan suffer from hay fever caused by cedar pollen, and every year, they are disturbed with severe symptoms during a season of just 2 to 3 months. Clinically, there is a big problem with quality of life, including daytime sleepiness and sleep problems.MethodTo clarify the influence of hay fever on sleep and daytime sleepiness subjectively, 22 patients with hay fever caused by cedar pollen were enrolled. We evaluated sleep architecture and objective sleepiness before the season and during the season using PSG and MSLT.ResultsWake time after onset (WASO) showed significant increase during the season compared to before the season: from 16.4 to 29.7 min. AHI does not change for the worse during the season. In 11 patients with nasal obstruction, total nasal resistance was >0.3pa/cm/sec, out of 22, rate of REM‐sleep decreased (from 24.2 to 20.8%), and mean MSLT decreased (from 12.4 to 8.5 min) significantly. Especially 4 out of 11 showed severe sleepiness that was recognized as disease (MSLT <5 min) during the season.ConclusionThere are strong associations between nasal symptoms, especially nasal obstruction, sleep quality, and daytime sleepiness.
Diagnosing Obstructive Sleep Apnea: Predictive Value of Friedman Tongue Position
Authors: Friedman Michael , Hamilton Craig S. , Samuelson Christian G. 
Published: February 2015

Objective1) Assess the association between tongue position and risk of obstructive sleep apnea (OSA) as measured by both Mallampati (MP ‐including classic 3‐level and modified 4‐level scoring with tongue protrusion) and Friedman Tongue Position (FTP‐no tongue protrusion). 2) Determine which of these assessment scales best predicts OSA risk.MethodPubMed, MEDLINE, Cochrane Trial Registry (through 12/2011), and relevant article bibliographies were searched. All studies were assessed by 3 reviewers. Systematic review and random‐effects meta‐analysis of studies assessing the association of tongue position and risk of OSA were performed. Outcomes are reported as odds ratios (OR).ResultsCombined data from 5 studies (46,264 patients) revealed an overall OR of 2.436 (1.828, 3.248; P <. 001) for presence of OSA with MP/FTP 3 or 4 compared with MP/FTP 1 or 2. Sensitivity analysis revealed OR of 2.185 (1.643, 2.905; P <. 001) for MP 3/4 and 4.408 (2.651, 7.327; P <. 001) for FTP 3/4, respectively. Combined data from 2 studies (240 patients) revealed an OR for OSA per 1‐point increase in MP/FTP of 2.351 (1.430, 3.865; P <. 001). Sensitivity analysis revealed OR of 2.5 (1.225, 5.103; P =. 012) and 2.219 (1.109, 4.437; P =. 024) per 1‐point increase in MP and FTP, respectively.ConclusionTongue position 3 or 4, whether classified by MP or FTP, is significantly associated with increased OSA risk. In the clinical assessment of patients with suspected OSA, FTP 3/4 appears to have a higher predictive value for OSA than classic MP 3 or modified MP 3/4.