bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Uncommon Case of Facial Trauma
Authors: Trozzi Marilena , De Vincentiis Giovanni , Sitzia Emanuela , Carretti Marco , Bottero Sergio 
Published: February 2015

ObjectivePresent a rare case of a massive posttraumatic nasal swelling hiding a complication of an undiagnosed nasal dermoid sinus cyst in a 3‐year‐old boy. Emphasize that the clinical history, careful assessment, and especially accurate imaging are essential for accurate diagnosis and the proper treatment to be applied.MethodA 3‐year‐old boy was admitted to our hospital because of swelling of the fronto‐nasal regions following a nasal trauma occurring 5 days earlier. X‐rays of the nasal bones in the lateral side were negative for fracture. Given the noteworthy facial deformation we opted for a hospitalization for further study.ResultsBone‐image CT and 3D‐CT revealed bone defects within the frontal skull base. MRI demonstrates that a dermoid cyst centered in a bone defect was in contact with the dura of the frontobasal area, and a dermal sinus extending to the frontonasal skin could also be detected. Only then we observed the midline pit on the nasal dorsum initially attributed to the outcomes of recent trauma. Surgical resection was performed by frontobasal craniotomy. The dermal sinus was followed subcutaneously into the orifice of the nasal skin. A small skin incision was made and the sinus was then totally removed.ConclusionRadiological imaging is crucial for defining diagnosis, but observation of disproportion between sign and medical history that it has been possible to direct toward the correct study and the appropriate therapy to be performed.
Effect of Endoscopic Sinus Surgery on Pulmonary Function of Chronic Rhinosinusitis with Asthma
Authors: Asako Mikiya , Tomoda Koichi 
Published: February 2015

ObjectiveTo evaluate the postoperative pulmonary function of chronic rhinosinusitis associated with nasal polyps and asthma.MethodA retrospective analysis was performed on 34 patients with/without chronic bronchial asthma who underwent ESS for medically refractory chronic rhinosinusitis with polyp. Patients received comprehensive asthma care before and after ESS (mean, 19.3 and 23.1 months, respectively). Twenty patients were not clearly diagnosed with asthma, 10 patients had mild to severe persistent aspirin‐tolerant asthma, and 4 patients had moderate to severe persistent aspirin intolerant asthma. Outcomes analyzed included pre‐ and post‐ESS individual and group mean upper airway symptom scores, Lund‐Mackay CT scores, and pulmonary function test results.ResultsAll groups showed a significant increase in pulmonary function 1 month after ESS (P <. 01). The various index biomarker in the pulmonary function is useful for evaluating lower airway condition. V50 and V25/Ht are the most accurate reflection markers of the bronchiolar constriction. There were significant increases in the V50 and V25/Ht before and after the sinus surgery in both the AIA and ATA groups (P <. 05). ATA group is more increased of the pulmonary function than AIA group after ESS, in addition, non‐asthma diagnosis group is also increased in the pulmonary function after surgery.ConclusionOur data indicate that patients with CRS/WP compose clinically the group of bronchiolar constriction.
EGCG Regulates Mucin by p38 MAPK/MMP‐9 Pathway in Asthma
Authors: Kim Young‐Da , Bae Chang Hoon , Song Si‐Youn , Lee Heung‐Man 
Published: February 2015

ObjectiveMucus plays an important role in protecting human airways from external environments by entrapping inhaled foreign particles and bacteria, and clearing them from the airways by ciliary movement. Epigallocatechin‐3‐gallate (EGCG) is a major component of green tea extract and known to provide numerous functions, such as anti‐oxidant effect, anti‐tumor effect, anti‐ diabetic effect, and anti‐inflammatory effect. However, the precise mechanism of action about anti‐inflammatory effect of EGCG is not fully defined.MethodThe effect of EGCG on phorbol 12‐myrisate 13‐ acetate (PMA)–induced MUC5B expression and signaling pathways were investigated in human NCI‐H292 airway epithelial cells, human nasal epithelial cells, and in asthma model of mice.ResultsPMA‐induced MUC5B mRNA and protein levels were significantly decreased after treatment with EGCG. PMA increased phosphorylation of p38 MAPK and this was significantly decreased after pretreatment with EGCG. PMA induced MMP‐9 overexpression and this was significantly attenuated by pretreatment with EGCG or specific inhibitor for p38 MAPK (SB203580). And EGCG inhibited PMA‐induced MMP‐9 protein activities in gelatin zymography. PMA induced MMP‐9 and MUC5B over‐expression in human nasal epithelial cells and this was significantly attenuated by pretreatment with EGCG.ConclusionThe results of this study demonstrated that EGCG down‐regulates MUC5B expression through the p38 MAPK dependent MMP‐9 signaling pathway. These results suggest that EGCG may have protective effect on asthma through the regulation of mucin gene expression in airway epithelial cells. Furthermore, EGCG could be a novel therapeutic agent for controlling asthma.
Endoscopic Orbital Decompression: When and How?
Authors: Naseri Iman 
Published: February 2015

Objective1) Identify acute and chronic indications for orbital and/or optic nerve decompression. 2) Review known techniques for endoscopic orbital decompression. 3) Evaluate the necessity to include inferior orbital wall/orbital floor. 4) Compare and contrast the endoscopic technique in comparison to various open methods.MethodRetrospective review of all patients that underwent endoscopic orbital decompression procedures between 2009 and 2011. Data analysis included review of perioperative clinical findings, operative technical details, radiology data, and outcomes.ResultsA total of 15 orbital decompressions were performed. All patients underwent endoscopic medial orbital wall decompression, 2 included the orbital floor. The majority of the patients had allergic fungal sinusitis as their primary diagnosis for surgical indication (n = 7, 47%). Neoplasms (n = 5, 33%) and Graves disease (n = 3, 20%) were the remaining diagnoses. Restricted ocular motility, proptosis, and diplopia were the most common presentations indicating surgery (n = 13, 11 and 8, respectively). Resolution of diplopia was observed in all patients, but delayed in Graves patients (2‐3 months). Proptosis improved in 7 patients (64%), without any significant difference among those including orbital floor.ConclusionThe endoscopic technique for orbital decompression is a safe and less invasive alternative to currently used open approaches. Sufficient medial wall decompression may yield sufficient outcomes, precluding the need for including the orbital floor. Further objective outcomes data is needed to compare proptosis among various modes of endoscopic decompression techniques.
Laser Transcanalicular DCR
Authors: Meher Ravi , Raj Anoop 
Published: February 2015

Objective1) To find out the success rate of LASER transcanalicular DCR.MethodRetrospective study from December 2008 to June 2011. Nasolacrimal duct obstruction causing epiphora. All the cases of laser transcanalicular DCR operated in the ENT department. These surgeries were performed by the author and co‐author of the same unit. Patency of the nasolacrimal fistula as determined by syringing.ResultsForty‐two cases of laser DCR were performed in the above mentioned period. Age group varied from 8 to 58 years. Ony 31 cases were available for prolonged follow‐up. The remaining 11 cases could not be traced. Out of 31 cases, 21 cases had no problem and the rhinostomy site was patent on syringing. Success rate −67.7% (21 cases). Ten patients had blocked rhinostomy site ob syringing thus the failure rate −32.2% (10 cases). All the failure cases under revision DCR using laser with lacrimal intubation using silicon stents in 8 cases.ConclusionThe failure of the laser transcanalicular DCR was because of occlusion of rhinostomy site by granulations, small opening, an and formation of synechiae. This was attributed to smaller opening made with laser, inadequate bony opening, formation of multiple openings in an attempt to enlarge the rhinostomy, or failure to identify correct rhinostomy site.
Polyp Recurrence Rate in Chronic Rhinosinusitis Phenotypes
Authors: Nakayama Tsuguhisa , Okushi Tetsushi , Asaka Daiya , Haruna Shin‐Ichi , Moriyama Hiroshi , Otori Nobuyoshi 
Published: February 2015

ObjectiveWe proposed that chronic rhinosinusitis (CRS) is classified by 4 phenotypes in the previous study. Three phenotypes in the 4 were well classified by nasal polyps and mucosal eosinophil count. In this study we investigated the difference of recurrence rate of nasal polyps after endoscopic sinus surgery between these three phenotypes.MethodThis study was a prospective collecting data and retrospective analysis. All patients were followed up for at least 180 days after endoscopic sinus surgery. We defined mucosal eosinophilia as over 80 eosinophils under high‐power magnification. Disease‐free survival curves were drawn using the Kaplan‐Meier method and compared using log‐rank test.ResultsA total of 264 of the 375 patients were enrolled in the study. The mean follow‐up period was 540.4 days. Polyp recurrence was significantly different between the 3 groups (P =. 016). Patients with cluster 4 (eosinophilic CRSwNP) had a higher polyp recurrence rate than cluster 2 (non‐eosinophilic CRSwNP; P =. 047) and cluster 1 (non‐eosinophilic CRSsNP; P =. 005). Cluster 1 and cluster 2 had no significant difference (P =. 362).ConclusionWe demonstrated polyp recurrence rate was different between the three phenotypes.
Quality of Life in Chronic Rhinosinusitis
Authors: Remenschneider Aaron K. , Metson Ralph B. 
Published: February 2015

Objective1) Establish baseline characteristics of patients with chronic rhinosinusitis using a novel general quality of life instrument, the European Quality of Life 5‐Dimension survey (EQ‐5D). 2) Compare patients with chronic rhinosinusitis with healthy individuals and with patients with common chronic medical conditions.MethodFrom February 2011‐2012, preoperative quality of life data were obtained from 225 patients with chronic rhinosinusitis prior to surgery at Massachusetts Eye and Ear Infirmary. Global function as well as to 5 distinct parameters (mobility, self‐care, activity, pain, anxiety) were compared against published values for healthy and disease controls.ResultsGeneral quality of life as measured using the EQ‐5D visual analog scale revealed that patients with chronic rhinosinusitis had significantly lower scores when compared with age matched controls: 72.48 ± 17.22 vs 78.75 ± 14.92 (P <. 01), 95% CI (–8.41 to −4.14). Patients with chronic rhinosinusitis also scored worse on pain/discomfort and anxiety/depression when compared to both healthy controls and individuals with diabetes or cardiovascular disease. (P <. 05). Mobility, self‐care, and activity level were not significantly impaired in patients with chronic rhinosinusitis.ConclusionPatients with chronic rhinosinusitis have impaired quality of life when compared with healthy controls. Pain/ discomfort and anxiety/depression are significantly worse when compared with healthy patients and those with other co‐morbidities. As a new and powerful quality of life tool, the EQ‐5D appears consistent with previously studied instruments for chronic rhinosinusitis.
Radiofrequency and Microdebrider Turbinate Reduction in Sheep
Authors: Meier Josh , Faquin William , Cunningham Michael J. 
Published: February 2015

Objective1) To compare the histologic and volumetric effects of bipolar radiofrequency ablation (RFA) and microdebrider turbinate reduction in a sheep model. 2) To evaluate the response of nasal mucosa in sheep to Compound 48‐80 (Sigma), a histamine‐releasing agent. 3) To further develop a sheep model of endonasal surgery.MethodTo induce nasal hypertrophy, 2 sheep received Compound 48‐80, and 2 sheep were controls. The right middle turbinate was treated with RFA, the left turbinate with microdebrider. In each group, 1 sheep was sacrificed immediately, the other at 3 weeks. Acoustic rhinometry, endoscopic photography and histologic analysis were performed.ResultsEndoscopic treatment of the sheep turbinates was feasible with standard endoscopic telescopes and equipment. There were similar increases in nasal volumes between the microdebrider and RFA groups immediately and at 3 weeks. Histologic analysis revealed that the RFA device resulted in a qualitatively increased amount of mucosal damage when compared to the microdebrider. At 3 weeks there was more squamous metaplasia in the RFA group. Endoscopic evaluation revealed similar effects in turbinate reduction between the two groups. Compound 48‐80 resulted in the expected decrease in nasal volume and increase in nasal secretions in one of two sheep.ConclusionThis pilot study suggests that the heat‐independent method of the microdebrider results in less mucosal injury and squamous metaplasia than RFA. Both methods result in turbinate reduction and increases in nasal volume. Continuation of this pilot study is planned to further define these modalities and the effects of Compound 48‐80.
Role of mRNA Expression in the Nasal Polyp Pathogenesis
Authors: Gungor Atila , Tufan Ersoy , Salihoglu Murat , Yilmaz Ismail , Baloglu Huseyin 
Published: February 2015

ObjectiveNasal polyposis (NP) not only has a significant impact on the life quality of patients but also affects 2.11% of the population is a chronic inflammatory disease of the upper airway. The aim of this study is to evaluate and understand nasal polyp pathogenesis.MethodHealthy mucosa and polyp samples were taken from 27 patients with nasal polyposis who underwent FESS. Total RNA was extracted from samples and converted to cDNA. Expressions of five given genes namely CC10, DMBT1, LTF, STAT, PIP were detected using QRT‐PCR technique. GAPDH gene were used for normalization.ResultsWhile there was no significant change in CC10 expression levels, we observed significant increase in the expressions of DMBT1, LTF, STAT and PIP compared to polyp tissue with healty mucosa.ConclusionWe observed significant changes in the expressions of DMBT1, LTF, STAT and PIP genes which are kniwn with anti‐inflammatory, antimicrobial, immunomodulatory, and antineoplastic properties.
Rotation Flaps after Draf Procedures: A Cadaver Study
Authors: DeConde Adam S. , Vorasubin Nopawan , Thompson Christopher F. , Suh Jeffrey D. 
Published: February 2015

ObjectiveTo describe the anatomy and application of local mucosal flaps to reduce cicatricial scarring of the frontal recess after Draf IIB and Draf III procedures.MethodDescription and illustration of the surgical technique of 2 local mucosal flaps after Draf IIB and III procedures in a cadaveric model.ResultsTwo distinct local rotation flaps can be successfully used after Draf IIB and Draf III procedures. 1) Prior to superior middle turbinectomy, a medially based mucosal flap is elevated from the medial aspect of the middle turbinate to the nasal septum. This flap is then placed on the posteromedial raw bone of the frontal recess after the Draf IIB. 2) Bilateral posteriorly based flaps are elevated off of the anterosuperior septum prior to the septectomy in a Draf III procedure. After the drillout is performed, the mucosal flaps are rotated to cover the frontal sinus posterior table.ConclusionUse of local mucosal flaps to provide primary healing after Draf IIB and Draf III procedures is technically feasible and may decrease the risk of restenosis after frontal sinus surgery.
Long‐term Effect of CN XII Stimulation for Obstructive Sleep Apnea
Authors: Woodson B. Tucker , De Vries Nico , Netzer Aviram , Lin Ho‐Sheng , Van De Heyning Paul 
Published: February 2015

ObjectiveCompared to traditional OSA surgeries that modify skeletal and soft tissues, hypoglossal nerve stimulation alters physiology to maintain upper airway patency. To evaluate long‐term stability of CN XII stimulation, AHI and nerve stimulation parameters were assessed and compared.MethodData were reviewed from a prospective multicenter feasibility trial of an implantable hypoglossal nerve stimulation device (Inspire, Inspire Medical) that includes both stimulation and sensing leads and a programmable stimulation generator. Polysomnographic and device outcomes were available in 24 of 36 subjects at 12‐month follow‐up.ResultsSix‐ to 12‐month responder rate (a priori = 50% reduction in AHI) improved (10/24 to 12/24). AHI (baseline, 6, and 12 month) remained constant in responder (33.8, 8.8, 10.0 events/h, P <. 01) and nonresponder (48.9, 60.3, 44.1 events/hr, P < ns) groups. Three subjects were reclassified as responders and 2 as nonresponders from 6 to 12 months. Average nerve stimulation thresholds (sensation, function, and subdiscomfort) did not change from baseline to 12 months. Stimulation parameters (frequency, pulse duration, stimulation intensity but not amplitude (2.2 [0.7] vs 1.5 [0.4] Volt, P =. 01)) were similar in responder groups. No additional device‐related adverse events were recorded at 12 months.ConclusionPolysomnographic measures recorded at 6 months are maintained at 12 months following CN XII implant in the majority of patients. Average stimulation thresholds remain constant over 1 year. Results support that clinically significant improvements in AHI are maintained over the 6 to 12 month interval.
MMA and CO2 Laser MLG in Obstructive Sleep Apnea Syndrome: New Parameters of Success
Authors: Carpes Arturo F. , Colombini Nelson E. P. , Pinto Jose A. 
Published: February 2015

ObjectiveTo describe the results obtained by maxillomandibular advancement associated with CO2 laser midline glossectomy in the surgical treatment of moderate to severe obstructive sleep apnea syndrome, based on polysomnographic analysis of macrostructure and microstructure of sleep.MethodFrom the period of February 2005 to December December 2008, 22 patients with moderate and severe OSAS,with or without maxillomandibular anteroposterior discrepancies from the Otorhinolaryngology–Head and Neck Surgery Nucleus of Sao Paulo were selected. These patients underwent MMA with CO2 Laser MLG. Evaluation included physical examination, cephalometric analysis, and polysomnographic data before and after surgery. The sleep study parameters used were: AHI, MD, minimum Sat O2, time of Sat O2 desaturation below 90%, sleep stages N1, N2, N3, and REM. The cephalometric parameters used were: SNA, SNB, PAS, PP2‐PP2. Evaluation of eventual differences in pre‐ and postoperative data were investigated with the appropriate statistical tools. The surgical treatment proved to be effective in 8 out of 22 of the cases (36.36%), according to international criteria of normality. On the other hand, for these patients the AHI was not the best parameter to evaluate the therapeutic success.ResultsThe DM (60.18% of improvement), stage N3 (59.9% of improvement), and time of Sat O2 <90% measured in minutes (81.81% of improvement) demonstrated they were the best instrument for characterizing the laboratorial control of desease.ConclusionThe surgical treatment perfomed with MMA associated with CO2 laser MLG was effective in treating patients with moderate to severe OSAS. The improvement using the most accepted parameter by the international community (AHI below 5) was 8 out of the 22 (36.36%). The AHI was not the most accurate instrument to evaluate the control of the desease. Although MD, stage N3, and time of Sat O2 below 90% measured in minutes demonstrated to be more appropriate indicators of surgical control of the desease. The time of Sat O2 <90% was the best parameter in the evaluation of the surgical treatment.
Otolaryngology Review Studies: Adherence to MA/SR Guidelines
Authors: Hicks Katherine E. , Malin Barry T. , Anand Akash G. , Gillespie M. Boyd , Day Terry A. 
Published: February 2015

ObjectiveMany high‐impact medical journals have adopted methodological standards for conducting systematic reviews (SRs) and meta‐analyses (MAs). These standards have emerged via the convergence of guidelines advocated by the Cochrane Group, the Agency for Health Care Research and Quality, the Guidelines International Network, and other groups in an effort to further utilize evidence‐based medicine (EBM) in clinical practice. The overarching goal of this study is to assess the successful application of these standards across otolaryngology literature.MethodStudies that employed formal SR/MA techniques and were published within the 16 highest impact general otolaryngology journals (up to December 1, 2011) were selected. Each study was graded by multiple reviewers using a scale based upon the 2009 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) criteria, including factors pertaining to database searches, study inclusion and exclusion criteria, data management, and bias minimization.ResultsOf the 84,284 studies published in the top 16 English‐language academic otolaryngology journals (up to 12/01/2011), 150 employed formal SR/MA techniques. Overall, 45% of these were devoted to head and neck topics, a much greater percentage than in any other otolaryngology subfield. Less than 0.2% of studies published in these journals employ SR/MA techniques, but this percentage has increased steadily over the past 10 years.ConclusionCurrently, SRs and MAs are regarded as the methodological “gold‐standard” for clinical reviews. The prevalence of such studies within the otolaryngology literature is increasing, but opportunity exists for broader application of these approaches and greater adherence to contemporary methodological standards.
4D Dynamic‐MRI as Glossectomy Speech Assessment Tool
Authors: Murano Emi Z. , Xing Fangxu , Zhuo Jiachen , Woo Jonghye , Gullapalli Rao , Stone Maureen , Prince Jerry L. 
Published: February 2015

ObjectiveQuantitative tools assessing functional outcomes after tongue cancer treatment are crucial for evaluation and comparison of surgical reconstruction techniques or chemoradiation protocols. Furthermore, tools measuring physiologic outcomes directly and specifically may lead to a better understanding of tongue adaptation control. We developed a 4D dynamic MRI to address these issues.MethodThis MRI tool included 2 components: 1) A static 3D high‐resolution MRI to identify structures spared from the surgery. 2) Dynamic cine‐ and tagged‐MRI scans at 26 frames/second to determine the tongue surface and measure point displacement during speech. Data were collected from 3 patients and 3 controls.ResultsThe 3D segmentation of the residual muscles were compared to the controls. Twenty‐six 3D tongue volumes with surface deformation during the utterance of the word /asouk/ showed that patients adapt their tongue shape for /S/. The medial grooving seen in controls is deviated to the surgical side and the lateral sides of the anterior tongue make palatal and dental contact in patients. The 3D tagged MRI in patients showed asymmetrical displacement in several distinct parts of the tongue not seen in controls. The local distinct pattern suggests local adaptation for utmost speech performance. All patients had above 98% intelligibility scores.ConclusionThis is the first study of 4D‐MRI relating residual tongue anatomy to 3D surface and internal kinematics during speech. This technique may provide a future predictive model for treatment options.