bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive management of temporal bone defects after oncologic resection
Authors: Hanasono Matthew M. , Silva Amanda K. , Yu Peirong , Skoracki Roman J. , Sturgis Erich M. , Gidley Paul W. 
Published: October 2012

AbstractObjectives/Hypothesis:To evaluate reconstructive outcomes following oncologic temporal bone resection.Study Design:Retrospective review.Methods:Subjects consisted of 117 patients undergoing temporal bone resection and reconstruction between 2000 and 2010. Reconstructive outcomes, including results following facial nerve repair, were analyzed.Results:Reconstruction was performed with a regional flap in 27 patients and a microvascular free flap in 90 patients. Operative time was shorter for cases involving reconstruction with regional flaps compared to free flaps (6.9 vs. 11.2 hours, P < .0001), as were intensive care unit and hospital stays (0.4 vs. 3.4 days, P < .0001 and 4.1 vs. 8.6 days, P < .0001, respectively). Overall complication rates were similar for regional and free flap cases (22.2% vs. 23.3%, P = 1.00), although donor site complications were more common with free flaps (0% vs. 13.3%, P = .07). Facial nerve repairs were performed in 19 patients. Of 14 patients with more than 12 months of follow‐up, 71.4% demonstrated signs of reinnervation and 42.9% achieved a House‐Brackmann score of 3 or better. The mean time to reinnervation was 7.9 months. Recovery was not significantly affected by preoperative nerve function, postoperative radiation, or advanced age (P = 1.00 in each case).Conclusions:We recommend regional flaps for small defects based on minimal donor site morbidity, and shorter operative times, intensive care unit, and hospital stays. For extensive defects and in cases involving prior surgery or radiation, free flaps are preferred. Facial nerve repair should be attempted whenever feasible, even in the setting of preoperative weakness, planned postoperative radiation, and advanced age. Laryngoscope, 2012
Assessment of frontal lobe sagging after endoscopic endonasal transcribriform resection of anterior skull base tumors: Is rigid structural reconstruction of the cranial base defect necessary?
Authors: Eloy Jean Anderson , Shukla Pratik A. , Choudhry Osamah J. , Singh Rahul , Liu James K. 
Published: October 2012

AbstractObjectives/Hypothesis:The endoscopic endonasal transcribriform approach (EETA) is a viable alternative option for resection of selected anterior skull base (ASB) tumors. However, this technique results in the creation of large cribriform defects. Some have reported the use of a rigid substitute for ASB reconstruction to prevent postoperative frontal lobe sagging. We evaluate the degree of frontal lobe sagging using our triple‐layer technique [fascia lata, acellular dermal allograft, and pedicled nasoseptal flap (PNSF)] without the use of rigid structural reconstruction for large cribriform defects.Study Design:Retrospective analysis.Methods:Nine patients underwent an EETA for resection of large ASB tumors from August 2010 to November 2011. The degree of frontal lobe displacement after EETA, defined as the ASB position, was calculated based on the most inferior position of the frontal lobe relative to the nasion‐sellar line defined on preoperative and postoperative imaging. A positive value signified upward displacement, and a negative value represented inferior displacement of the frontal lobe.Results:The average cribriform defect size was 9.3 cm2 (range, 5.0–13.8 cm2). The average distance of postoperative frontal lobe displacement was 0.2 mm (range, −3.9 to 2.9mm) without any cases of significant brain sagging. The mean follow‐up period was 10.1 months (range, 4–19 months). There were no postoperative CSF leaks.Conclusions:Rigid structural repair may not be necessary for ASB defect repair after endoscopic endonasal resection of the cribriform plate. Our technique for multilayer cranial base reconstruction appears to be satisfactory in preventing delayed frontal lobe sagging. Laryngoscope, 2012
Sprayable chitosan/starch‐based sealant reduces adhesion formation in a sheep model for Chronic sinusitis
Authors: Medina Jennifer G. , Das Subinoy 
Published: October 2012

AbstractObjectives/Hypothesis:Postoperative adhesion formation after endoscopic sinus surgery (ESS) remains a complication associated with high revision rates. This study determines the efficacy of a sprayable chitosan/starch‐based sealant for reducing adhesions in an ESS sheep model for chronic sinusitis.Study Design:Prospective, blinded, randomized controlled trial.Methods:Sheep (n = 14) with eosinophilic rhinitis (determined by the presence of eosinophilia in nasal secretions) underwent ESS with middle turbinectomies, standardized mucosal injuries created on the lateral nasal wall, and partial thickness wounds created around the ethmoid cell region. Surgery was performed bilaterally (28 nasal cavities). Animals were randomized into treatment with sprayable chitosan/starch‐based sealant (n = 7, 14 nasal cavities) or no treatment (n = 7, 14 nasal cavities). Two animals in the treatment group expired due to anesthetic complications associated with the turbinectomies, leaving five animals (10 sites) that completed the study. Presence of adhesions was assessed by endoscopic evaluation at days 14 and 28 after initial surgery. Adhesion formation was confirmed via necropsy of sinus cavities at day 28 after initial surgery.Results:Adhesions were observed in all seven control animals, resulting in an 86% (95% confidence interval [CI], 65–100) adhesion rate (12 of 14 sites). The five surviving treatment animals had a 10% (95% CI, 0–33) adhesion rate (one of 10 sites). Treatment with the sprayable chitosan/starch‐based sealant resulted in a 76% reduction (95% CI, 32–100) of adhesions (P < .002).Conclusions:In this sheep model for chronic sinusitis, treatment with sprayable chitosan/starch‐based sealant reduced adhesion formation by 76% after ESS (P < .002). Laryngoscope, 2013
Improved objective outcomes and quality of life after adenotonsillectomy with inferior turbinate reduction in pediatric obstructive sleep apnea with inferior turbinate hypertrophy
Authors: Cheng Po‐Wen , Fang Kai‐Min , Su Huang‐Wei , Huang Tsung‐Wei 
Published: October 2012

AbstractObjectives/Hypothesis:Whether adenotonsillectomy (AT) is sufficient for pediatric obstructive sleep apnea syndrome (OSAS) with persistent severe allergic rhinitis (PSAR) remains unclear. This study attempts to identify the role of inferior turbinate reduction in treating pediatric OSAS with PSAR.Study Design:Case series with planned data collection.Methods:Fifty‐one subjects aged 3 to 12 years with OSAS and PSAR were enrolled. Among them, 23 patients underwent AT concurrent with microdebrider‐assisted inferior turbinoplasty (MAIT) (group AT‐MAIT) and 28 patients underwent AT alone (group AT). Before surgery and at 1 year after surgery, objective outcomes were assessed using overnight polysomnography and acoustic rhinometry. Subjective outcomes were evaluated using the Obstructive Sleep Apnea (OSA)‐18 quality‐of‐life questionnaire (OSA‐18).Results:Following surgery, the median apnea‐hypopnea index, minimal oxygen saturation, and snoring index were 0.8 (/h), 94 (%), and 104 (/h) in group AT‐MAIT, respectively, compared with 3.5 (/h), 93 (%), and 158 (/h) in group AT, respectively (P < .05). In group AT‐MAIT, the median postoperative minimal cross‐sectional area recorded by acoustic rhinometry was 0.31 cm2, significantly larger than 0.16 cm2 in group AT (P < .01). Compared with postoperative scores in group AT, those in group AT‐MAIT were significantly improved in domains of physical symptoms, emotional symptoms, daytime function, caregiver concerns, and overall OSA‐18 scores (P < .05).Conclusions:Analytical results suggest that AT with concurrent MAIT achieves favorable subjective and objective outcomes in pediatric OSAS with PSAR. We believe that volume reduction of the inferior turbinate plays an important role in treating pediatric OSAS with inferior turbinate hypertrophy. Laryngoscope, 2012
The role of aerodigestive tract endoscopy in penetrating neck trauma
Authors: Soliman Ahmed M.S. , Ahmad Sidrah M. , Roy Deborshi 
Published: October 2012

Objective/HypothesisTo determine the role of aerodigestive tract endoscopy in the management of penetrating neck trauma.Study DesignRetrospective case series.MethodsA search of the hospital's trauma database was performed for patients who presented with penetrating neck trauma between July 1989 and June 2008. The mechanism and site of injury, airway status and manipulation, physical findings, diagnostic and therapeutic steps taken, and outcomes were all recorded.ResultsOne hundred sixty‐three patients were identified. There were 144 males and 19 females. The mean age was 28 years (range, 13 to 65 years). There were 105 gunshot wounds, 9 shotgun injuries, and 48 stab wounds. Seventy‐three patients (45%) underwent emergent neck exploration, of which 15 had upper aerodigestive tract injuries; intraoperative endoscopy was performed on 13 and was used to guide the repair. Ninety patients (55%) did not meet the criteria for emergent neck exploration. Endoscopy in this group was performed in symptomatic patients, which revealed two cases of unilateral true vocal fold motion impairment, one mucosal laceration of the right mainstem bronchus, one questionable area of injury at the apical segment of the right upper lobe bronchus, and one mucosal laceration of the proximal esophagus.ConclusionsAerodigestive tract endoscopy is critical in assessing and guiding surgical repair of injuries noted on surgical exploration. In stable patients with a low clinical suspicion of aerodigestive tract injury, it was of low yield. We propose a new algorithm for assessing aerodigestive tract injuries that includes multidetector computed tomography, in which only symptomatic patients who fail to meet the criteria for emergent neck exploration undergo endoscopy.Level of Evidence4 Laryngoscope, 124:S1–S9, 2014
Effect of turbinate surgery in rhinoseptoplasty on quality‐of‐life and acoustic rhinometry outcomes: A randomized clinical trial
Authors: Lavinsky‐Wolff Michelle , Camargo Humberto Lopes , Barone Carolina Rocha , Rabaioli Luisi , Wolff Fernando Herz , Dolci José Eduardo Lutaif , Polanczyk Carisi Anne 
Published: October 2012

AbstractObjectives/Hypothesis:To evaluate the role of inferior turbinate reduction during rhinoseptoplasty in quality‐of‐life outcomes and nasal airway cross‐sectional area.Study Design:Randomized clinical trial.Methods:Individuals over 16 years with nasal obstruction, candidates to functional and aesthetics primary rhinoseptoplasty, were evaluated from December 2010 though January 2012 at a tertiary University Hospital, Brazil. Eligible participants were randomly allocated to rhinoseptoplasty with or inferior turbinate reduction through submucosal diathermy. Outcomes: Relative changes ([postop–preop]/preop score) in specific (Nasal Obstruction Symptom Evaluation; NOSE) and general quality‐of‐life instruments (WHOQOL‐bref), nasal obstruction visual analogue scale (NO‐VAS) and nasal area measurements in acoustic rhinometry. Outcomes were blindly assessed 3 months postoperatively. Protocol was registered at ClinicalTrials.gov (NCT01457638).Results:50 patients were included, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32 ± 12 yr and 58% were female. Rhinoseptoplasty improved specific and general quality‐of‐life scores irrespective of turbinate intervention (P < 0.001).There was no difference between subjects submitted or not to inferior turbinate reduction in NOSE score (−75% vs. −73%; P = 0.893); all WHOQOL‐bref score domains (P > 0.05), NO‐VAS (−88% vs. −81%; P = 0.89) and acoustic rhinometry recordings (P > 0.05).During follow‐up less patients in the rhinoplasty with inferior turbinate reduction group were using topical corticosteroids (6[24%] vs. 13[54%]; P = 0.03). Multivariable analyses, adjusting for postoperative topical corticosteroid use and previous nasal fracture, had no effect on these results.Conclusions:Turbinate reduction through submucosal diathermy during primary rhinoseptoplasty did not improve short‐term general and specific quality‐of‐life outcomes and acoustic rhinometry recordings. The role of turbinate reduction in sparing chronic corticosteroid use should be confirmed in long‐term follow‐up studies. Laryngoscope, 2013
Improvement of tracheal flap method for laryngotracheal separation
Authors: Shino Masato , Yasuoka Yoshihito , Murata Takaaki , Ninomiya Hiroshi , Takayasu Yukihiro , Takahashi Katsumasa , Chikamatsu Kazuaki 
Published: October 2012

AbstractObjectives/Hypothesis:Recurrent pneumonia due to intractable aspiration is a life‐threatening disease. A tracheal flap method for children without previous tracheostomy has been previously reported. This study reports that improvements of this method and its three subtypes are widely applicable to patients with various conditions.Study Design:Surgical technique study.Methods:The tracheal flap method does not involve transection of the trachea but achieves laryngotracheal separation using the tracheal, mucoperichondrial, and sternohyoid muscle, along with anterior cervical skin flaps. This method can be divided into three subtypes as follows: A‐type, utilizing the tracheal flap (for patients without previous tracheostomy); B‐type, utilizing the mucoperichondrial and sternohyoid muscle flaps (for patients lacking an anterior tracheal wall); and C‐type, utilizing the esophageal flap (for patients with severe hypersalivation). In all three subtypes, the anterior cervical skin flap is employed.Results:The tracheal flap method was performed in 30 patients (24 children and six adults) at risk of developing intractable aspiration pneumonia. In all 30 cases, aspiration pneumonia was prevented without severe complications. No fistula formation was observed.Conclusions:All three subtypes (A‐, B‐, and C‐type) of the tracheal flap method are effective in preventing the recurrence of aspiration pneumonia. This method is applicable to diverse patient backgrounds regardless of age or previous tracheostomy. It is less invasive than Lindeman procedure. Furthermore, this method is acceptable to patients' families and improves the QOL of both patients and caregivers. Laryngoscope, 2012
Endoscopic ligation of the patulous eustachian tube as treatment for autophony
Authors: Rotenberg Brian W. , Busato Gian‐Marco , Agrawal Sumit K. 
Published: October 2012

AbstractObjectives/Hypothesis:Patulous eustachian tube remains a challenging management problem in otolaryngology. The autophony experienced by this patient population can be severe, and as yet no reliable surgical method exists to reduce or eliminate this annoying symptom. Our objective was to develop a novel endoscopic technique to assist these patients.Study Design:Longitudinal case series.Methods:A prospective longitudinal study was conducted of a series of consecutive patients undergoing surgery for patulous eustachian tube. Under transnasal endoscopic guidance, using a combination of fat plugging, endoluminal cauterization, and suture ligation, 14 ears underwent surgical treatment during a 4‐year period. The main outcome measure assessed was the level of autophony present after surgery as compared to baseline. Audiometric outcomes, surgical time, and complications were also recorded.Results:There was sustained satisfactory subjective improvement in the autophony in 12 of the 14 ears (85.7%) at primary surgery, with nine of these 12 ears (75%) demonstrating full autophony cessation. Wilcoxon signed rank test showed a significant improvement in autophony in the study population compared to baseline (z = 3.16, P < .001). The mean operating length of time per ear over the full duration of our series was approximately 45 minutes. Postoperative audiometry showed that surgery had no impact on hearing.Conclusions:Multilayer endoscopic ligation of the patulous eustachian tube resulted in a high autophony improvement rate. The procedure is technically straightforward, and results were sustained at 6‐month follow‐up. Laryngoscope, 2013
Treatment modalities and outcomes of olfactory neuroblastoma
Authors: Song Chang Myeon , Won Tae‐Bin , Lee Chul Hee , Kim Dong‐Young , Rhee Chae‐Seo 
Published: October 2012

AbstractObjectives/Hypothesis:To analyze the clinical features of olfactory neuroblastoma (ONB) and compare the treatment results according to various treatment modalities, and to validate various staging systems.Study Design:Retrospective analysis.Methods:This study included 35 patients with ONB. Treatment consisted of neoadjuvant chemotherapy and radiation therapy (seven patients), traditional craniofacial resection (TCFR, 12 patients), endoscopic craniofacial resection with craniotomy (ECFR, 11 patients), and transnasal endoscopic resection without craniotomy (five patients). The overall mean follow‐up period was 64.9 months and mean disease‐free survival (DFS) was 50.2 months.Results:Five‐year overall survival and 5‐year DFS rates were 76.0% and 61.8%, respectively. Five‐year DFS rates for nonsurgical treatment, TCFR, ECFR, and transnasal endoscopic resection without craniotomy group were 35.7%, 41.7%, 80.8%, and 100%, respectively (P = .01). Neck metastasis negatively affected survival (P = .03). DFS rate of patients in the endoscopic surgery group was higher than the nonendoscopic surgery group on Cox multivariate regression analysis (P = .02). The modified Kadish classification system predicted DFS more accurately than the Biller and Dulguerov classification system (P = .04). Locoregional recurrence occurred in 23% (period of recurrence after treatment, mean 49 months; range, 3–143) of patients with ONB, and distant metastasis in 26%. ECRF group showed lesser perioperative bleeding amount and shorter operation time compared with TCFR. However, the admission period was not statistically different.Conclusions:Endoscopic surgery for advanced ONB showed successful survival results compared with nonendoscopic surgery on multivariate analysis, and limited morbidities. Modified Kadish classification best predicted DFS for ONB. Long‐term follow‐up is necessary due to its late recurrence. Laryngoscope, 2012
Surgical resection of endolymphatic sac tumors in von Hippel‐Lindau disease: Findings, results, and indications
Authors: Kim H. Jeffrey , Hagan Marygrace , Butman John A. , Baggenstos Martin , Brewer Carmen , Zalewski Christopher , Linehan W. Marston , Lonser Russell R. 
Published: October 2012

AbstractObjectives/Hypothesis:To define the surgical treatment and outcomes of von Hippel‐Lindau (VHL) disease‐associated endolymphatic sac tumors (ELSTs), we analyzed consecutive VHL patients who underwent ELST resection.Study Design:Retrospective investigation of consecutive VHL patients who underwent resection of ELSTs at a clinical research center between 1999 and 2010.Methods:Analysis of serial clinical examinations, audiograms, imaging studies, and operative findings were analyzed.Results:Thirty‐one consecutive patients with ELSTs (15 males, 16 females) underwent resection of 33 tumors (mean follow‐up, 49.9 ± 48.0 months; range, 1.0–116 months). One patient had bilateral ELST resections and one patient underwent reoperation for recurrence. Mean age at surgery was 38.2 ± 10.2 years (range, 12–67 years). Whereas 29 ears (88%) had direct radiographic evidence of an ELST, four ears (12%) did not. Mean tumor size was 1.3 ± 1.1 cm (range, 0.2–5.2 cm). Whereas two patients (two ears, 6%) were asymptomatic, 29 patients (31 ears, 94% of ears) had associated audiovestibular symptoms, including sensorineural hearing loss (28 ears, 84%), tinnitus (24 ears,73%), and vertigo (21 patients, 68%). Postoperatively, hearing was stabilized (27) or improved (three) in 97% of 31 ears. Complete tumor resection was achieved in 30 ears (91% of 33 ears). Complications included cerebrospinal fluid leak in two ears (6%) and transient lower cranial nerve palsy in one ear (3%).Conclusions:Surgical resection of ELSTs can be performed with hearing preservation and a reduction in audiovestibular dysfunction. Early surgical resection can prevent or decrease disabling audiovestibular symptoms, enhance the opportunity for complete resection, and preserve hearing. Laryngoscope, 2012
The role of upper and lower airway patency in chronic rhinosinusitis with nasal polyps and asthma
Authors: Huang Zhenxiao , Zhou Bing , Zhang Qi , Huang Qian , Sun Yan , Wang Mingjie , Wang Xiangdong , Wang Chengshuo , Li Yunchuan , Cui Shunjiu 
Published: October 2012

AbstractObjectives/Hypothesis:To investigate the role of airway patency and factors associated with airway patency in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma.Study Design:Retrospective study.Methods:The upper and lower airway patency of 140 patients with CRSwNP and asthma (asthma group) and 42 patients with CRSwNP without asthma (nonasthma control group) was measured using acoustic rhinometry, rhinomanometry, and spirometry. Total serum immunoglobulin E and eosinophil counts were also compared. The severity of nasal diseases in these patients was assessed via the Lund–Mackay score (LMS) and Lund–Kennedy score (LKS).Results:There was no difference between the asthma and nonasthma groups in terms of total nasal resistance at 75 Pa (R75T), bilateral minimum cross‐sectional area (MCAR+L), or bilateral nasal cavity volume between 0 and 7.0 cm3 (V7R+L). Forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25–75) of the asthma group were significantly lower than those of the nonasthma group. FEV1 and FEF25–75 were not correlated with R75T, MCAR+L, V7R+L, or severity of nasal disease. For the patients with asthma, LMS and serum eosinophil counts were independent predictors of MCAR+L.Conclusions:The presence of asthma may not influence upper airway patency in CRSwNP patients. In CRSwNP patients with asthma, impairment of upper airway patency was associated with changes in LMS and eosinophilia, and in these patients lower airway patency was significantly lower than that of the control group (without asthma). In CRSwNP patients with asthma, there was little or no association between upper and lower airway patency. Laryngoscope, 2013
Artificial neural network classification of pharyngeal high‐resolution manometry with impedance data
Authors: Hoffman Matthew R. , Mielens Jason D. , Omari Taher I. , Rommel Nathalie , Jiang Jack J. , McCulloch Timothy M. 
Published: October 2012

AbstractObjectives/Hypothesis:To use classification algorithms to classify swallows as safe, penetration, or aspiration based on measurements obtained from pharyngeal high‐resolution manometry (HRM) with impedance.Study Design:Case series evaluating new method of data analysis.Methods:Multilayer perceptron, an artificial neural network (ANN), was evaluated for its ability to classify swallows as safe, penetration, or aspiration. Data were collected from 25 disordered subjects swallowing 5‐ or 10‐mL boluses. Following extraction of relevant parameters, a subset of the data was used to train the models, and the remaining swallows were then independently classified by the ANN.Results:A classification accuracy of 89.4 ± 2.4% was achieved when including all parameters. Including only manometry‐related parameters yielded a classification accuracy of 85.0 ± 6.0%, whereas including only impedance‐related parameters yielded a classification accuracy of 76.0 ± 4.9%. Receiver operating characteristic analysis yielded areas under the curve of 0.8912 for safe, 0.8187 for aspiration, and 0.8014 for penetration.Conclusions:Classification models show high accuracy in classifying swallows from dysphagic patients as safe or unsafe. HRM‐impedance with ANN represents one method that could be used clinically to screen for patients at risk for penetration or aspiration. Laryngoscope, 2013