bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mometasone Furoate for Adenoidal Hypertrophy in Adolescents
Authors: Sahin‐Yilmaz Asli , Celebi Saban , Yilmaz H. Baki , Oysu Cagatay 
Published: February 2015

Objective1) To find out whether the symptoms attributable to adenoid hypertrophy in adolescents may be treated with intranasal mometasone furoate (MF) application. 2) To learn if adenoid hypertrophy in adolescents may decrease in size with intranasal MF.MethodA prospective, double‐blind, randomized, crossover study was conducted in 28 subjects (12‐18 years) with adenoidal hypertrophy. Subjects used intranasal MF or placebo for a duration of 6 weeks with a washout period of 3 weeks. Subjective symptoms and adenoid size were evaluated.ResultsAt the initiation of the study, there was no significant difference between the mean symptom scores for any of the sinonasal symptoms between the 2 treatment groups. Placebo users had no statistically significant reduction in their sinonasal symptoms (P >. 05 for all) other than snoring (P =. 011). MF users had a statistically significant reduction in all symptoms (P <. 05 for all) other than coughing (P =. 527). There was a significant difference between the 2 treatment groups in the mean posttreatment scores for total subjective symptom scoring and rhinorrhea (P =. 031, P =. 012 resp). There was no significant difference in baseline endoscopy scores between the 2 treatment groups (P =. 317). There was a significant reduction in nasal endoscopy scores in the MF group compared to placebo group (P =. 034).ConclusionMF may have some advantage over placebo for the symptoms attributable to adenoid hypertrophy in adolescents. Intranasal MF decreases the size of the adenoid hypertrophy in this group of patients.
New Technique for the Endoscopic Treatment of CSF Fistulas
Authors: Chaparro Morante Juan C. , Venegas Monica Hidalgo , La Borda Alberto Trelles Polo Y. 
Published: February 2015

Objective1) Report our experience in surgical treatment for closure of CSF fistulas of different etiologies, with a new endoscopic technique without invasive surgery. 2) Improve the treatment of CSF leakage, thus avoiding craniotomy and its sequelae.MethodWe present 5 cases of adult patients with CSF fistula treated by endoscopic surgery from July to December 2011 using cartilage and mucoperichondrium tragal graft, resorbable thread as a guide and sterile sponge, previus revivig edges. Overlay technique was used and nasal packing was for 5 days. Endoscopic controls were carried out.ResultsIn all surgery cases closure of the fistula was observed at 6 weeks. There were no recurrences and no reoperationes were necessary. All patients improved their symptoms without reoccurring liquorrhea.ConclusionEndoscopic closure of CSF fistulas with the technique of cartilage graft has proved a very safe method for this type of defect in the skull base as well as being reliable, secure, and free of sequelae known as craniotomies.
Nitric Oxide Synthase in the Nasal Mucosa
Authors: Yoda Shigetoshi , Fukushima Hisaki , Shibata Dai , Akisada Takeshi , Harada Tamotsu 
Published: February 2015

ObjectiveThe amount of nitric oxide (NO) in the nasal cavity is significantly higher in allergic rhinitis patients than in healthy individuals. The purpose of this study was to identify NO synthase (NOS) isoforms (NOS‐1, NOS‐2, and NOS‐3) and examine their localization, gene expression, and protein expression in allergic rhinitis model mice.MethodMale BALB/c mice were intraperitoneally administered Cryptomeria japonica 1 (Cryj1) and adjuvant (primary immunization) 3 times; thereafter, Cryj1 was administered daily into the nasal cavity (secondary immunization). The expression of NOS‐1, NOS‐2, and NOS‐3 in the nasal mucosa was investigated using real‐time polymerase chain reaction, and Western blot analysis.ResultsThe expression of NOS‐1 mRNA was significantly decreased, and NOS‐2 and NOS‐3 mRNA levels were significantly increased in the allergy group compared to the control group. Protein expression of NOS‐1 was significantly decreased and that of NOS‐2 was significantly increased in the allergy group compared with the control group, but no significant difference was noted in the levels of NOS‐3 protein.ConclusionThis study shows that not only NOS‐2 but also NOS‐1 and NOS‐3 are involved in the pathogenesis of allergic rhinitis.
Optimal Approach to the Sphenoid Sinus: The Missed Guide
Authors: Younes Ahmed , Alhamshary Ahmed S. , Romeh Hossam I. , Albirmawy Osama A. 
Published: February 2015

ObjectiveTo formulate an updated applicable algorithm for selection of the optimal surgical approach to the sphenoid sinus.MethodRetrospective review. The records of 63 patients who had undergone surgery for sphenoid sinus lesions, at Otolaryngology Department, Tanta University, between 2000 and 2009 were reviewed. Four different surgical approaches were identified: Endoscopic transnasal sphenoidotomy (TNS), endoscopic transethmoidal sphenoidotomy, endoscopic transpterygoid sphenoidotomy, and endoscopic transnasal sphenoidotomy with posterior septectomy. The approaches were compared in: mean age, preoperative imaging data, pathological diagnosis, percentage of revision procedures, and surgical complications.ResultsTNS was the most commonly used approach (65%). Endoscopic transethmoidal sphenoidotomy was the second approach (25%). Endoscopic transpterygoid sphenoidotomy was used in 3%. It was used for management of lateral sphenoid recess lesions. Endoscopic transnasal sphenoidotomy with posterior septectomy was used in 6% for sellar, parasellar, and clival lesions. No major complications were committed.ConclusionSelection of the appropriate approach to the sphenoid depends mainly on the disease extent displayed by preoperative imaging. The endoscopic transnasal approach was suitable for management of isolated sphenoid sinus lesions. Eendoscopic transethmoid approach was used for management of pansinus involvement. The endoscopic transpterygoid approach was used for dealing with lesions of the lateral sphenoid recess and the endoscopic transnasal sphenoidotomy with posterior septectomy was used for management of sellar, parasellar, and clival lesions.
Orbital Complication of a Paranasal Sinus Actinomycosis
Authors: Pimentel Joao C. , Escada Pedro A. , Cavilhas Pedro 
Published: February 2015

Objective1) Describe the first reported case of paranasal sinus actinomycosis associated with an orbital complication. 2) Describe other unusual features of the case: the occurrence of the infection in an immunocompetent pregnant patient, the involvement of the ethmoid sinus, the safety of a surgical treatment in a 15‐week pregnant patient.MethodCase report of a 25‐year‐old woman, 15 weeks pregnant. Disease studied: Ethmoid sinus actinomycosis complicated by an subperiosteal orbital abscess. Setting: Tertiary referral university hospital. Intervention: Intravenous antibiotic therapy associated with a surgical treatment under general anesthesia. Outcome measurement: Safety and efficacy of the treatment.ResultsThe patient was admitted for treatment of the complicated rhinosinusitis. She immediately started intravenous antibiotic therapy with amoxicillin and clavulanic acid and a surgical drainage under general anesthesia was indicated. Risks for the patient and for the fetus were discussed and the informed consent was obtained for the anesthetic and for the surgical procedures. A combined external and transnasal endoscopic approach was performed to treat the infection. Actinomyces meyeri was isolated. The patient improved and was discharged after 14 days of medical treatment. Eight months after surgery the patient and her newborn are both well and no sequelae were registered.ConclusionActinomycosis of the paranasal sinus can involve primarily the ethmoid sinus, do not have a history of dental procedures or trauma, and result in orbital complications. Standard medical and surgical therapies for complicated rhinosinusitis are safe and effective, even in a pregnant patient.
Pan‐American Clinical Guideline on Rhinosinusitis
Authors: Dibildox‐Martinez Javier , Mayorga Butron Jose L. , Macías Fernández Luis A. , Casiano Roy R. , Carrau Ricardo L. , Javer Amin R. , Gordon Bruce R. 
Published: February 2015

ObjectiveThis evidence‐based clinical practice guideline (CPG) aims to improve clinical decision making of general practitioners and specialists in the treatment of acute and chronic rhinosinusitis in adults. Support clinicians in clinical decision making for medical treatment with target in the pathophysiological process and evidence‐based efficacy, safety, and tolerability.MethodThe Pan‐American Association of Otorhinolaryngology and Head and Neck Surgery, in partnership with the Ibero American Agency for Development and Assessment of Health Technologies, developed a clinical practice guideline on medical management of acute and chronic rhinosinusitis in adults. This document provides punctual evidence‐based recommendations for primary care physicians and otolaryngologists on the medical management of these conditions and complies with evidence‐based medicine fundamentals and with well‐validated guidelines methodology as recommended by the National Institute for Clinical Excellence, the National Institutes of Health, and The Scottish Intercollegiate Guidelines Network.ResultsThis document provides from A Grade to D Grade clinical recommendations for treatment of these conditions. The Guideline Development Group made recommendations based on well‐designed, randomized controlled trials and systematic reviews. Some clinical questions could not be answered by high quality research and for these questions a Panel Delphi was conducted to provide clinical guidance. Overall there is a need for well‐designed RCTs and economic assessments to answer most of the gaps of knowledge for the treatment of acute and chronic rhinosinusitis.ConclusionThis clinical practice guideline provides guidance for the medical treatment of adults with acute and chronic rhinosinusitis.
Rhinosinusitis in the Immunocompromised Cancer Population
Authors: Jackson Ryan S. , Phommachanh Viengsouk , Keeler Jarrod A. , Pechter William , Greene John N. , Padhya Tapan , Tabor Mark H. 
Published: February 2015

ObjectiveThe microbiology of acute and chronic sinusitis in the general population is well documented, however, this is not well characterized in vulnerable subgroups. Our primary aim is to evaluate the paranasal sinus microbiology of immunocompromised patients at a tertiary cancer center.MethodFollowing institutional review board approval, records at Moffitt Cancer Center were retrospectively reviewed using ICD‐9 codes for in‐hospital treatment of sinusitis while undergoing concurrent oncologic therapy. All patients had nasal endoscopy with aerobic middle meatal culture. Demographics, type of malignancy, leukocyte count, glycemic status, and culture results were recorded.ResultsEighty patients were identified from June 2000 to April 2009. Malignancies included leukemia (63%), lymphoma (22%), multiple myeloma (5%), carcinoma (5%), and sarcoma (4%). One patient (1%) had common variable immunodeficiency. A total of 102 sinus cultures were collected. Of those, 59 (58%) were interpreted as no growth (n = 20) or usual respiratory flora (n = 39). Of the 46 positive cultures, 58 organisms were isolated. There were 16 fungi (28%), 12 coagulase‐negative Staphylococcus (20%), 9 methicillin‐sensitive Staphylococcus aureus (16%), 8 methicillin‐resistant Staphylococcus aureus (14%), 6 Pseudomonas species (10%), 3 Moraxella catarrhalis (5%), and 4 other gram‐negative bacilli (7%) isolated.ConclusionPathogens identified in this population differ from published data examining the general population. There is an increased percentage of negative cultures, fungi and coagulase negative staphylococcus. We found fewer streptococcus pneumonia species. We attribute this change in flora to frequent empiric treatment of this population with broad‐spectrum antibiotics.
Stratus Relieva: Treatment for Chronic Rhinosinusitis
Authors: Baptista Peter M. , de Abajo Jorge , Fernandez Secundino , Barona Luz 
Published: February 2015

ObjectivePatients with chronic rhinosinusitis resistant to systemic treatment have as an alternative endoscopic nasal surgery. The Relieva Stratus system has allowed local treatment in paranasal cavities, avoiding an aggressive surgery and high corticoesteroids systemic treatment. We describe our experience with the system in the first six patients.MethodFour patients suffering ethmoid and 2 with frontal chronic rhinosinusitis have been included. The Stratus catheter was implanted endoscopically under general anesthesia in combination with balloon sinuplasty technique for either the maxillary or the frontal sinus. Triamcinolone was used for local delivery. Stratus was removed in office 4 week later.ResultsStratus Relieva was implanted in patients with chronic inflammation of the ethmoid or frontal sinus. No major complications were observed. Four catheters were implanted in the ethmoid bulla and 2 in the frontal sinus. They were removed in office under local anesthesia. Intraoperaory bleeding was minimal. Patients described no foreign object sensation after surgery. We observed good evolution in all patients but one, in which Stratus Relieva was performed. This patient persisted with chronic inflammation of the maxillary and ethmoid sinus and functional endoscopy surgery was performed as alternative for definitive treatment.ConclusionResults with this device are promising although longer observation period is needed. It is possible that the patient that did not show an improvement of disease may have not been an adequate candidate for this surgery. Therefore, we consider that appropriate selection of patients is necessary for a good outcome.
Sublingual Immunotherapy for Allergic Rhinitis
Authors: Zhang Edward Z. , Fook‐Chong Stephanie , Leong Jern‐Lin 
Published: February 2015

ObjectiveTo study the efficacy and safety of sublingual immunotherapy (SLIT) based on the original American Academy of Otolaryngic Allergy (AAOA) Consensus dosing protocol for treatment of allergic rhinitis (AR).MethodPatients undergoing SLIT for more than 12 months between 2007 to 2010 were prescribed escalation (over 3 months) and maintenance doses as recommended by AAOA. Sinonasal‐Outcome‐Test‐20 (SNOT‐20) questionnaire scores were used for calculations of repeated measures analysis of variance (ANOVA) with contrast testing to define trends.ResultsData from 15 men and 6 women with a mean follow‐up duration of 17.57 months were analyzed. Fourteen patients had minor side effects including AR exacerbation (5 cases), itching (8), rash (2), diarrhea (1), and palatal ulcer (1). None required admission or treatment discontinuation. ANOVA testing revealed a significant linear decreasing trend in rhinological (F1,13 = 11.2), ear/facial (F1,13 = 5.4), sleep (F1,13 = 6.9), psychological (F1,13 = 13.1), and overall SNOT‐20 (F1,13 = 14.5) scores. Our results show overall SNOT‐20 scores improving by 31% from baseline within 3 months initiation of therapy, and continued to improve progressively during the maintainance phase up to 69%. Domain scores analyzed showed greatest improvements in ear/facial symptoms (up to 86%) and psychological function (up to 77%). Rhinologic and sleep function scores also showed impactful improvements of up to 56% and 61%, respectively.ConclusionThis is the first published paper to study and demonstrate the safety and efficacy of SLIT based on AAOA consensus dosing protocol. A standardized regime will allow more meaningful comparison between studies.
Successful Surgery in Pediatric Chronic Nasal Obstruction
Authors: Pepe Graciela , Parras Jorge , Morel Pablo 
Published: February 2015

Objective1) To validate a minimally invasive surgical approach including endoscopic fiberdiodelaser‐assisted turbinoplasty, RFQ adenoidectomy, and sinus washes, as a first‐line treatment for children with chronic nasal obstruction and noncomplicated recurrent sinusitis that failed at maximal medical treatment.MethodA prospective study of 50 children aged 3 to 13 years with persistent sinonasal symptoms was conducted in a tertiary private setting. Surgery under general anesthesia was done. The survey included NOSE instrument, child behavior, use of sinonasal medication and parent satisfaction at entry, 1, 6, and at least 24 months after surgery.ResultsSignificant improvement in NOSE score was observed 1 month after the procedure, and remains unchanged after 6 and 24 months of follow‐up. Basal NOSE 92.5% ± 9.4 vs NOSE 1 month 7.2 % ± 12, NOSE 6 month 8.3 ± 15.2; 24 months 6.3 ± 10.3 (ANOVA P =. 0001). Patients used significantly less sinonasal medications. None remained with altered behavior (P. 001 McNemar’s test). Parent satisfaction was very high (Likert scale) with 95.8% at 6 months and 93% at 24 months.ConclusionLaser‐assisted turbinoplasty RFQ adenoidectomy and sinus washes are a successful approach for treating pediatric chronic nasal obstruction and sinusitis.
The Allergen‐Glycerin Balance
Authors: Rekkerth Donna J. , Grier Thomas J. 
Published: February 2015

Objective1) Review challenges monitoring allergen and glycerin levels in patient vials. 2) Describe the allergen and glycerin content of treatment board vials. 3) Demonstrate use of an algebraic calculator for determining the final glycerin concentrations. 4) Describe table comparing allergen levels in maintenance vial mixtures.MethodConvenient tools have been created to simplify calculation of final glycerin concentrations present in buildup and maintenance immunotherapy mixtures, and the final allergen doses administered relative to current immunotherapy practice parameter recommendations. Information was studied from 2005‐present.ResultsA limited tolerance to elevated glycerin levels can prompt reductions in injection volume (and allergen dose) for patient safety and compliance. The IDT and MQT algorithms introduce a variety of allergen and glycerin levels to patient vials that can be difficult to monitor or calculate easily.ConclusionThe effectiveness and safety of subcutaneous immunotherapy is linked directly to patient tolerance of both allergen loads and glycerin levels. Convenient tools have been created to simplify calculation of final glycerin concentrations present in buildup and maintenance immunotherapy mixtures, and the final allergen doses.
The “Mickey Mouse” Sign
Authors: Manickavasagam Jaiganesh , Mirza Showkat , Sinha Saurabh 
Published: February 2015

ObjectiveIn transnasal endoscopic pituitary surgery and transsellar approaches to anterior skull base lesions, a bony sella window is created with the lateral limits being the carotid arteries.MethodCoronal CT scan of the sphenoid sinuses were reviewed in a tertiary referral hospital and compared with intra operative findings.ResultsSphenoid anatomy is variable in terms of the degree of pneumatization and bony anatomy around the pituitary gland and internal carotid arteries. We describe a radiological sign ascertained from computerized tomography (CT) that when present indicates whether the carotid arteries can be readily identified endoscopically on entering the sphenoid sinus. On the axial CT the carotid arteries may produce protuberances either side of the sella which together with the bony sella and dorsum sella appear to form the outline of the head of Mickey Mouse or a teddy bear.ConclusionWhen this sign is not present then the junction between the sella and carotids may not be clear and surgeons must be cautious or use neuronavigation.
Utility of Current Sialendoscopes in the Sinonasal Cavity
Authors: Joshi Arjun S. , Singh Ameet 
Published: February 2015

Objective1) To describe the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model. 2) To suggest the novel uses for sialendoscopes and potential improvements in design.MethodA cadaveric study was performed in a tertiary care hospital setting in October 2011. Currently available sialendoscopes were used for visualization and interventions in the paranasal sinuses. Four cadaver heads were studied pre‐ and postdissection. Outcomes included identification of ostia, cannulation of sinuses, success of mucosal biopsy, and clarity of images.ResultsThere were no significant differences in types of scopes. Both Marchal and Erlangen scopes were demonstrated to be effective in both visualizing and cannulating the sphenoid sinuses in pre‐ and postdissected settings (8/8). Neither type allowed for adequate visualization of the maxillary ostia without dissection, but did allow for evaluation and cannulation after antrostomy. Larger diameter scopes were associated with the least distortion of image during assessment of the maxillary ostia. Mucosal biopsy within the sphenoid sinus was possible before dissection, but not in the maxillary sinus.ConclusionSialendoscopes can be used for visualization and interventions in the sinonasal cavity but are limited mainly to the sphenoid sinus. They may be considered as a minimally‐invasive method for drug delivery and/or biopsy in the postoperative setting for all sinuses. The design can be improved somewhat.
Geniotubercle Advancement Effect on Swallow Function
Authors: Rohrer Joseph W. , Eller Robert , Santillan Phyllis , Barrera Jose E. 
Published: February 2015

Objective1) Evaluate swallowing characteristics before and after geniotubercle advancement (GTA). 2) Determine if GTA’s effects on tongue‐base position could be useful for patients who have dysphagia without OSA.MethodPatients with AHI greater than 10 scheduled for GTA were enrolled consecutively. Video fluoroscopic swallow study (VFSS) was performed preoperatively and 4 months postoperatively. Imagej64 software (National Institutes of Health, Bethesda, Maryland) was used to measure hyolaryngeal elevation and displacement. Video recordings assessed valecular pooling, aspiration, and bolus movement. Studies were reviewed by a speech pathologist and an otolaryngologist.ResultsPreoperative demographics AHI range was 12.4 to 72 with a mean of 51.4 and a median of 65. Postoperatively AHI was 3.8 to 22.4 with a mean of 11.6 and a median of 11.2. There was no reported pre‐ or postoperative dysphagia or aspiration. There was no radiographic evidence of silent aspiration. Hyolaryngeal superior elevation was 0.40, 0.39 (P =. 85), anterior displacement changes were 0.27, 0.17 (P =. 23), and total motion was 0.50, 0.43 (P =. 13).ConclusionWhile geniotubercle advancement surgery was effective at reducing the AHI in all patients in this series, the procedure did not significantly affect the swallowing function of patients. It also did not appear to significantly alter the hyolaryngeal movement, making it unlikely to assist with patients suffering from dysphagia.
Inferolateral Pharyngoplasty
Authors: Tanyeri Hasan M. , Aksoy Elif A. , Serin Gediz M. , Polat Senol , Unal Omer F. 
Published: February 2015

ObjectiveThis study describes inferolateral pharyngoplasty (ILP) and its effectiveness as a surgical technique to enlarge pharyngeal air space inferolaterally, which complements submucosal uvulopalatopharyngoplasty (smUPPP) in the treatment of obstructive sleep apnea (OSA).MethodFifty‐two patients underwent complete tonsillectomy, including lingual portions of palatine tonsils during smUPPP. Reconstruction included double layer closure, muscle, and mucosa emphasizing inferolateral portions of smUPPP. Pre‐ and postoperative Müller maneuver and respiratory disturbance index (RDI) were analyzed.ResultsThe study group consisted of 47 men (90.38%) and 5 women (9.61%). The mean age was 46.6 ± 9.5 years. The pharyngeal collapse varied between 30% and 100% preoperatively. The pharyngeal collapse decreased to values between 20% and 50% postoperatively. Mean RDI levels decreased from 33.3 ± 22.9 to 23.7 ± 22.8 (P =. 027) following surgeries in OSA patients.ConclusionILP is a complementary procedure to smUPPP that might increase the effectiveness of the procedure. This effect might originate from double layer closure in particular emphasis on inferolateral portions. We propose that smUPPP in conjunction with ILP is an effective procedure to ameloriate OSA condition.