bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polymorphism between Loci for Human Leukocyte Antigens DR and DQ in Patients with Nasal Polyps
Authors: Zhai Lijie , Sun Yiqing , Tang Linghao , Liu Hui 
Published: October 2014

Objectives: We explored a potential association between nasal polyps (NPs) and polymorphism at loci for human leukocyte antigen (HLA) DR and HLA-DQ. Methods: Polymorphism at loci HLA-DR and HLA-DQ were examined in 30 patients with NPs and in 81 healthy subjects by use of the polymerase chain reaction-sequence specific primer method. Results: HLA-DR16, HLA-DQ8, and HLA-DQ9 were found to be significantly associated with NPs. HLA-DR16, HLA-DQ8, and HLA-DQ9 specificities were found at higher frequencies in patients with NPs than in control subjects (5% versus 0.62%, RR = 8.9, p = .03; 10% versus 2.47%, RR = 4.81, p = .01; and 20% versus 6.18%, RR = 4.73%, p = .001; respectively). In contrast, HLA-DQ7 was found at lower frequencies in patients with NPs than in controls (10% versus 20.37%, RR = 0.36, p = .04). Conclusions: We conclude that HLA-DR16, HLA-DQ8, and HLA-DQ9 represent potential susceptibility determinants and that HLA-DQ7 might confer resistance in nasal polyps.
Administration of Esmolol in Microlaryngeal Surgery for Blunting the Hemodynamic Response during Laryngoscopy and Tracheal Intubation in Cigarette Smokers
Authors: Louizos Antonios A. , Hadzilia Sophie J. , Davilis Dimitrios I. , Samanta Evangelia G. , Georgiou Loucas G. 
Published: October 2014

Objectives: Cigarette smokers constitute a group of patients with an increased hemodynamic response to tracheal intubation. We studied the dose-response and side effects of bolus administration of esmolol hydrochloride in cigarette smokers undergoing elective microlaryngeal surgery, when esmolol was used for reducing the intense hemodynamic response to laryngoscopy and tracheal intubation. Methods: We randomly allocated 165 patients (American Society of Anesthesiologists physical status classes I to III) to receive placebo (Eplac) or esmolol 1 mg/kg (E1) or 2 mg/kg (E2). The esmolol was given 2 minutes before laryngoscopy and tracheal intubation. The same anesthetic technique was used in all patients. Cardiovascular parameters were recorded every minute for the first 5 minutes and thereafter every 3 minutes. Bronchospasm, other side effects, and rescue esmolol treatment were noted during anesthesia. Results: In group Eplac, significant increases (p < .05) in arterial blood pressure and heart rate were observed in the first 3 minutes after tracheal intubation. In group E1, significant increases (p < .05) in diastolic blood pressure were observed in the first 2 minutes after intubation. In group E2, no significant fluctuations were recorded in cardiovascular parameters after intubation. During surgery, 17% of the patients in group Eplac showed an increase in blood pressure and tachycardia. Conclusions: We conclude that esmolol administration of 2 mg/kg during induction of anesthesia in smokers provides hemodynamic stability after laryngoscopy and tracheal intubation with no severe side effects.
Endoscopic Management of Blunt Pediatric Laryngeal Trauma
Authors: Elmaraghy Charles A. , Tanna Neil , Wiet Gregory J. , Kang D. Richard 
Published: October 2014

Objectives: Blunt laryngeal trauma in the pediatric population is an uncommon but unique entity that can be potentially life-threatening. Given the infrequency of these events, its management can pose a clinical dilemma. The authors review the evaluation and treatment of blunt pediatric laryngeal trauma. Methods: We present a case report and a review of the literature. Results: We describe the case of a 3-year-old boy who presented with laryngeal injury following blunt trauma. The patient sustained endolaryngeal hematomas and mucosal lacerations with exposed cartilage. After mucosal approximation, the patient was successfully managed in a critical care setting without a tracheostomy. Conclusions: With an appropriate and thorough evaluation of the pediatric patient, endoscopic management without a surgical airway may be considered as a viable alternative for blunt laryngeal trauma.
Value of Temporal Bone Density Measurements in Otosclerosis Patients with Normal-Appearing Computed Tomographic Scan
Authors: Tringali Stéphane , Pouget Jean-François , Bertholon Pierre , Dubreuil Christian , Martin Christian 
Published: October 2014

Objectives: Previous studies demonstrated that otosclerosis diagnosis benefits from temporal bone density measurements. We sought to assess bone density measurements of the fissula ante fenestram (FAF) in normal patients, in patients with otosclerosis, and in patients with cholesteatoma. We discuss the value of temporal bone density measurements in patients with otosclerosis who have a normal-appearing computed tomographic (CT) scan. Methods: This was a prospective case-control study in which 219 temporal bones (123 adults, 18 to 84 years of age) were included between November 1, 2002, and April 30, 2004. All patients underwent a CT scan of the temporal bones. Axial views were obtained with density measurement of the FAF. Results: The FAF density was significantly different (p < .0001) in the otosclerosis group (n = 119) compared to the control group (n = 100). There was no significant difference between the otosclerosis group with a normal-appearing CT scan and the control group (p = .64). Conclusions: From our results, it may be suggested that 1) temporal bone density measurements seem not to be strictly comparable between CT scan devices; and 2) temporal bone density measurements of the FAF did not allow the diagnosis of otosclerosis when the CT scan appeared normal.
Multifocal Extranodal Mucosa-Associated Lymphoid Tissue Lymphoma Affecting the Larynx
Authors: Arndt Susan , Veelken Hendrik , Schmitt-Gräff Annette , Aschendorff Antje , Maier Wolfgang , Richter Bernhard 
Published: October 2014

Objectives: Extranodal marginal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) accounts for about 7% to 8% of all B-cell lymphomas and 50% of all gastric lymphomas. Long-term localized growth is typical of MALT lymphoma. Multifocal manifestations are possible in advanced stages. MALT lymphoma of the larynx is a very rare disease; only 15 cases have been reported in the literature. Methods: We report a case of multifocal MALT lymphoma affecting the larynx associated with extraesophageal reflux, chronic laryngitis, and gastric Helicobacter pylori infection. The staging revealed a recurrent tumor of MALT lymphoma in the stomach and an involvement of the right conjunctiva. Results: Following recent reports on successful treatment of MALT lymphoma with antibiotics, initial empirical therapy with doxycycline calcium led to a subjective clinical symptom improvement but no objective response as assessed by laryngoscopy, magnetic resonance imaging of the larynx, and esophagogastroduodenal endoscopy. Because of the advanced stage and multiple extranodal manifestations of the MALT lymphoma, the patient received 3 cycles of chemoimmunotherapy according to the FCR protocol (fludarabine phosphate-cyclophosphamide-rituximab). No evidence of disease was observed after a 6-month follow-up. Conclusions: In the rare diagnosis of MALT lymphoma of the larynx, comprehensive staging is indispensable to exclude multifocal involvement. In contrast to the treatment of primarily localized MALT lymphoma, multifocal disease warrants systemic therapy.
Clinical and Pathological Analysis of Recurrent Inverted Papilloma
Authors: Oikawa Keita , Furuta Yasushi , Itoh Tomoo , Oridate Nobuhiko , Fukuda Satoshi 
Published: October 2014

Objectives: We analyzed the clinical characteristics, pathological findings, and treatment outcomes of patients with recurrent sinonasal inverted papilloma (IP). Methods: This retrospective study consisted of 13 patients with recurrent IP. Patient data were collected on prior treatment, sites of recurrence, surgical procedures, pathological findings, and postoperative time to recurrence. Results: Eleven of the 13 patients (85%) had recurrence in the ethmoid sinus, particularly at the lamina papyracea (n = 8; 62%). Inverted papilloma with severe dysplasia (SD) was observed in 4 patients, 3 of whom showed malignant transformation of the recurrent tumor. Craniofacial resection was performed in 2 of the 4 patients, resulting in no further recurrence. However, the tumor was not managed in the remaining 2 patients. In the 9 patients without SD, lateral rhinotomy was performed in 6 patients and endoscopic sinus surgery was selected in 3 patients who had a small tumor without scar formation. No further recurrence was observed in the 9 patients. Conclusions: Careful management of IP around the lamina papyracea is essential during initial surgery. Recurrent IP without SD can be successfully managed by lateral rhinotomy in most cases, and by endoscopic sinus surgery in selected cases. However, more aggressive treatment, including craniofacial resection, should be considered in IP with SD, which is associated with a high rate of recurrence and malignant transformation.
Analysis of Human Glottal Velocity Using Hot-Wire Anemometry and High-Speed Imaging
Authors: Kataoka Hideyuki , Arii Shiro , Ochiai Yoshitaka , Suzuki Toyohiko , Hasegawa Kensaku , Kitano Hiroya 
Published: October 2014

Objectives: The aim of this study was to analyze glottal velocity and glottal opening and closure. For this purpose, we developed a miniature, flexible, hot-wire probe that can make truly instantaneous measurements of the human larynx in vivo. Methods: A miniature hot-wire tip was inserted into a flexible transnasal endoscope. Fiberscopic examination was performed transnasally so that we could observe glottal vibration using high-speed imaging. The tip of the hot-wire probe was placed just above the glottis. The position of the probe was carefully monitored and checked with another flexible endoscope. Results: Changes in velocity were recorded periodically. The velocity was higher in close proximity to the vocal folds. High-speed motion pictures were taken at a rate of 2,000 frames per second with an auxiliary light source. Conclusions: Quantitative analysis of glottal velocity is required to improve our understanding of the relationship between laryngeal physiology and acoustics in humans. To solve the problem of synchronization inaccuracy, glottal velocity was captured instantaneously in the high-speed imaging system's processor memory.
Streptococcus Viridans Has a Leading Role in Rhinosinusitis Complications
Authors: Hwang Siew Yoong , Tan Kun Kiaang 
Published: October 2014

Objectives: We sought to determine whether the bacteria in complicated rhinosinusitis were the typical acute rhinosinusitis triad of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. We also compared the difference in yield between infection sites and blood cultures. Methods: We performed a retrospective review of all patients who had required surgical intervention for rhinosinusitis complications over 7 years at a tertiary care pediatric hospital. Results: There were a total of 28 patients during the review period. Twenty-five organisms were isolated from 21 patients, of which Streptococcus viridans formed 44% of the isolates (11 of the 25). The typical triad of bacteria only formed 20% of the isolates (5 of the 25), and none of these bacteria were found in the group with intracranial complications. Infection site cultures had a superior yield compared to blood cultures (p <.001). Ninety-six percent of the bacteria were sensitive to a combination of amoxicillin-clavulanate and cloxacillin. Conclusions: In distinction to the typical bacteria of acute rhinosinusitis, S viridans is the leading cause of rhinosinusitis complications. It is not merely a commensal organism of the upper respiratory tract.
Duodenal Contents Reflux-Induced Laryngitis in Rats: Possible Mechanism of Enhancement of the Causative Factors in Laryngeal Carcinogenesis
Authors: Ling Zhi-Qiang , Mukaisho Ken-Ichi , Hidaka Miyoko , Chen Kuan-Hao , Yamamoto Gaku , Hattori Takanori 
Published: October 2014

Objectives: The main factors considered responsible for the onset of laryngeal cancer are tobacco smoking and alcohol abuse. Recently, gastroesophageal reflux has also been implicated as a causative factor in several laryngeal disorders, including laryngeal cancer. However, the significance of gastroesophageal reflux in laryngeal cancer is controversial. Methods: We investigated the histologic features of the esophagus and larynx in a rat model of reflux of the duodenal contents. Cell proliferation was also evaluated in laryngeal samples by detection of Ki67 antigen. Results: In this reflux model, laryngitis with infiltration of inflammatory cells and proliferation of small mucous glands was evident from 10 weeks after operation, and basal cell hyperplasia around the epiglottis and hyperplastic changes in the larynx were detected at 30 weeks. No dysplastic or malignant lesions were detected in the laryngeal samples within the duration of the experiment, in spite of detection of malignancy in 31.3% of lesions in esophageal samples at 30 weeks. The Ki67 index at each week was significantly higher than that of the control animals. Conclusions: Previous studies have shown smoking and alcohol abuse to have refluxogenic effects. Reflux of duodenal contents causes laryngitis. Reflux does not appear to be an independent risk factor for laryngeal carcinogenesis, but it may enhance the acknowledged etiologic risk factors, namely, smoking and alcohol abuse, by promoting cell proliferation.
Relationship between Sinusitis and Adenoid Size in Pediatric Age Group
Authors: Berçin A. Sami , Ural Ahmet , Kutluhan Ahmet , Yurttaş Veysel 
Published: October 2014

Objectives: We sought to examine the relationship between adenoid volume and the stage of rhinosinusitis, as well as the relationship between age and adenoid size. Methods: Forty-two children complaining of nasal discharge, whose paranasal sinus computed tomographic scans had been obtained, were involved in the study. The patients with adenoid enlargement underwent adenoidectomy. The volumes of adenoid vegetation were measured in square centimeters, and paranasal sinus computed tomographic scans were classified according to the Lund-Mackay staging system. Results: No statistically significant difference existed between patients whose Lund-Mackay scores were 0 and those with scores greater than 0. There seems to be no correlation between the Lund-Mackay score and the degree of adenoid vegetation. Conclusions: Adenoid vegetation may cause nasal discharge that is not necessarily due to sinusitis. We could not find any supportive data for the statement “The greater the adenoid tissue, the more extensive the sinusitis.”
Measuring Edema in Irradiated Head and Neck Cancer Patients
Authors: Patterson Joanne M. , Hildreth Anthony , Wilson Janet A. 
Published: October 2014

Objectives: Edema is a common side effect of radiotherapy for head and neck cancer. Systems have been developed to record and monitor changes that occur after radiotherapy. These lack the sensitivity to record edema in specific laryngopharyngeal structures. The aim of this study was to develop a rating scale to measure edema in the larynx and pharynx. Methods: This was an exploratory study to develop a new measure, with the help of an expert panel, assessing interrater and intrarater reliability. A consensus group developed the rating scale. Eleven structures and 2 spaces were identified as areas sensitive to the development of edema. The terms no, mild, moderate, and severe were used to describe the degrees of edema. The scale was piloted and then tested for interrater and intrarater reliability on 5 speech and language therapists. They viewed 25 nasendolaryngoscopic images (23 patients who had had radiotherapy and 2 healthy volunteers). The images were rated with the scale. This process was repeated 1 week later. Results: Images were taken from patients with oral, oropharyngeal, nasopharyngeal, or laryngeal cancer. All had had radiotherapy or chemoradiotherapy. All raters were experienced in viewing larynges via nasendolaryngoscopy. The interrater reliability for scoring the edema rating scale was moderate (weighted kappa, 0.54). Lower levels of agreement were found for the tongue base, valleculae, pharyngeal walls, and anterior commissure. The intrarater reliability was very good (weighted kappa, 0.84). Conclusions: The edema rating scale can be scored with very good test-retest reproducibility and moderate levels of agreement between clinicians. Modifications to the method are suggested to increase interrater reliability.
Age-Related Changes in the Murine Larynx: Initial Validation of a Mouse Model
Authors: Abdelkafy Wael M. , Smith Johnathon Q. , Henriquez Oswaldo A. , Golub Justin S. , Xu Jianguo , Rojas Mauricio , Brigham Kenneth L. , Johns Michael M. 
Published: October 2014

Objectives: Changes in voice are commonly associated with aging (presbyphonia). Age-related voice change significantly impairs elderly individuals' ability to communicate meaningfully with others and affects their quality of life. With changing age demographics in our society and increasing emphasis on quality of life, treatment of presbylaryngis is becoming more paramount. Methods: We used 9 aged and 9 young mice to validate a mouse model for the aging larynx. We stained the larynges with Alcian blue to determine the hyaluronic acid content, trichrome stain to determine the collagen content, and immunohis-tochemical stain for α smooth muscle actin to determine the myofibroblast content. Morphometric measurements were performed for muscle area, muscle thickness, and muscle fiber diameter. Results: Statistically significant differences in the density measurements of hyaluronic acid and collagen reflected decreased hyaluronic acid and increased collagen content in the aging larynx. We found α smooth muscle actin–labeled myofibroblasts only in the aged larynges. No statistically significant differences were found in the morphometric measurements. Conclusions: Aged mice may make a practical model for the age-related changes in the vocal folds that can be used further in studies aiming to correct these changes.
Monitoring Tracheal Tube Cuff Pressures in the Intensive Care Unit: A Comparison of Digital Palpation and Manometry
Authors: Morris Lue G. , Zoumalan Richard A. , Roccaforte J. David , Amin Milan R. 
Published: October 2014

Objectives: Tracheal tube cuff overinflation is a recognized risk factor for tracheal injury and stenosis. International studies report a 55% to 62% incidence of cuff overinflation among intensive care unit (ICU) patients. However, there are no data on tracheotomy tubes, and no recent data from ICUs in the United States. It is unknown whether routine cuff pressure measurement is beneficial. We sought to determine the incidence of cuff overinflation in the contemporary American ICU. Methods: We performed an Institutional Review Board-approved, prospective, observational study of endotracheal and tracheotomy tubes at 2 tertiary-care academic hospitals that monitor cuff pressure differently. At hospital A, cuff pressures are assessed by palpation; at hospital B, cuff pressures are measured via manometry. We audited cuff pressures in an unannounced fashion at these hospitals, using a handheld aneroid manometer. Cuffs were considered overinflated above 25 cm H2O. Results: We enrolled 115 patients: 63 at hospital A and 52 at hospital B. Overall, 44 patients (38%) were found to have overinflated cuffs. The incidence of overinflation was identical at the 2 hospitals (38%; p = .99). Of the endotracheal tubes, 43% were overinflated, as were 32% of the tracheotomy tubes (p = .24). Conclusions: Despite increasing awareness among intensivists and respiratory therapists, the incidence of tracheal tube overinflation remains high, with both endotracheal and tracheotomy tubes. Our finding that the use of manometry to assess cuff pressures did not reduce the incidence of overinflation suggests that a more vigilant management protocol may be necessary.
Injectable Form of Cross-Linked Hyaluronan is Effective for Middle Ear Wound Healing
Authors: Angeli Simon , Connell Sarah , Gibson Brian , Ozdek Ali , McElveen John T. , Van De Water Thomas R. 
Published: October 2014

Objectives: Two studies were designed to investigate a hyaluronan (HA) gel for middle ear (ME) wound healing. Methods: We used a guinea pig model of ME wound healing. In a long-term study, we performed a comparison of hearing and ME inflammation in 3 groups. Group 1 (n = 8) underwent bilateral wounding of ME mucosa and unilateral packing of the ME with HA gel (Sepragel). Group 2 (n = 6) was the same as group 1 except that the packing was absorbable bovine collagen sponges (Gelfoam). Group 3, the control group (n = 14), had operated, unpacked ears. In a short-term study, we investigated ME retention of HA gel at 1 and 2 weeks (n = 16). Results: At 1 week, all ears showed decreased distortion product otoacoustic emissions (DPOAEs) and auditory brain stem responses (ABRs) secondary to ME packing and postsurgical inflammation. The controls recovered preoperative DPOAEs and ABRs by week 2. Group 1 had decreased low-frequency DPOAEs at weeks 2 and 6, but their high-frequency DPOAEs and ABRs recovered to preoperative values by week 6. Group 2 had hearing losses that persisted throughout the study. Group 1 showed normal ME and inner ear histologic characteristics. Group 2 showed inflammatory cells within the ME and cochleas. Group 1 showed less packing retention than did group 2 at week 6 (p = 016). Eighty-five percent of the HA packing remained at 1 week, and 73% at 2 weeks. Conclusions: Hyaluronan gel was a relatively safe and effective ME packing material in our animal model.
Preoperative Staging and Surgical Approaches for Sinonasal Inverted Papilloma
Authors: Oikawa Keita , Furuta Yasushi , Nakamaru Yuji , Oridate Nobuhiko , Fukuda Satoshi 
Published: October 2014

Objectives: We sought to determine the value of preoperative staging by magnetic resonance imaging (MRI) assessment in the surgical management of sinonasal inverted papillomas (IPs). Methods: Preoperative MRI staging was used to assess 22 patients with IPs. In addition to the Krouse staging system, T3 cases were categorized as subgroup T3-B if tumors extended into the frontal sinus or the supraorbital recess; otherwise, they were categorized as T3-A. Standard endoscopic sinus surgery (ESS) was the first choice for T1 and T2 cases. Endoscopic approaches, including ESS combined with endoscope-assisted transantral approach and endoscopic medial maxillectomy, were considered in T3-A cases, and external approaches were considered in T3-B cases. Patients were followed for a minimum of 1 year after surgery. Results: Preoperative MRI staging and postoperative staging were coincident in 21 of the 22 patients (95%). All 8 T2 cases were treated by an endoscopic approach. Of 10 T3-A cases, 9 (90%) were treated by an endoscopic approach and 1 (residual case) was treated by an external approach. All 3 of the T3-B cases underwent an external approach. One T4 case with malignant transformation underwent an external approach followed by radiotherapy. After a median follow-up period of 22 months, none of the 22 patients had had a recurrence. No major complications were observed after endoscopic approaches, but epiphora or hemorrhage requiring transfusion occurred in 3 of the 5 patients (60%) who underwent external approaches. Conclusions: Preoperative staging of IP by MRI is useful for selecting cases that can be managed by endoscopic approaches, resulting in lower rates of tumor recurrence and morbidity.