bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uvulopalatopharyngoplasty: Results of a Patient Questionnaire
Authors: Carpenter Janette M. , LaMear William R. 
Published: October 2014

Objectives: This study was performed to evaluate patient satisfaction after uvulopalatopharyngoplasty (UPPP). Methods: One hundred forty-five patients returned surveys in an otolaryngology group. The patients had undergone UPPP for snoring, sleep apnea, or both between April 1, 2000, and April 5, 2005. Results: Most patients (103; 78%) reported being satisfied with their surgery, and most (96; 71%) stated that they would choose to have the surgery again. Postoperative improvement was reported by 85% of patients who had surgery for snoring alone, 88% of those who had surgery for sleep apnea alone, and 83% of those who had surgery for both. Patients who had a sleep study before surgery had a satisfaction rate of 90.3%, whereas only 62% of those who did not have a sleep study were satisfied. Fifty-three percent of those who had used continuous positive airway pressure still needed it after the operation. Conclusions: Most patients who had UPPP were satisfied and would choose to have the surgery again. The most satisfied patients had sleep apnea or sleep apnea and snoring together, as well as a sleep study before surgery. It is important to emphasize that UPPP does not cure everyone of sleep apnea or snoring and that it may not eliminate the need for continuous positive airway pressure.
EP4 Agonist Inhibits Lipopolysaccharide-Induced Mucus Secretion in Airway Epithelial Cells
Authors: Hattori Reiko , Shimizu Shino , Majima Yuichi , Shimizu Takeshi 
Published: October 2014

Objectives: We examined the in vivo effects of agonists for prostaglandin E2 receptors (EP1, EP2, EP3, and EP4) on mucus hypersecretion. We also examined the in vitro effects of EP agonists on airway epithelial cells. Methods: For the in vivo study, we induced hypertrophic and metaplastic changes of goblet cells in rat nasal epithelium by intranasal lipopolysaccharide (LPS) instillation. For the in vitro study, we used NCI-H292 cells and cultured human nasal epithelial cells. Results: Subcutaneous injection of the EP4 agonist (1 to 100 μg/kg) dose-dependently inhibited LPS-induced mucus production and neutrophil infiltration. The EP3 agonist (100 μg/kg) also had some inhibitory effects on mucus production, whereas the EP1 and EP2 agonists showed no effect. The LPS-induced mucus secretion was significantly inhibited by the EP3 and EP4 agonists at 10−6 mol/L in cultured epithelial cells. The LPS-induced interleukin-8 secretion was also inhibited by the EP3 and EP4 agonists. Conclusions: These results indicate that the EP4 agonist inhibited LPS-induced airway mucus hypersecretion directly or indirectly through the suppression of interleukin-8 secretion and neutrophil infiltration.
Effect of Fibroblasts on Epithelial Regeneration on the Surface of a Bioengineered Trachea
Authors: Nomoto Yukio , Kobayashi Ken , Tada Yasuhiro , Wada Ikuo , Nakamura Tatsuo , Omori Koichi 
Published: October 2014

Objectives: Our group applied a tracheal prosthesis, which was composed of polypropylene as the frame and collagenous sponge as the scaffold, to the first human case and had successful results. The objective of this study was to find a way to acquire more rapid re-epithelialization with fibroblasts on this tracheal prosthesis. Methods: Tracheal epithelial cells, which were isolated from the trachea of rats, were suspended in a collagenous gel. The collagenous gel with fibroblasts was layered on a collagenous sponge. The grafts of this “bioengineered trachea” were implanted into tracheal defects of rats, and the regenerated epithelium on the grafts was histologically examined. Results: Seven days after implantation, stratified squamous epithelium covered almost all of the surface of the gel, and some of the implanted fibroblasts in the gel were lined up just below the epithelium. Fourteen days after implantation, columnar and cuboidal ciliated epithelium covered almost all of the surface of the defects, and the implanted fibroblasts had disappeared. The numbers of regenerated epithelial cells at 14 days after implantation were larger than those of control models without fibroblasts, with statistical significance. Conclusions: The results suggested that the grafts of bioengineered trachea composed of collagenous sponge and collagenous gel with tracheal fibroblasts accelerated epithelial differentiation and proliferation in vivo.
Current State of Scanning Micromanipulator Applications with the Carbon Dioxide Laser
Authors: Remacle Marc , Lawson Georges , Nollevaux Marie-Cécile , Delos Monique 
Published: October 2014

Objectives: The development of the scanning system AcuBlade has considerably enhanced carbon dioxide laser energy delivery, improving cutting and ablation modes. The scanning system can be applied with the 2 available high-powered pulsed waves, SuperPulse and UltraPulse. This study was conducted to determine whether there are any differences in phonosurgery between the SuperPulse and UltraPulse lasing applications with regard to thermal diffusion into the surrounding tissues, healing time, and clinical results. Methods: Thirteen patients with bilateral and similar vocal fold lesions underwent operation — One side in SuperPulse mode and the other side in UltraPulse mode. The parameters for phonosurgery were depth of 0.2 mm, 10 W, single pulse, and 0.10 second for SuperPulse, and 2 passes, 10 W, single pulse, and 0.10 second for UltraPulse. Results: Incisions were sharper with UltraPulse, making the surgery easier, but at the first postoperative follow-up visit, after 8 to 10 days, no differences were observed in the presentation, the healing, or the vibration of the 2 vocal folds. Coagulation along the incision line was 25 μm for SuperPulse and 15 μm for UltraPulse (median values). Conclusions: In comparison with SuperPulse, the UltraPulse carbon dioxide laser made the procedure easier, but did not improve the clinical outcome.
Multicenter Registry of Balloon Catheter Sinusotomy Outcomes for 1,036 Patients
Authors: Levine Howard L. , Sertich Anthony P. , Hoisington Douglas R. , Weiss Raymond L. , Pritikin Jordan ,   for the PatiENT Registry Study Group
Published: October 2014

Objectives: This study assesses the safety and effectiveness of balloon catheters used as instruments in sinus surgery in a “real-world” multicenter registry of 1,036 patients across 27 US otolaryngology practices. Methods: Data were collected by standardized chart review with centralized database administration for all consecutive functional endoscopic sinus surgeries that included the use of balloon catheters across the 18-month time period from December 2005 to May 2007. Results: Balloon catheters were used in 3,276 peripheral (maxillary, frontal, and sphenoid) sinuses, for an average of 3.2 sinuses per patient. There were no major adverse events related to the use of balloon catheter instruments. The revision rate was 1.3% of sinuses treated with a balloon catheter after an average follow-up of 40.2 weeks. Sinus symptoms were improved in 95.2%, unchanged in 3.8%, and worse in 1.0% of patients. Postoperative sinus infections were significantly less frequent and less severe compared to infections before surgery. The results were consistent across all patient categories, including balloon-only patients and revision patients. Conclusions: Use of balloon catheters as instruments in sinus surgery appears to be relatively safe and effective and to improve the patient's quality of life. The results are consistent and generalizable across a wide range of sinusitis patients and physician practices. The complication rates, revision rates, and patient symptom improvement rates all compare favorably with previously reported results of functional endoscopic sinus surgery.
Role of Sialoscopy in the Treatment of Stensen's Duct Strictures
Authors: Koch Michael , Iro Heinrich , Zenk Johannes 
Published: October 2014

Objectives: The origin of strictures of Stensen's duct often remains unclear, but chronic recurrent parotitis may be one associated disease. Failure of conservative therapy leads to a recommendation of parotidectomy in a high percentage of cases. Nowadays, development of new, minimally invasive methods may lead to a fundamental change in the treatment regimen. Methods: We retrospectively evaluated 39 patients who presented with symptomatic strictures of Stensen's duct from 2002 to 2005. Sialoscopy was performed with semirigid endoscopes. Therapy consisted of irrigation and intraductal infusion of cortisone. If possible, interventional sialoscopy was carried out as the first-line procedure. If indicated, operative procedures of the duct were performed. Results: After irrigation and intraductal medication, 17.9% of the patients were free of symptoms. Interventional sialoscopy was carried out in 74.4%, with a success rate of 75.9%. Operative duct procedures (extended papillotomy or resection of papilla stricture with duct reinsertion) were carried out in 23% of cases. In 5.1% of the total cases, parotidectomy was unavoidable. Conclusions: Sialoscopy-based methods play a central role in gland-preserving treatment of strictures of Stensen's duct. Sialoscopy has proven to be a fast, useful, and relatively safe therapeutic tool with a high success rate. Parotidectomy is the last choice in symptomatic cases.
Acute Myopericarditis Complicating Acute Tonsillitis: Beware the Young Male Patient with Tonsillitis Complaining of Chest Pain
Authors: Talmon Yoav , Gilbey Peter , Fridman Nancy , Wishniak Alice , Roguin Nathan 
Published: October 2014

Objectives: We describe 11 cases of myopericarditis complicating bacterial tonsillitis. Methods: We performed a retrospective study of all cases of myopericarditis treated at one hospital during the years 2005 and 2006. Results: The patients were all young men. The average latency from the onset of throat pain to the onset of chest pain was 4.6 days. All patients complained of chest pain. The most common electrocardiographic finding was transient ST segment elevations. The levels of cardiac enzymes and troponin were elevated in all cases. Conclusions: Otolaryngologists should be aware of this rare entity. Additional studies are indicated to evaluate the exact incidence of myopericarditis associated with acute streptococcal tonsillitis.
Concurrent Influenza A and Group A Beta-Hemolytic Streptococcal Pharyngotonsillitis
Authors: Brook Itzhak , Gober Alan E. 
Published: October 2014

Objectives: A concurrent group A β-hemolytic Streptococcus (GABHS)–influenza virus pharyngotonsillitis (PT) is generally not considered in diagnoses, even though mixed bacterial-viral infections are common in other respiratory tract infections. This report describes our experience in diagnosing a potential mixed GABHS–influenza virus PT in children. Methods: Acute and convalescent antistreptolysin O (ASO) and anti-DNase B titers were obtained from 12 children with acute PT and clinical presentation that suggested viral infection, and in whom both rapid influenza A virus and rapid GABHS tests were positive. Results: The children did not receive any antimicrobial therapy, and all recovered from their acute PT within 2 to 5 days and were all asymptomatic upon their return visit 3 to 4 weeks later. GABHS was recovered from 2 of the children on their return visit. However, ASO and anti-DNase B titers were not elevated in these individuals. The ASO and anti-DNase B titers determined in the first serum samples were less than the age-adjusted normal values for all of the children. However, these titers rose by at least two-dilution (0.2 logarithm) in the convalescent sera as compared with the acute ones in 4 of the 12 children (33%). One of the 8 children who had no increase in ASO and anti-DNase B titers had an acute GABHS PT 5 months later. One-year follow-up of all of the children showed no anomalies. Conclusions: This report is the first to describe a concomitant GABHS and influenza A virus PT, as evident by increased ASO and anti-DNase B titers in a third of the patients who had both of these organisms detected in their upper airways.
Management of Neurologic Disorders of the Larynx
Authors: Woodson Gayle 
Published: October 2014

Objectives: I review the literature on management of neurologic disorders of the larynx. Methods: I reviewed the literature on laryngeal physiology, clinical evaluation of laryngeal function, and the clinical presentation and treatment of neurologic disorders that frequently affect the larynx. Results: Laryngeal function is complex, as this organ is important in breathing, speech, and swallowing. Coordination of these roles is very susceptible to disruption by neurologic disorders. Diagnosis of neurologic disease is primarily based on history and physical examination; however, the diagnosis of laryngeal dysfunction is frequently overlooked, because the larynx is not easily accessible to examination by non-otolaryngologists. Evaluation of laryngeal function includes listening to the voice, systematic observation of the larynx during speech and nonspeech tasks, and, sometimes, ancillary tests. Neurologic disorders that affect laryngeal function include Parkinson's disease, essential tremor, stroke, amyotrophic lateral sclerosis, multiple sclerosis, and dystonia. The otolaryngologist can sometimes provide treatment to specifically improve symptoms of laryngeal involvement. Conclusions: Otolaryngology consultation is important in the diagnosis and treatment of neurologic disorders that affect laryngeal function. The otolaryngologist should be able to perform a systematic evaluation of laryngeal and pharyngeal function, and should be aware of the clinical presentation of neurologic disorders that affect the larynx.
Should a Hearing Aid in the Contralateral Ear Be Recommended for Children with a Unilateral Cochlear Implant?
Authors: Beijen Jan-Willem , Mylanus Emmanuel A. M. , Leeuw A. Rens , Snik Ad F. M. 
Published: October 2014

Objectives: To predict bimodal benefit before cochlear implantation, we compared the performances of participants with bimodal fitting and with a cochlear implant alone on speech perception tests. Methods: Twenty-two children with a cochlear implant in one ear and a hearing aid in the other (bimodal fitting) were included. Several aided and unaided average hearing thresholds and the aided word recognition score of the hearing aid ear were related to the bimodal benefit on a phoneme recognition test in quiet and in noise. Results with bimodal fitting were compared to results with the cochlear implant alone on a phoneme recognition test in quiet and in noise. Results: No relationship was found between any of the hearing thresholds or the aided phoneme recognition score of the hearing aid ear and the bimodal benefit on the phoneme recognition tests. At the group level, the bimodal scores on the phoneme recognition tests in quiet and in noise were significantly better than the scores with the cochlear implant alone. Conclusions: Preoperatively available audiometric parameters are not reliable predictors of bimodal benefit in candidates for cochlear implantation. Children with unilateral implants benefit from bimodal fitting on speech tests. This improvement in performance warrants the recommendation of bimodal fitting even when bimodal benefit cannot be predicted.
Clinical Experience with Gray's Minithyrotomy Procedure
Authors: Paniello Randal C. , Sulica Lucian , Khosla Siddarth M. , Smith Marshall E. 
Published: October 2014

Objectives: Endoscopic approaches for submucosal vocal fold surgery may limit the surgeon's ability to release scars or to precisely implant filler material such as fat. In 1999, Gray et al described the “minithyrotomy” approach to this region. Technical aspects of this important new technique, clinical indications, and early results are reviewed. Methods: We performed a retrospective review and compiled the data of the office records, clinical notes, and videostroboscopic examinations of all of the four authors' patients who underwent this procedure. Results: Twenty-one patients underwent 22 minithyrotomy procedures for vocal fold scarring (6), lateralizing scar following polytetrafluoroethylene removal or trauma (5), scar with radiation fibrosis (2), sulcus vocalis (2), or presbylarynx or bowing (6) — Bilaterally in 14 operations and unilaterally in 8. There were 13 male patients and 8 female patients, with a mean age of 58.3 years (range, 22 to 87 years). The mean follow-up was 9.1 months (range, 1 to 46 months). After submucosal vocal fold exploration, autologous fat was implanted in 20 of the 21 patients. Postoperative videostroboscopy demonstrated improved mucosal pliability in 19 cases and improved glottal closure in 20 cases. Most patients noted voice improvement. Complications were minimal. Conclusions: Gray's minithyrotomy is a highly effective approach for treating vocal fold scar processes, bowing, sulcus vocalis, and, potentially, other conditions.
Cidofovir Efficacy in Recurrent Respiratory Papillomatosis: A Randomized, Double-Blind, Placebo-Controlled Study
Authors: McMurray J. Scott , Connor Nadine , Ford Charles N. 
Published: October 2014

Objectives: We performed a prospective, double-blind, placebo-controlled, longitudinal adjuvant therapy trial to determine the efficacy of cidofovir in the treatment of severe recurrent respiratory papillomatosis (RRP). Although results of case series suggest that cidofovir may decrease the frequency and rapidity of papilloma regrowth, no blinded placebo-controlled studies have demonstrated efficacy. Methods: Adults and children (n = 19) with aggressive RRP received either active drug (cidofovir) or placebo. When surgical intervention was needed, drug or placebo was injected into affected areas after surgical removal of disease. The following measures were made at baseline and at 2-month intervals for the course of 12 months: Derkay papilloma severity grading scale, Voice Handicap Index, Health-Related Quality of Life, and total number of procedures performed over 12 months. Results: At 2- and 12-month follow-ups, there was a significant (p < .05) improvement in the Derkay Severity Score within the cidofovir and placebo groups, but no difference between groups, and no difference between groups in the number of procedures performed. Significant improvement was found in Voice Handicap Index scores in the cidofovir group at the 12-month follow-up. No differences were seen in Health-Related Quality of Life. Conclusions: A randomized, blinded, placebo-controlled trial is necessary in the study of RRP, because the natural history of the disease can include remissions and reactivations. We found a significant improvement in the Derkay Severity Score 12 months after the baseline assessment in patients treated with cidofovir. This effect, however, was also seen in the placebo group. Accordingly, we were unable to provide proof of efficacy of cidofovir in the treatment of RRP.
Effect of Changing Airway Pressure on the Ability of the Human Nose to Warm and Humidify Air
Authors: Sahin-Yilmaz Asli , Baroody Fuad M. , deTineo Marcy , Cuttance Georgina , Makinson Doug , Pinto Jayant M. , Naureckas Edward T. , Naclerio Robert M. 
Published: October 2014

Objectives: Nasal continuous positive airway pressure (CPAP) treatment causes nasal symptoms that are believed to result from the drying effects of the air on the nasal mucosa, and these symptoms affect compliance with therapy. We hypothesized that the increased air pressure on the nasal mucosa caused by positive pressure from CPAP would decrease the ability of the nose to warm and humidify inspired air, explaining these symptoms. Methods: We performed a 4-way crossover trial using CPAP pressures of −5, 0, +5, and +10 cm H2O in 10 subjects. The ability to warm and humidify inspired air was determined by measurement of the temperature of a fixed volume of cold, dry air entering and exiting the nostril and calculation of the amount of water supplied to the airstream by the nose. Results: The water content of air was unaffected at the pressures studied. Conclusions: The pressure of delivered CPAP does not affect the ability of the nose to warm and humidify inspired air.
Observations on Bilateral Symmetry of the Stapedial Footplate Lesion and Narrowing of the Oval Window Niche in Otosclerosis
Authors: Gristwood Ronald Edward , Bedson Janet 
Published: October 2014

Objectives: We consider whether patients with bilateral otosclerosis who have surgery on their second ear show symmetry in the degree of severity of their footplate otosclerosis. Methods: The severity of the stapedial otosclerotic lesion and the degree of narrowing of the oval window niche by exostoses were recorded for each ear of 269 patients who elected to undergo operation on the second ear. The severities and similarities of the otosclerotic lesion affecting the oval window niche were compared between the ears. Results: The majority of oval window niches were normal in width in both ears. A niche narrowed to less than 0.8 mm in diameter was rare and tended to affect both ears (5.6% first ears and 5.95% second ears; χ2 = 134.6 on 4 df; p < .0001). The degree of footplate otosclerosis was classified and amalgamated into 3 broad categories: Minor (47.2%), moderate (21.6%), and severe (31.2%). A high degree of bilateral symmetry of the stapedial footplate lesion was found (χ2 = 162.2 on 4 df; significant at .0001 level). Conclusions: The findings at the oval window of the first ear in regard to the severity of otosclerotic involvement of the stapes footplate and narrowing of the niche by exostoses do allow a fair prediction of the pathological findings in the second ear, if that ear is suitable for stapes surgery and the patient elects to have an operation. The surgeon is forewarned of possible difficulties and technical challenges if an operation has been performed on the first ear.
Long-Term Results of Laryngeal Suspension and Upper Esophageal Sphincter Myotomy as Treatment for Life-Threatening Aspiration
Authors: Kos Martijn P. , David Eric F. L. , Aalders IJke J. , Smit C. Frits , Mahieu Hans F. 
Published: October 2014

Objectives: We evaluated the long-term results of laryngeal suspension and upper esophageal sphincter (UES) myotomy in patients with life-threatening aspiration. Methods: In the period 1995 to 2004, 17 patients with severe aspiration caused by insufficient laryngeal elevation and absent or negligible pharyngeal constrictor muscle activity during deglutition resulting in aspiration pneumonia were surgically treated with a laryngeal suspension procedure and UES myotomy. Preoperative and postoperative videofluoroscopy was performed to assess swallowing and aspiration. Results: In 9 of the 17 patients, long-term (more than 1 year) full oral intake without aspiration was achieved. Three other patients demonstrated improvement of deglutition with partial restoration of oral intake with adjusted food consistency, but remained partly dependent on gastrostomy feeding for adequate nutrition. Two patients no longer had cases of aspiration pneumonia, but were unable to achieve even modified oral intake. Three patients finally underwent total laryngectomy — 2 of them after initial successful full oral intake without aspiration but with recurrent aspiration as a result of progression of neuromuscular disease. None of the patients succumbed to aspiration pneumonia. Conclusions: In most of our patients, life-threatening aspiration was successfully treated by UES myotomy and laryngeal suspension with restoration of oral intake.