bluuebunny/crossref_metadata_2025_split huggingface dataset:
Balloon Dilatation for the Frontal Sinus
Authors: Pace‐Asciak Pia , Hathorn Iain F. , Sunkaraneni Vishnu , Chen Rui , Habib Al , Javer Amin R. 
Published: February 2015

Objective1) To evaluate frontal sinus ostia patency after balloon dilation with the Ventera Sinus Diltation System (which has not been tested before) compared with traditional frontal sinusotomy. 2) To compare the mean blood loss and the mean surgical time for frontal sinusotomy during balloon dilatation compared with traditional methods.MethodA single‐blinded, randomized, controlled, prospective study of 30 patients will be conducted. Patients undergoing FESS for chronic rhinosinusitis are randomized to balloon dilation of 1 frontal sinus and traditional frontal sinusotomy on the opposite sinus. Patients act as their own controls. Ostial patency and size will be assessed 5 weeks, 3 months, and 6 months postoperatively using endoscopy and curved suctions.ResultsOur initial results in 19 patients are promising. All frontal sinus ostia in both groups were successfully opened and 100% were patent with both techniques at 5 weeks and 3 months postoperatively. Balloon dilatation shows a mean surgical time of 10 minutes compared with 18 minutes in traditional FESS. Mean blood loss is less with balloon dilatation (54 mL vs 86 mL).ConclusionThe initial findings suggest the Ventera Sinus Dilation System is easy to use and successfully dilates the frontal sinus ostia quicker and with less blood loss. Also, short‐term patency appears to be comparable to traditional frontal sinusotomy.
Chordomas and Chondrosarcomas of the Clivus
Authors: Hermann Diego R. , Balsalobre Leonardo , Balieiro Fernando O. , Weber Raimar , Stamm Aldo E. C. 
Published: February 2015

ObjectiveTo report chordomas and chondrosarcoma cases treated with endoscopic assisted transnasal transclival approach.MethodRetrospective case series of 26 patients with clivus chordomas and 2 patient with chondrosarcoma, treated between 1996 and 2011 at a tertiary referral center using the endoscopic assisted transnasal‐transclival approach. The extension of the surgical procedure was classified in gross‐total, subtotal and partial resection. Eighteen were primary cases and 10 had previous operation. The most common symptoms was diplopia (VI nerve palsy: 61%), all regions involved by the tumor were reported. Patients were submitted to endoscopic assisted transnasal‐transclival (TN‐TC) approach with or without transpterygoidal (TP) approach. Four patients were also submitted to petrous approach.ResultsIn patients who presented chordomas/chondrosarcomas (28 cases), range of surgical resection was: in 14 patients (50%) gross total resection, in 7 (25%) subtotal removal, and in 7 (25%) partial removal. In 10 cases there was tumor extension to posterior fossa, and 6 cases achieved gross total resection. Postoperative complications were: CSF leak (6 cases), 5 of them before using the nasal septal flap. Meningitis (3 cases). Pneumoencephalus (2) and 3 deaths.ConclusionEndoscopic assisted transnasal surgery is an alternative way to treat these cases and in expert hands this technique can obtain good results. The extent of resection was better in cases without previous surgery than in reoperation cases. Posterior fossa invasion was not a restriction factor to gain a gross total resection, using this technique. Complication as CSF leak dropped dramatically after skull base reconstruction using the triple “F”(fat, fascia and nasal septal flap).
Modified Endoscopic Frontal Sinus Surgery
Authors: Ma Yanhong , Tan Guolin 
Published: February 2015

ObjectiveTo modify the endoscopic frontal sinus surgery and improve the therapeutic effect of recurrent chronic frontal sinusitis.MethodEndoscopic frontal sinus surgery through an approach of frontomaxillary process‐agger nasi (FPA) was carried out in 51 patients with recurrent frontal sinusitis.The therapeutic effect was prospectively evaluated with statistically validated measures of sinusitis‐specific quality of life (SNOT20).ResultsBoth 6 and 12 months after surgery significant improvements were found in sinus specific health status, including a reduction of total score of SNOT20 and mean score of identified 5 important symptoms (P <. 05). The globe evaluation showed “Much improved” in 35 patients (68.6%), “Improved” in 9 patients (17.6%), and “Not improved” in 7 patients (13.7%). An overall frontal sinus patency rate was achieved in 85% patients.ConclusionEndoscopic frontal sinus surgery through an approach of FPA is a brief, less invasive endoscopic procedure to treat the recurrent chronic frontal sinusitis.
Vertical Dome Division: A Quality‐of‐Life Outcome Study
Authors: Lavinsky‐Wolff Michelle , Camargo Humberto L. , Manzini Michelle , Romanczuk Sabrina , Pizzoni Rodrigo , Dolci Jose E.L. , Polanczyk Carisi A. 
Published: February 2015

ObjectiveTo assess quality‐of‐life outcomes in patients undergoing vertical dome division technique using a validated instrument, the Rhinoplasty Outcome Evaluation (ROE).MethodPatients undergoing primary cosmetic and functional rhinoseptoplasty using vertical dome division were consecutively evaluated from December 2010 through October 2011 at a facial plastic clinic of a tertiary center in Brazil. During surgery patients were classified as normal‐, thin‐, or thick‐skinned. ROE and 100‐mm visual analogue scales (VAS) were administered pre‐ and postoperatively.ResultsThirty‐one patients were included, and all answered pre‐ and postoperative questionnaires. Mean age was 31 ± 13 years, 18 (58%) were female, and mean follow‐up was 92 days (range 30‐191). ROE scores was higher postoperatively (75 [±16] vs 32 [±18]; P <. 001). Post‐ and preoperative ROE and VAS variation were 42 (±17) and 68 (40‐81), P <. 001. Postoperative ROE scores were similar among normal or thin‐skinned and thick‐skinned patients (78 [±13] vs 69 [±19]; P =. 123). VAS postoperative scores were higher among normal or thin skinned (90 mm [77‐100]) than among thick‐skinned patients (69 mm [51‐93]; P =. 008). Follow‐up is ongoing.ConclusionOur preliminary results demonstrated that vertical dome division is a versatile technique to nasal tip refinement that resulted in improvement of rhinoplasty‐related short‐term quality‐of‐life outcomes. Skin thickness does not seem to be a condition for using vertical dome division technique. Follow‐up is still ongoing.
Systematic Review: The Rhinological Manifestations in Women
Authors: Pace‐Asciak Pia , Kozak Frederick K. , Chadha Neil K. 
Published: February 2015

Objective1) To understand the current evidence between the effects of pregnancy, postpartum, menopause, contraception, and hormone replacement therapy (HRT) on diseases of the nose. 2) To appraise the level of evidence in the current literature.MethodSystematic search strategy using PubMed (1966‐2011) and EMBASE (1980‐2011) was done to study diseases of the nose in women during different stages of life. Study appraisal and data extraction were performed independently by 2 authors. The level of evidence was categorized according to the Oxford Center of Evidence‐Based Medicine.ResultsTitles and abstracts of 1005 studies from PubMed and 1756 studies from EMBASE were reviewed, resulting in 429 being retrieved. Included articles were categorized as related to pregnancy, postpartum, menopause, contraception, or hormone replacement therapy with the following findings: Pregnancy: changes reported in olfaction (12 studies), allergy (30 studies), rhinitis (25 studies), epistaxis (8 studies), tumor growth (31 studies), Wegener’s (23 studies), and Churg‐Strauss disease (8 studies); Postpartum: effects included allergic rhinitis (20 studies), altered olfaction (7 studies), choanal atresia with drug ingestion (5 studies), and nasal tumors (8 studies); Menstruation: alteration in olfaction (17 studies), rhinitis (7 studies), and allergy (3 studies); Menopause: rhinitis (5 studies); HRT: alteration in olfaction (3 studies), and rhinitis (11 studies); and Estrogen therapy: considered for recurrent epistaxis (15 studies).ConclusionThe various stages of life in women have been shown to have impact on nasal pathophysiology, altering olfaction and increasing epistaxis, allergic symptoms, tumor growth, and auto‐immune disease.
Temporary Sphenopalatine Artery Occlusion: A Cadaver Study
Authors: Fitzgerald Patrick J. 
Published: February 2015

ObjectiveTo assess the ability of a surgical device (SinuStat, Sinocclusive LLC) to temporarily occlude flow in the sphenopalatine artery in the human cadaver model.MethodThe experiment was performed on January 28, 2012, in the setting of a fully accredited ambulatory surgical suite. A human cadaver model simulating hydraulic pressure of 100 mm Hg in the maxillary artery was obtained by cannulating this artery via external dissection to the infratemporal fossa. The sphenopalatine artery and its immediate branches were identified endoscopically and perforated distal to the foramen with a 21G spinal needle. Control (without device in place) and study (with device in place) flow were evaluated endoscopically for the amount of penetration to the nasal cavity of dye‐enhanced normal saline. Four sequential insertions and removals of the device were tested.ResultsThe placement of the SinuStat device into the sphenopalatine foramen, compared to control flow, resulted in complete or near complete cessation of flow in 4 of 4 insertions.ConclusionIn the model studied, the SinuStat temporary sphenopalatine artery occlusion device completely or near‐completely occludes flow from the sphenopalatine artery when subjected to a static hydraulic pressure of 100 mm Hg. Use of the SinuStat device in endonasal procedures is thus anticipated to completely or near‐completely occlude blood flow through the sphenopalatine artery at mean arterial pressures around 100 mm Hg. More studies will be required to determine the impact this will have on the quality of the surgical field during endonasal surgery.
Safety of Outpatient Surgery for Obstructive Sleep Apnea
Authors: Baugh Reginald F. , Burke Bonnie , Fink Brian , Garcia Richard , Kominsky Alan , Yaremchuk Kathleen L. 
Published: February 2015

ObjectiveThis retrospective cohort study of adult Medicaid obstructive sleep apnea (OSA) patients undergoing head and neck airway surgery sought to determine their safety experience. Physicians will: 1) Gain insight into inpatient and ambulatory management considerations for OSA. 2) Understand how administrative data sets can be used to answer quality questions.MethodFour hundred fifty‐two patients (404 ambulatory, 48 inpatient) receiving head and neck airway surgery from 01/01/2009 to 06/30/2011. Four safety indicators were reported from administrative data for 30 days: ER visit, inpatient admission, observation day, and 3 or more PCP visits. MI, DVT, stroke, PE, tracheostomy, or transfusions were noted.ResultsOSA subjects (3.29 ambulatory, 3.78 inpatient) had greater risk scores (sicker) than plan members (P <. 05). The majority (89%) of the surgeries were ambulatory. No difference in safety indicator rates was identified between ambulatory and inpatient groups (P >. 61). ER visit was the most common adverse outcome (19% overall). Median time to first ER visit was significantly longer among ambulatory patients (7 days) than inpatients (3 days) (P =. 03). The observed catastrophic complication rate among ambulatory patients was zero (95% CI: 0.0%‐1.1%). Administrative data sets can be used to provide insight into practice safety questions.ConclusionContrary to guidelines, OSA patients are undergoing ambulatory head and neck airway surgery. Administrative data sets can be used to provide insight into practice safety questions. Further study is warranted of ambulatory surgery management of adult sleep apnea patients.
Sleep Architecture Patterns in Enuretic Children with OSA
Authors: Thottam Prasad J. , Kovacevic Larisa , Madgy David , Abdulhamid Ibrahim 
Published: February 2015

ObjectiveNocturnal enuresis (NE) has been described in children with obstructive sleep apnea (OSA) related to adeno‐tonsillar hypertrophy. For those affected adeno‐tonsillectomy has demonstrated to improve both NE and OSA in many patients. Our objective is to determine if preoperative sleep architecture is associated with complete resolution of NE after adeno‐tonsillectomy.MethodA prospective study of 18 pediatric patients (1/2011‐2/2012) with primary NE who underwent adeno‐tonsillectomy for OSA was conducted. Both preoperative polysomnograms (PSG) and pre‐ and postoperative reports of NE were recorded. Resolved vs unresolved postoperative nocturnal enuresis (RNE vs UNE) was the outcome evaluated. Data was assessed via chi‐square/t test analyses.ResultsMean child age was 8.28 (SD = 2.3 years). All children reported presurgical primary NE. No RNE vs UNE age/gender differences were identified. Postsurgery, over half of participants reported NE resolution. Significant improvement of NE was identified in children with higher preoperative AHIs (RNE mean = 21.4; UNE mean = 3.6; t = 2.33, P =. 03) and lower preoperative oxygen saturations (RNE lowest % = 78.1; UNE lowest % = 89.6; t = 2.72, P =. 03). All children with prolonged stage 2 sleep reported postsurgical NE resolution, whereas two‐thirds of the children with prolonged delta sleep and all with above normal REM reported persistent postsurgical NE.ConclusionAdeno‐tonsillectomy is a treatment option for OSA with NE. Preliminary data demonstrates that children with high AHIs, significant oxygen desaturations, and abnormally prolonged stage 2 sleep have a high resolution rate of NE postoperatively. There are significant differences in preoperative sleep architecture between UNE and RNE patients with OSA.
Section for Residents and Fellows‐in‐Training Survey Results
Authors: Kelley Kanwar , Rosenberg Tara L. , Dowdall Jayme R. , Liu Jeffrey C. , Raol Nikhila P. , Zafereo Mark E. 
Published: February 2015

Objective1) To present data from the Section for Residents and Fellows‐in‐Training (SRF) annual survey from 2002‐2011. 2) To compare and analyze trends in resident demographics and posttraining career choices.MethodWe conducted a retrospective review of data from surveys distributed between 2002 and 2011. Respondent demographic data including age, postgraduate year, gender, and geographic distribution were analyzed. Responses about training experiences, fellowship selection, debt burden, and posttraining practice choice were studied in order to elicit trends.ResultsRespondents have consistently rated otolaryngology, anesthesia, and trauma/critical care as the most important intern rotations for otolaryngology residents. Each year, approximately 70% of respondents have reported interest in pursuing a fellowship. Pediatric otolaryngology fellowship is now the most popular fellowship among respondents. There has been a recent increase in the percentage of respondents who are interested in pursuing a career in academics. Location, family, and lifestyle have consistently been the most important factors in determining choice of practice. Respondents have reported increasing levels of educational debt over the 10 years of the survey.ConclusionThe AAO‐HNS SRF survey is an opportunity to collect important data regarding resident/fellow training. Several factors limit the generalizability of these results. Despite its limitations, these unique data provide valuable information for continual evaluation and improvement of physician training in the specialty.
Self Ear Cleaning among Educated Young Adults in Nigeria
Authors: Olaosun Adedayo O. , Ayeni Olusola , Fawole O. I. , Olaosun Oluwafunmilayo A. 
Published: February 2015

ObjectiveThe objectives of this study are: 1) Determine prevalence of “self‐ear‐cleaning” and of “ear symptoms” among educated young adults in Nigeria. 2) Identify materials and reasons for self‐ear‐cleaning. 3) Determine association between socio‐demographic characteristics and self‐ear‐cleaning. 4) Determine association between self‐ear‐cleaning and “ear symptoms.”MethodIn a cross‐sectional study in November 2011, semi‐structured questionnaires were administered to subjects recruited by stratified random sampling from a youth camp. Outcome variables were “self‐ear‐cleaning” and “ear symptoms” while independent variables were sociodemographic and “personal history” variables. Statistical analysis employed univariate, bivariate, and multiple regression techniques.ResultsA total of 1012 subjects were studied (M:F = 1.05:1). Prevalence of self‐ear‐cleaning was 93.4%, cotton buds were most commonly used (91.5%), and the most common reasons were health reasons (50.9%). Prevalence of ear symptoms was 34.1%; 79.3% had never visited a doctor for ear complaints. No significant association existed between self‐ear‐cleaning and ear symptoms (χ2– 0.135, P‐.713) or visit to doctor for ear complaints (χ2−0.858, P‐.354). Although significant associations existed between self‐ear‐cleaning and sex, religion, geopolitical zone, parent’s education, and family members’ practice, opinion that the practice is harmful (OR 0.1, P‐.005) and father’s self‐ear‐cleaning (OR‐28.485, P‐.001) were the only significant predictors of self‐ear‐cleaning.ConclusionThe prevalence of self‐ear‐cleaning in this study and the lack of significant association with the occurrence of ear symptoms challenges traditional thinking. It raises questions about the extent to which self‐ear‐cleaning actually contributes to the development of ear disease. More studies are urgently needed to determine the true relationship.
CCR7 Expression Predicts Cervical Metastasis in Oral Squamous Cell Carcinoma
Authors: Ledgerwood Levi G. , Tinling Steven , Gandour‐Edwards Regina , Farwell D. Gregory 
Published: February 2015

Objective1) Determine whether expression of the chemokine receptor CCR7 is associated with an increased likelihood of cervical lymph node metastasis in oral squamous cell carcinoma. 2) Explore the significance of CCR7 expression in the localization of squamous cell carcinoma cells within the primary tumor and metastatic lymph nodes.MethodTissue samples from primary tumors and cervical metastases of patients with oral squamous cell carcinoma were compared for their expression of CCR7 through immunohistochemistry. CCR7 expression was assessed in 30 primary tumor samples from patients without cervical metastases and compared to 30 samples from patients with metastases.ResultsCCR7 expression was found to be significantly higher in squamous cell carcinoma samples from patients with cervical lymph node metastases. Primary tumors of patients with cervical metastases showed significantly higher CCR7 staining, χ2 = 16.936, P <. 001. N0 patients showed small foci of CCR7 positivity while tumors from N+ patients showed large areas of CCR7 positivity.When examining the lymph nodes with metastatic cancer, all patients showed CCR7 expression (30/30 N+ patients). Especially high levels were seen in cells surrounding lymphovascular structures.ConclusionCCR7 expression levels are associated with increased likelihood of cervical metastases of squamous cell carcinomas, suggesting a role for this receptor in lymphatic invasion. This finding may provide a novel diagnostic tool to predict the risk of occult lymphatic metastasis in patients with oral squamous cell carcinoma.
Effects of Copper Tripeptide on Healing Irradiated Tissues
Authors: Parker Noah P. , Ardeshirpour Farhad , Schmechel Stephen , Lassig Amy Anne D. 
Published: February 2015

ObjectiveTo evaluate clinical and immunohistochemical effects of topical copper tripeptide (GHK‐Cu) on wound healing in an in vivo irradiated rat model.MethodAfter dorsal radiation to a human‐equivalent‐dose of 66.67 gray and a recovery period, 2x8‐cm cranially based dorsal flaps were created. Twice daily GHK‐Cu (test) or Eucerin (control) was applied for 10 days. Animals were euthanized, digital images of flaps were taken, and harvested tissues were stained for vascular endothelial growth factor (VEGF).ResultsThirteen test and 10 control animals were included. Photographs were converted to binary to calculate total pixels within the necrotic region and area of ischemia. The mean ischemic areas were 5.0 cm2 (standard deviation 0.9) for tests and 3.8 cm2 (1.1) for controls, which were significantly different (P =. 01). Digitized slides allowed for calculation of the percent of pixels reaching specific brown calorimetric thresholds and for an intensity staining score with higher scores indicating more intense staining. The VEGF mean intensity scores were 0.34 (0.19) for tests and 0.54 (0.41) for controls, which were not significantly different. Unpaired t tests were utilized for statistical analyses.ConclusionIn this study, irradiated soft tissue flaps treated with topical GHK‐Cu demonstrated a greater amount of flap ischemia and no difference in VEGF production compared to controls. These findings contrast prior studies suggesting a favorable growth factor environment and an improvement in wound healing with GHK‐Cu treatment.
Value‐Based Analysis of Septoplasty and Turbinate Specimens
Authors: Chu Jaemi , Daniero James J. , Pribitkin Edmund A. 
Published: February 2015

Objective1) Determine the frequency and clinical relevance of unanticipated histopathologic results in routine sinonasal surgery. 2) Evaluate the necessity for histopathologic processing of septal cartilage, bone, and inferior turbinate specimens during routine sinonasal surgery.MethodA retrospective review of histopathologic reports on all adult patients undergoing sinonasal surgery at a tertiary care hospital during a 5‐year period from 2005 to 2010 was performed. All cases with the preoperative diagnosis of sinonasal neoplasia, autoimmune disease, or directed septal biopsies were excluded from review.ResultsA total of 1198 pathology reports were reviewed from 1175 individual patients. This included histopathologic evaluation of 1194 septal cartilage and bone specimens and 715 inferior turbinate specimens. None of the patients had an unanticipated histopathology finding other than squamous metaplasia and inflammation.ConclusionMany surgeons obtain histopathologic diagnoses on all tissue removed from a patient. Based on our extensive review, histopathology of the septum and inferior turbinates in routine sinonasal cases may not be necessary. In the current era of cost‐containment in medicine, using a value‐based approach to processing routine tissue by waiving histopathologic evaluation could provide significant cost savings.
Head and Neck Cancer Stem Cells: The Effect of HPV
Authors: Tang Alice L. , Owen John H. , Hauff Samantha , Park Jung J. , Bradford Carol R. , Carey Thomas E. , Prince Mark E. 
Published: February 2015

ObjectiveTo determine the relative sensitivity to cisplatin of cancer stem cells (CSC) and if behavior and proportion of CSC in cell lines is affected by HPV. We determined the effect of HPV oncogenes on the tumorigenicity of naturally infected, HPV‐negative, and viral oncogene transduced human HNSCC cells in mice.MethodUsing naturally infected HPV+ and HPV– cell lines, we isolated CSC by flow cytometry with ALDH. Chemoresistence was determined using colony formation assays. Two HPV– cell lines underwent lentiviral transduction of E6/E7. Native and E6/E7 transduced cells were compared for lung colonization after tail vein injection in NOD/SCID mice.ResultsHPV+ CSCs were more resistant to cisplatin than non‐CSCs. There were no differences in chemoresistance between HPV+ and HPV– cells. HPV– cells yielded low colony formation after cell sorting across all groups. However, after transduction with E6/E7, increased colony formation was observed in both CSC and non‐CSC for these same cells. Results from tail vein injections yielded no differences in development of lung lesions between E6/E7 transduced cells vs non‐E6/E7 cells.ConclusionCSC are more resistant to cisplatin than non‐CSC. Chemotherapy may shrink tumor bulk by eliminating non‐CSC, but CSC have inherent mechanisms that allow evasion. HPV does not affect CSC in the face of therapy, suggesting that other factors, possibly immune regulated, explain the observed better outcomes in HPV+ cancer patients.