bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Characteristics of Preoperative Balance Disorders in Cochlear Implant Candidates
Authors: Krause Eike , Louza Julia P. R. , Hempel John-Martin , Wechtenbruch Juliane , Rader Tobias , Gürkov Robert 
Published: October 2014

Objectives: The aim of this study was to elucidate the frequency and characteristics of preoperative vertigo symptoms in patients who undergo cochlear implantation (CI), in order to differentiate them from CI-related symptoms. Methods: In a prospective observational study, 47 adult CI candidates were asked about vertigo problems on a questionnaire. A subdivision into 3 groups was done: Group A (probable otogenic vertigo), group B (possible otogenic vertigo), and group C (not otogenic vertigo). Horizontal semicircular canal function was measured. Patients with vertigo complaints were compared to patients without vertigo with regard to the presence of abnormal vestibular function findings. Results: Twenty-five patients (53%) reported preoperative vertigo problems. In 21 (84%), the patient's history suggested a probable (group A) or possible (group B) otogenic origin. Patients with vertigo more often had abnormal findings on vestibular function testing than did patients without vertigo. This difference, however, was not statistically significant. Conclusions: A considerable number of CI candidates have preoperative vertigo symptoms. These cannot be explained by horizontal semicircular canal function alone. In order to understand why CI patients develop postoperative vertigo, analysis of prospective preoperative vestibular function test findings and vertigo symptoms is necessary.
Cell Growth Inhibition and Down-Regulation of Survivin by Silibinin in a Laryngeal Squamous Cell Carcinoma Cell Line
Authors: Bang Choong-Il , Paik Soon-Young , Sun Dong-Il , Joo Young-Hoon , Kim Min-Sik 
Published: October 2014

Objectives: Abnormalities in the regulation of apoptotic cell death have been shown to have an important effect on the pathogenesis and progression of cancer. Survivin, which is identified in most cancers and has recently been identified as an inhibitor of apoptosis, is a potential therapeutic target for cancer management. We investigated cell growth, apoptosis, and expression of survivin in laryngeal squamous cell carcinoma cell lines after treatment with the bioactive compound silibinin. Methods: Cultured human laryngeal squamous cell carcinoma SNU-46 cells were treated with different concentrations of silibinin, and the degree of cell growth and apoptosis was analyzed. Additionally, survivin protein and messenger RNA were analyzed by Western immunoblotting and reverse transcription–polymerase chain reaction. Results: Silibinin inhibited the growth of SNU-46 cells in a both dose- and time-dependent manner (p < 0.01). Upon fluorescence-activated cell sorter analysis, silibinin (200 μmol/L) treatment increased the proportion of apoptotic cells from 7% to 40%. At high concentrations (more than 150 μmol/L), silibinin greatly reduced messenger RNA and protein expression of survivin. Conclusions: Our findings demonstrate that silibinin induced apoptosis of laryngeal squamous carcinoma cells by a mechanism involving decreased survivin expression, which suggests the possibility that silibinin may be an effective treatment of laryngeal cancers.
Adjustable Tongue Advancement for Obstructive Sleep Apnea: A Pilot Study
Authors: Hamans Evert , Boudewyns An , Stuck Boris A. , Baisch Alexander , Willemen Marc , Verbraecken Johan , Van de Heyning Paul 
Published: October 2014

Objectives: Surgical treatment of obstructive sleep apnea (OSA) caused by hypopharyngeal collapse of the upper airway can be considered in patients who are intolerant to continuous positive airway pressure (CPAP). The present procedures addressing the hypopharynx are invasive and have substantial morbidity and limited efficacy. Methods: Ten patients (mean age, 44 years) with moderate to severe OSA, ie, an apnea-hypopnea index (AHI) between 15 and 50, with CPAP intolerance were included in a prospective, nonrandomized, multicenter study to evaluate the feasibility, safety, and efficacy of a novel tongue advancement procedure. The procedure consists of the implantation of a tissue anchor in the tongue base and an adjustment spool at the mandible. Titration of this tissue anchor results in advancement of the tongue and a patent upper airway. Results: The mean AHI decreased from 22.8 at baseline to 11.8 at the 6-month follow-up (p = 0.007). The Epworth Sleepiness Scale score decreased from 11.4 at baseline to 7.7 at the 6-month follow-up (p = 0.094), and the snoring score decreased from 7.5 at baseline to 3.9 at the 6-month follow-up (p = 0.005). Four technical adverse events were noted, and 1 clinical adverse event occurred. Conclusions: Adjustable tongue advancement is a feasible and relatively safe way to reduce the AHI and snoring in selected patients with moderate to severe OSA and CPAP intolerance. Technical improvements and refinements to the procedure are ongoing.
Computerized Scoring System for the Diagnosis of Foreign Body Aspiration in Children
Authors: Kadmon Gili , Stern Yoram , Bron-Harlev Efrat , Nahum Elhanan , Battat Erez , Schonfeld Tommy 
Published: October 2014

Objectives: Foreign body aspiration (FBA) is a life-threatening event in children. The gold standard for diagnosis is bronchoscopy, but there is no consensus regarding indications for the procedure. The aim of this study was to formulate a predictive model for assessing the probability of FBA in suspected cases as an aid in the decision to perform diagnostic bronchoscopy. Methods: The files of 150 patients who underwent bronchoscopy for suspected FBA at our center between 1996 and 2004 were reviewed for medical history, physical examination, and radiologic studies. The findings were analyzed by logistic regression. Results: Using the file data, we formulated a predictive model wherein each parameter received a numeric coefficient representing its significance in evaluating suspected FBA. The most significant parameters were age 10 to 24 months, foreign body in the child's mouth and severe respiratory complaints during the choking episode, hypoxemia, dyspnea or stridor following the acute event, unilateral signs on lung auscultation, abnormal tracheal radiogram, unilateral infiltrate or atelectasis, and local hyperinflation or obstructive emphysema on chest radiogram. Conclusions: In our predictive model, every case of suspected FBA can be assigned a score based on the specific parameters present, which is then entered into a probability formula to determine the likelihood of a positive diagnosis. This model may serve as a useful tool for deciding on the use of bronchoscopy in all children with suspected FBA.
Development of Mucosal Thickening after Radiotherapy in Contralateral Sinuses of Patients with Nasal Cavity and/or Paranasal Sinus Carcinoma
Authors: Wang Jong Hwan , Lee Bong-Jae , Lee Jeong Hyun , Kim In June , Jang Yong Ju 
Published: October 2014

Objectives: The aim of this study was to investigate the development of radiotherapy (RT)–induced mucosal thickening (MT) of the contralateral sinuses in patients with nasal cavity and/or paranasal sinus carcinoma. Methods: We retrospectively reviewed the medical records and the initial and follow-up computed tomography (CT) scans of 37 patients with RT and 10 controls without RT. The CT scans were scored on the Lund-Mackay (LM) staging system. Results: Fifteen of the 37 patients had MT before RT, and the mean LM score was 0.68. The MT incidence significantly increased, to 72.9% (p = 0.009), and the LM score significantly increased, to 2.84 (p < 0.001), by 3 months after RT, after which the LM score decreased gradually to 1.73 at 36 months after RT. Four of the 10 controls had MT before treatment, and their mean LM score was 0.7. Their MT incidence and LM score had not changed significantly at 3 months after treatment. The pretreatment LM scores of the patient group and the control group were not significantly different, but their posttreatment LM scores were significantly different at the 3-month follow-up (p = 0.033). Conclusions: Use of RT in patients with nasal cavity and/or paranasal sinus carcinoma may cause a significant increase in the incidence of MT and in the LM scores in all sites of the paranasal sinuses by 3 months after RT, after which the LM score decreases gradually.
Is There a Need for Positron Emission Tomography Imaging to Stage the N0 Neck in T1-T2 Squamous Cell Carcinoma of the Oral Cavity or Oropharynx?
Authors: Schroeder Ursula , Dietlein Markus , Wittekindt Claus , Ortmann Monika , Stuetzer Hartmut , Vent Julia , Jungehuelsing Markus , Krug Barbara 
Published: October 2014

Objectives: We assess whether negative findings on computed tomography (CT), magnetic resonance imaging (MRI), and/or 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) may contribute to the decision-making process of elective neck dissection (eND) in patients with squamous cell carcinoma of the oral cavity or the oropharynx (oSCC) staged cT1-T2 cN0 cM0. Methods: We interpreted CT, MRI, and 18FDG-PET images separately, after combining the data of CT with those of 18FDG-PET and the data of MRI with those of 18FDG-PET. Each set of results was then compared with the histopathologic results of ipsilateral or bilateral eND in a prospective, blinded study. Results: The histopathologic examination of 594 lymph nodes revealed 4 metastases less than 4 mm in diameter and 3 micrometastases (less than 2 mm) in 6 of 17 patients. On CT, MRI, and 18FDG-PET, respectively, 5, 5, and 0 cases were true-malignant (true positives) and 4, 10, and 1 cases were false-malignant (false positives). The accuracy was not enhanced by fusing CT with 18FDG-PET or MRI with 18FDG-PET. Conclusions: The detectability threshold of occult metastases appears to be below the spatial and contrast resolution of CT, MRI, and 18FDG-PET. The decision for eND in patients with cT1-T2 cN0 cM0 oSCC cannot be based upon cross-sectional imaging at the resolutions currently available.
Immunologic Response of the Laryngeal Mucosa to Extraesophageal Reflux
Authors: Birchall Martin A. , Bailey Michael , Gutowska-Owsiak Danuta , Johnston Nikki , Inman Charlotte F. , Stokes Christopher R. , Postma Gregory , Pazmany Laszlo , Koufman Jamie A. , Phillips Anne , Rees Louisa E. 
Published: October 2014

Objectives: Extraesophageal reflux is common. The treatment costs are high, and there are associations with other diseases, including laryngeal cancer. Our studies of the mucosal immune response to this common inflammatory disease suggest an important role for the nonclassic antigen-presenting molecule CD1d in the response to inflammation. This study was performed to further explore the relationship between the CD1d–NKT cell–iGb3 axis and reflux. Methods: We carried out a prospective study of laryngeal biopsies from 12 patients with laryngopharyngeal reflux and 11 controls. Quantitative multiple-color immunofluorescence using antibodies for lymphocytes (CD3, CD161) and classic and nonclassic major histocompatibility complex (I, II, β2m, CD1d) was performed, and univariate and multivariate analysis and co-localization measurements were applied. Results: Epithelial major histocompatibility complex class I and II expression was unchanged by reflux, but expression of CD1d increased (p < 0.05; luminal layers) and confidence intervals diminished in the reflux group. Co-localization of NKT cells with CD1d increased in patients (p < 0.01); iGb3 exhibited strong expression throughout all layers of the laryngeal epithelium. Conclusions: These data indicate a role for the CD1d–NKT cell–iGb3 axis in response to extraesophageal reflux in humans. This represents a useful target for novel diagnostics and treatments for this common condition.
Validity and Reliability of the Eating Assessment Tool (EAT-10)
Authors: Belafsky Peter C. , Mouadeb Debbie A. , Rees Catherine J. , Pryor Jan C. , Postma Gregory N. , Allen Jacqueline , Leonard Rebecca J. 
Published: October 2014

Objectives: The Eating Assessment Tool is a self-administered, symptom-specific outcome instrument for dysphagia. The purpose of this study was to assess the validity and reliability of the 10-item Eating Assessment Tool (EAT-10). Methods: The investigation consisted of 4 phases: 1) line-item generation, 2) line-item reduction and reliability, 3) normative data generation, and 4) validity analysis. All data were collected prospectively. Internal consistency was assessed with the Cronbach alpha. Test-retest reliability was evaluated with the Pearson product moment correlation coefficient. Normative data were obtained by administering the instrument to a community cohort of healthy volunteers. Validity was assessed by administering the instrument before and after dysphagia treatment and by evaluating survey differences between normal persons and those with known diagnoses. Results: A total of 629 surveys were administered to 482 patients. The internal consistency (Cronbach alpha) of the final instrument was 0.960. The test-retest intra-item correlation coefficients ranged from 0.72 to 0.91. The mean (±SD) EAT-10 score of the normal cohort was 0.40 ± 1.01. The mean EAT-10 score was 23.58 ± 13.18 for patients with esophageal dysphagia, 23.10 ± 12.22 for those with oropharyngeal dysphagia, 9.19 ± 12.60 for those with voice disorders, 22.42 ± 14.06 for those with head and neck cancer, and 11.71 ± 9.61 for those with reflux. The patients with oropharyngeal and esophageal dysphagia and a history of head and neck cancer had a significantly higher EAT-10 score than did those with reflux or voice disorders (p < 0.001). The mean EAT-10 score of the patients with dysphagia improved from 19.87 ± 10.5 to 5.2 ± 7.4 after treatment (p < 0.001). Conclusions: The EAT-10 has displayed excellent internal consistency, test-retest reproducibility, and criterion-based validity. The normative data suggest that an EAT-10 score of 3 or higher is abnormal. The instrument may be utilized to document the initial dysphagia severity and monitor the treatment response in persons with a wide array of swallowing disorders.
Endoscopic Localization of the Anterior and Posterior Ethmoid Arteries
Authors: Han Joseph K. , Becker Samuel S. , Bomeli Steven R. , Gross Charles W. 
Published: October 2014

Objectives: Understanding the endoscopic locations of the anterior and posterior ethmoid arteries is important during endoscopic sinus or endoscopic skull base procedures so that these arteries can be avoided. Therefore, the objective of this study was to define the endoscopic locations of the ethmoid arteries. Methods: Twenty-four cadaver heads were used to identify the endoscopic location of the ethmoid arteries via an external incision. An image guidance system was used to record the locations of these arteries. The anterior ethmoid artery was referenced to the axilla of the middle turbinate, and the posterior ethmoid artery to the anterior wall of the sphenoid sinus. The closest lamella to these arteries was identified. Results: Forty-eight nasal cavities were dissected. The mean distance from the axilla to the anterior ethmoid artery was 17.5 mm. The anterior ethmoid artery was located immediately anterior to (31%), at (36%), or immediately posterior to (33%) the superior attachment of the basal lamella. The mean distance from the posterior ethmoid artery to the anterior ethmoid artery was 14.9 mm. The mean distance from the posterior ethmoid artery to the anterior wall of the sphenoid sinus was 8.1 mm. The posterior ethmoid artery was either anterior to (98%) or at (2%) the anterior face of the sphenoid sinus. Conclusions: Specific endoscopic anatomic relationships and measurements have been presented for the anterior and posterior ethmoid arteries.
Sleep-Related Deglutition in Patients with Sleep Apnea-Hypopnea Syndrome
Authors: Sato Kiminori , Nakashima Tadashi 
Published: October 2014

Objectives: We investigated sleep-related deglutition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: Deglutition during sleep was examined in 10 patients with a mean (±SD) age of 48 ± 11 years who had severe OSAHS (apnea-hypopnea index, 66.6 ± 17.6) via time-matched recordings of polysomnography and surface electromyography of the thyrohyoid and suprahyoid muscles. Results: During sleep, deglutition was episodic, and was absent for long periods. Deglutition did not occur during apnea or hypopnea periods. The mean number of swallows per hour during the total sleep time was 5.4 ± 3.1. The mean period of the longest absence of deglutition was 43.5 ± 14.7 minutes. Most deglutition occurred in association with respiratory electroencephalographic arousal after apnea or hypopnea. Approximately 70% of swallows were followed by inspiration. Deglutition was related to the sleep stage. The mean number of swallows per hour was 6.2 ± 6.1 during stage 1 sleep, 6.0 ± 3.4 during stage 2 sleep, 3.0 ± 5.2 during stage 3 sleep, and 0 during stage 4 sleep. The deeper the sleep stage, the lower the mean deglutition frequency. The mean number of swallows per hour was 4.5 ± 3.0 during rapid eye movement sleep. Conclusions: Deglutition was infrequent and displayed a unique pattern in patients with OSAHS during sleep.
Model of Evoked Rabbit Phonation
Authors: Ge Ping Jiang , French Lesley C. , Ohno Tsunehisa , Zealear David L. , Rousseau Bernard 
Published: October 2014

Objectives: We describe a method for eliciting phonation in an in vivo rabbit preparation using low-frequency, bipolar pulsed stimulation of the cricothyroid muscles with airflow delivered to the glottis. Methods: Ten New Zealand White breeder rabbits weighing 3 to 5 kg were used in this study. The cricothyroid muscles were isolated bilaterally, and separate pairs of anode-cathode hooked-wire electrodes were inserted into each muscle. A Grass S-88 stimulator and 2 constant-current PSIU6 isolation units were used to deliver bipolar square wave pulses to each cricothyroid muscle, with airflow delivered to the glottis through a cuffed endotracheal tube. Results: Phonation was evoked with a 50-Hz, 4-mA stimulus train of 1-ms pulses delivered to each cricothyroid muscle. The pulse trains were on for 2 seconds and were repeated every 5 seconds over a period of 180 minutes. Airflow was delivered at 143 cm3/s, producing phonation measuring 71 to 85 dB sound pressure level. Conclusions: Evoked phonation is feasible in rabbits by use of bipolar stimulation of the cricothyroid muscles with airflow delivered to the glottis. The in vivo rabbit preparation described may provide a useful small animal option for studies of evoked phonation. From the level and consistency of the adduction observed, we hypothesize that current spreading to the underlying adductor muscles and nerves resulted in neural pathway involvement beyond discrete activation of the cricothyroid muscle, providing sufficient approximation of the vocal folds for phonation.
Th2 Cytokine Inhibitor Suplatast Tosilate Inhibits Antigen-Induced Mucus Hypersecretion in the Nasal Epithelium of Sensitized Rats
Authors: Shimizu Shino , Hattori Reiko , Majima Yuichi , Shimizu Takeshi 
Published: October 2014

Objectives: Th2 cytokines such as interleukin (IL) 4 and IL-13 are potential mediators for mucus hypersecretion in allergic inflammation. To elucidate the functions of Th2 cytokines in allergic rhinitis, we examined the in vivo effects of the Th2 cytokine inhibitor suplatast tosilate on mucus hypersecretion and eosinophil infiltration in rat nasal epithelium. Methods: We induced hypertrophic and metaplastic changes in goblet cells in the nasal epithelium of ovalbumin-sensitized rats by intranasal challenge with ovalbumin. The effects of orally administered suplatast tosilate on mucus production and eosinophil infiltration were examined. Results: Suplatast tosilate (30 and 100 mg/kg) dose-dependently inhibited ovalbumin-induced mucus production and eosinophil infiltration. These suppressions of mucus production and eosinophil infiltration were only effective when suplatast tosilate was given in the effector phase; administration in the induction phase resulted in no effect. Conclusions: These results indicate that Th2 cytokines are important mediators of mucus hypersecretion and eosinophil infiltration in allergic rhinitis. Suplatast tosilate may be useful for the treatment of allergic rhinitis by attenuating the inflammation of the effector phase.
Multimodality Education for Airway Endoscopy Skill Development
Authors: Deutsch Ellen S. , Christenson Thomas , Curry Joseph , Hossain Jobayer , Zur Karen , Jacobs Ian 
Published: October 2014

Objectives: Airway endoscopy is a difficult skill to master. A unique practicum was designed to help otolaryngology residents develop endoscopy skills. The learning modalities included lectures, an animal laboratory, high-fidelity manikins, virtual bronchoscopy simulation, and standardized patients. This study compares the relative subjective value of these learning modalities for skill development and realism. Methods: Participants used a Likert scale (1 = disagree to 5 = agree) and open responses to anonymously rate the efficacy of 5 learning modalities for teaching airway management, endoscopy skills, and clinical leadership and for providing a realistic experience. Results: The results in 2007 were uniformly positive, with mean scores for every category and modality greater than 4 for developing cognitive, psychomotor, and affective skills; managing normal and abnormal conditions; preventing and managing complications; improving endoscopy skills; understanding team process; and experiencing overall and manual “feel” realism. In 2008, the participants were encouraged to more critically evaluate the course. The ratings demonstrated statistically significant differences between the mean scores for 4 of the 9 evaluation categories in 2007 and all 9 categories in 2008. Conclusions: Specific learning modalities (eg, lecture, animal laboratory, high-fidelity manikin, virtual bronchoscopy, standardized patient) were perceived to have different values for teaching airway management, developing endoscopy skills, teaching clinical leadership, and providing a realistic experience. We propose that these learning modalities can be used in a complementary manner.
Normal Values for Pharyngeal pH Monitoring
Authors: Chheda Neil N. , Seybt Melanie W. , Schade Robert R. , Postma Gregory N. 
Published: October 2014

Objectives: We performed a prospective study of asymptomatic adult volunteers to establish normative values of pharyngeal pH using a novel pH probe. Methods: The Dx-pH probe is a novel pH device capable of measuring liquid and aerosolized acid levels. Twenty asymptomatic patients (Reflux Symptom Index less than 10 and Reflux Finding Score less than 6) underwent simultaneous investigation with this probe placed in the oropharynx and a dual antimony probe placed in the hypopharynx and esophagus. The reflux parameters measured from the oropharyngeal probe included the percentage of time and the number of events in which the pH was less than 5.5, 5.0, 4.5, and 4.0. Results: The upper limits of normal (95th percentile) for the number of events below pH of 5.5, 5.0, 4.5, and 4.0 per 24-hour period were 16.6, 10.7, 7.4, and 0.2, respectively. The upper limits of normal (95th percentile) for an acid exposure time below pH of 5.5, 5.0, 4.5, and 4.0 per 24-hour period were 820 seconds, 385 seconds, 75 seconds, and 3 seconds, respectively. Conclusions: Normative pharyngeal pH values are presented. Further studies are required to determine clinical relevance.