bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune Stimulation for the Treatment of Papilloma
Authors: Poetker David M. , Kerschner Joseph E. , Patel Nalin J. , Bauman Nancy M. , Sandler Anthony D. 
Published: October 2014

Objectives: There is no curative therapy for recurrent respiratory papillomatosis. Unmethylated dinucleotides of cytosine and guanine (CpG) are potent immune stimulants that have shown efficacy against tumors as monotherapy, as vaccine adjuvants, and in combination with chemotherapies. We examined the therapeutic effect of CpG oligodeoxynucleotides in the treatment of papillomavirus in a cottontail rabbit model (CRPV). Methods: Twenty rabbits were infected with CRPV; 10 were treated with 11 weekly CpG inoculations while treatment control rabbits received intralesional saline solution. Eight rabbits (4 treatment, 4 control) were rechallenged with CRPV 17 weeks after the initial viral challenge and monitored for new papilloma development. Results: Papillomas developed in all 20 rabbits (100%) within 4 weeks of infection. The diagnosis was confirmed histologically. There was no difference in the average tumor burden between the treatment and control groups after 11 weeks of CpG treatments or after 9 additional weeks of observation. There was no difference between the groups in papilloma size at the site of the injections, nor was there eradication of papillomas at remote sites in either group. No new papillomas developed in any of the 8 animals that were rechallenged. Conclusions: We have reproduced an effective mammalian papilloma model for preclinical immunotherapeutic testing. Despite the potency of CpG in triggering host immunity, CpG oligodeoxynucleotide did not show a therapeutic effect against the large papilloma burdens tested in this study. The lack of effect suggests that either enhanced papilloma antigen presentation or targeting of immune-evasive mechanisms used by the papillomas is needed to treat bulky disease with an immunotherapeutic strategy.
Imaging the Mucosa of the Human Vocal Fold with Optical Coherence Tomography
Authors: Burns James A. , Zeitels Steven M. , Anderson R. Rox , Kobler James B. , Pierce Mark C. , de Boer Johannes F. 
Published: October 2014

Objectives: Discerning the layered microstructure of the vocal folds is critical for effective phonomicrosurgery. Optical coherence tomography (OCT), a noncontact, noninvasive technology that provides cross-sectional images by means of backscattered light, offers the potential for delineating these layers in vivo. Methods: The glottal mucosa of 3 human cadaver larynges was imaged with conventional OCT and polarization-sensitive OCT (PS-OCT). Images were obtained through the epithelium and lamina propria. Results: Although the superficial layer of the lamina propria appeared quite homogeneous, the outer surface of the superficial lamina propria was correlated with an increase in backscatter with OCT. The superficial lamina propria and vocal ligament were correlated with a marked increase in tissue birefringence with PS-OCT. Conclusions: This preliminary study demonstrates the capacity of OCT and PS-OCT for visualizing the layered microstructure of the vocal fold mucosa. We believe that these imaging techniques will have applications in the exploration of solutions to vocal fold scarring and in imaging vocal fold disorders in the clinic and operating room.
Cortical Adaptation following Partial Glossectomy with Primary Closure: Implications for Reconstruction of the Oral Tongue
Authors: Mosier Kristine , Liu Wen-Ching , Behin Babak , Lee Christopher , Baredes Soly 
Published: October 2014

Objectives: The considerable variability in functional outcomes for speech and swallowing with different reconstruction techniques following partial glossectomy may reflect the ability of patients to adapt to altered tongue structure. The purpose of this study was to determine mechanisms of cortical adaptation in swallowing to partial glossectomy reconstructed with primary closure. Methods: Four patients treated with partial glossectomy and primary closure underwent functional magnetic resonance imaging at a mean of 6 months after operation, and the data were compared to those from 8 healthy controls. Results: Statistically significant increases in activity occurred predominately in the parietal cortices and the cerebellum. The volume of the resection was most highly correlated with activity in the premotor and parietal cortices and cerebellum. Conclusions: The adaptive changes in the cortex following partial glossectomy with primary closure reflect adaptation to the biomechanics of tongue movement during swallowing, and not altered sensation in the tongue.
Silent Sinus Syndrome: A Case Presentation and Comprehensive Review of All 84 Reported Cases
Authors: Numa William A. , Desai Urmen , Gold Daniel R. , Heher Katrinka L. , Annino Donald J. 
Published: October 2014

Objectives: The term silent sinus syndrome has been used to describe the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical chronic maxillary sinusitis. Currently, it is believed to occur as a result of the sequence of events following maxillary sinus hypoventilation due to the obstruction of the ostiomeatal complex. Methods: In this study, we present a case of true silent sinus syndrome. In addition, we highlight the previously published cases of silent sinus syndrome, as well as provide a review of the etiology, pathophysiology, radiologic diagnosis, surgical treatment, and pitfalls to avoid in the management of patients with silent sinus syndrome. Results: Eighty-three previously published cases of silent sinus syndrome were reported in the literature and are summarized in this review. Conclusions: A well-defined set of criteria is needed to classify a patient under the diagnosis of silent sinus syndrome, which include enophthalmos and/or hypoglobus in the absence of clinically evident sinonasal inflammatory disease.
Tissue Maturation Correlating to Clinical Manifestations in Juvenile Angiofibroma
Authors: Sennes Luiz U. , Fortes Felipe S. G. , Butugan Ossamu , Saldiva Paulo H. , Bernardi Fabiola C. 
Published: October 2014

Objectives: Juvenile nasopharyngeal angiofibroma is a rare benign tumor that affects young male patients and shows a characteristic development from its origin. It is not a true neoplasm, but shows features of vascular processes, developing into a more fibrous condition. The aim of this study was to correlate the clinical manifestations and the histologic findings of the tumor. Methods: Thirty-six patients without previous treatment were studied. We correlated the incidence and duration of the clinical manifestations (nasal obstruction, epistaxis, nasal and/or pharyngeal tumor, and facial deformity) and morphometric histologic analyses of the central region of the tumor (number, caliber, and presence of muscle cells in the vessel wall, and tissue maturity and cellularity). Results: The duration of nasal obstruction, the presence of nasal and/or pharyngeal tumor, and facial deformity were significantly correlated with the number of vessels, the tissue maturation, and the cellularity of the tumor. Epistaxis showed a strong correlation with the presence of muscle fibers in the vessels. Conclusions: There are correlations between the duration of the clinical manifestations and histologic maturation in the central portion of the tumor.
HspE7 Treatment of Pediatric Recurrent Respiratory Papillomatosis: Final Results of an Open-Label Trial
Authors: Derkay Craig S. , Smith Richard J. H. , McClay John , van Burik Jo-Anne H. , Wiatrak Brian J. , Arnold James , Berger Bruce , Neefe John R. 
Published: October 2014

Objectives: We sought to evaluate the effectiveness of HspE7, a recombinant fusion protein of Hsp65 from Mycobacterium bovis BCG and E7 protein from human papillomavirus 16, to improve the clinical course of pediatric patients with recurrent respiratory papillomatosis. Methods: An open-label, single-arm intervention study was conducted in 8 university-affiliated medical centers. Twenty-seven male and female patients with recurrent respiratory papillomatosis, ages 2 to 18 years, were enrolled and followed up to 60 weeks. Before enrollment, these patients required surgery on average every 55 days. After a baseline debulking surgery, the patients received HspE7 500 μg subcutaneously monthly, for 3 doses over 60 days. The primary end point was the length of the interval from the last surgery during the treatment period until the first debulking surgery in the posttreatment period, compared with the median intersurgical interval (ISI) of the 4 surgeries before the treatment. Results: The mean of the first posttreatment ISI increased 93% (from 55 days to 106 days; p < .02). The median ISI for all surgeries after treatment was similarly prolonged (mean, 107 days; p < .02), indicating a sustained treatment effect, and was associated with a significant decrease in the number of required surgeries (p < .003). Unexpectedly, the treatment effect was most striking in the 13 female patients, who had statistically significant increases in both the first posttreatment ISI (142%; p < .03) and the median ISI (147%; p < .03). The most common adverse events were mild-to-moderate injection site reactions. Conclusions: Treatment with HspE7 appears to significantly improve the clinical course in pediatric patients with RRP insofar as it reduces the frequency of required surgeries. These results warrant a confirmatory phase III trial.
Prognosis of Inner Ear Periphery and Central Vestibular Plasticity in Sudden Deafness with Vertigo
Authors: Kitahara Tadashi , Takeda Noriaki , Nishiike Suetaka , Okumura Shin-Ichi , Kubo Takeshi 
Published: October 2014

Objectives: We sought to elucidate the clinical problems and otopathology of patients with sudden deafness with vertigo (SDV). Methods: In 24 patients with SDV who had significant canal paresis (CP) at their first visit to our hospital between 1997 and 2001, we examined pure tone audiograms, caloric tests, and several questionnaires twice, at the first visit within 5 days after the onset and around 2 years after steroid therapy. Results: These examinations revealed that improvements of auditory and vestibular function in patients with SDV tended to be correlated with one another. Sixteen of the 24 patients (66.7%) still had CP. This rate in SDV was significantly worse than that reported previously for vestibular neuritis (VN). On the other hand, patients with SDV with long-lasting CP had a faster reduction of head-shaking afternystagmus and of handicaps in their everyday life due to dizziness than did patients with VN and CP. Conclusions: These findings suggest that SDV may deteriorate the inner ear function more severely but accelerate the central vestibular compensation more effectively than VN after the lesion. It is well known that vestibular neurectomy causes much more severe motion-induced dizziness after surgery than does labyrinthectomy. Taken together, these findings suggest different regions of damage in SDV (mainly the labyrinth, as in labyrinthectomy) and VN (mainly the ganglion, as in vestibular neurectomy).
Phonetic Effects of Paralytic Dysphonia
Authors: Hartl Dana M. , Crevier-Buchman Lise , Vaissière Jacqueline , Brasnu Daniel F. 
Published: October 2014

Objectives: This study was performed to determine whether and how unilateral vocal fold paralysis (UVFP) affects the production and perception of voiced stop consonants as compared with unvoiced stops, and to analyze the phonetic effects of UVFP on the voicing feature. Methods: Phonetic constructs pronounced by 7 male patients with UVFP and 5 normal male subjects were recorded. The 432 speech tokens consisted of intervocalic, prevocalic, and postvocalic stop consonants (/p/, /t/, /k/, /b/, /d/, /g/) in the vowel contexts / a/ and /i/. Perceptual consonant identification testing was performed with 5 voice and speech professionals as listeners. The type and frequency of errors made in consonant identification were analyzed. Spectrographic analysis was used to analyze acoustic cues. Results: The rate of correct consonant identification was significantly lower for tokens pronounced by patients with UVFP (77.3% versus 97.6%, p =.0001) because of incorrect identification of the voiced consonants, frequently perceived as their unvoiced homologues. Confusion between dental and alveolar place of articulation for unvoiced stops was also noted. Conclusions: Unilateral vocal fold paralysis alters the voiced-unvoiced stop consonant distinction and the dental-palatal stop consonant distinction in an experimental nonspeech context. This finding implies the existence of a phonetic handicap for patients with UVFP. Further studies should determine the effects of UVFP on global speech intelligibility.
Alterations in Contractile Properties of Tongue Muscles in Old Rats
Authors: Ota Fumikazu , Connor Nadine P. , Konopacki Richard 
Published: October 2014

Objectives: Fatigue and weakness are well-known signs of aging that are related to sarcopenia, or loss of skeletal muscle mass, organization, and strength. Sarcopenia may affect swallowing. The tongue plays a vital role in swallowing, but there is limited knowledge regarding age-related changes in lingual muscle contractile properties. Our purpose was to determine whether alterations in tongue force, temporal features of tongue muscle contraction, and fatigability are manifested as a function of aging in old rats. Methods: We evaluated tongue muscle contractile properties in young and old Fischer 344/Brown Norway rats. Contractions were elicited via bilateral electrical stimulation of the hypoglossal nerves. Results: Maximum tongue forces and fatigability were not significantly altered in old animals, but aging was associated with significantly longer twitch contraction time and longer half-decay recovery time intervals (p <.01). Conclusions: The results indicated that old animals generated sufficient maximum tongue forces, but were slower in achieving these forces than young animals. These findings are consistent with reports of altered temporal parameters of tongue actions during swallowing in humans, and suggest that a disruption in the timing of muscle contraction onset and recovery may contribute to the altered tongue kinetics observed with aging.
Individual Subject Laryngeal Dimensions of Multiple Mammalian Species for Biomechanical Models
Authors: Hunter Eric J. , Titze Ingo R. 
Published: October 2014

Objectives: This report provides a detailed knowledge base of individual subject laryngeal cartilage dimensions across multiple species to assist researchers in creating subject-specific biomechanical laryngeal models. Methods: The raw data from previous laryngeal cartilage studies were grouped by species (for human, canine, and ovine) and by cartilage (arytenoid, thyroid, and cricoid) by means of a previously reported labeling scheme. No animals were sacrificed specifically for the present study. Results: More than 1,500 measurements from 37 subjects are presented in 15 tables. No comparisons of the average measures were attempted, as they were done in previous studies. Conclusions: By means of a database of individual subject dimensions, a laryngeal model could be designed and tested to morph from one subject to the next, predicting subject-specific results of laryngeal function. Eventually, this would lead to modeling patient-specific laryngeal disorders and the prediction of therapeutic outcomes. An electronic downloadable version of the database is made available to assist in this effort.
Clinical Characteristics of Eosinophilic Esophagitis in Children
Authors: Dauer Eileen H. , Freese Deborah K. , El-Youssef Mounif , Thompson Dana M. 
Published: October 2014

Objectives: The role of eosinophilic esophagitis (EE) in aerodigestive tract disorders in children is underestimated and overlooked, primarily because of a lack of understanding of this disorder by otolaryngologists. We sought to better characterize the clinical presentation of EE in order to increase awareness among otolaryngologists. Methods: We retrospectively reviewed 71 children with biopsy-proven EE to determine the most common symptoms and laboratory findings that should increase the clinical suspicion of EE. Results: Dysphagia, food impaction, and emesis were the most common symptoms in children with EE. Asthma was the most common airway diagnosis. Rhinosinusitis was the most common otolaryngological diagnosis. Food allergy was present in 60% of the children tested. Eighty-three percent of the children with elevated immunoglobulin E levels had thick linear streaking or patchy white exudate of the esophagus seen on esophagoscopy. Other major medical comorbidities existed in more than half of the children with EE, of which psychiatric disorders and other disorders of the aerodigestive tract were the most common. Conclusions: Eosinophilic esophagitis may contribute to treatment failure in patients with common and complicated aerodigestive tract disorders. To encourage clinicians to avoid overlooking the diagnosis, we present an evaluative algorithm to increase the suspicion of this entity.
Influence of Vocal Fold Scarring on Phonation: Predictions from a Finite Element Model
Authors: Berry David A. , Reininger Haven , Alipour Fariborz , Bless Diane M. , Ford Charles N. 
Published: October 2014

Objectives: A systematic study of the influence of vocal fold scarring on phonation was conducted. In particular, phonatory variables such as fundamental frequency, oral acoustic intensity, and phonation threshold pressure (PTP) were investigated as a function of the size and position of the laryngeal scar. Methods: By means of a finite element model of vocal fold vibration, the viscoelastic properties of both normal and scarred vocal fold mucosae were simulated on the basis of recent rheological data obtained from rabbit and canine models. Results: The study showed that an increase in the viscoelasticity of the scarred mucosa resulted in an increase in fundamental frequency, an increase in PTP, and a decrease in oral acoustic intensity. With regard to positioning of the scar, the PTP increased most significantly when the scar was within ±2 mm of the superior-medial junction of the vocal folds. Conclusions: The systematic data obtained in this investigation agree with the general clinical experience. In the future, these findings may be further validated on human subjects as newly emerging technologies such as linear skin rheometry and optical coherence tomography allow the histologic and viscoelastic properties of the normal and scarred vocal fold mucosae to be measured in the clinic.
Radiology of the Cochlear Aqueduct
Authors: Migirov Lela , Kronenberg Jona 
Published: October 2014

Objectives: We sought to determine normative data for the radiologic presentation of the cochlear aqueduct (CA), hypothesizing that increasing the scanner's resolution could enhance detection capability. Methods: Axial sections of 502 high-resolution computed tomography (CT) images of temporal bones (488 patients) were reviewed. A type 1 CA was visualized on CT scans up to the vestibule, and its portion in the otic capsule segment could be seen as a thin (<1 mm) streak. In type 2, we were able to detect the medial Two thirds of the structure, but we failed to see the whole otic capsule portion. In type 3, only the external aperture of the aqueduct and/or the medial third was seen. We defined undetectable CAs as type 4. Results: We obtained CT scans with 0.6-, 1.1-, or 1.3-mm-thick slices through the petrous bones in 9.5%, 58.8%, and 31.7% of cases, respectively. The CA was visible and bilaterally symmetric in 49% of the images, and type 2 was the most commonly detected CA type (36%). The CA was invisible on either side in 21.9% of scans, irrespective of CT resolution, and was asymmetric in 53 of the 502 images. The CA types varied with changes in resolution, although type 3 appeared unchanged independent of alterations in resolution in most cases. Conclusions: There was no significant difference in CT detection capability between CA types at different resolutions. Computed tomography failed to demonstrate any CAs ≥1 mm in width in the otic capsule segment.
Predicting Outcome in Aged and Severely Ill Patients with Prolonged Respiratory Failure
Authors: Baskin Jonathan Z. , Panagopoulos Georgia , Parks Christine , Komisar Arnold 
Published: October 2014

Objectives: Consultations for tracheotomy are often sought on aged and severely ill patients with respiratory insufficiency. This patient population has high short-term mortality rates and is difficult to stratify on the basis of expected outcome. We examined whether APACHE III (Acute Physiology and Chronic Health Evaluation III) scores or neurologic status assessment (NSA) scores in sedated individuals are predictive of outcome. Methods: We performed a retrospective study examining aged patients who underwent tracheotomy for respiratory insufficiency and prolonged intubation. The APACHE III scores (n = 30) and NSA (based on a modified Glasgow Coma Scale) scores (n = 37) were calculated before tracheotomy. All patients were mildly sedated. Using APACHE III and NSA scores as predictor variables and using death and ability to be weaned from the ventilator as outcome variables, we performed a Kaplan-Meier survival analysis and a Cox proportional hazard regression. Results: The APACHE III was not significantly predictive of either outcome. Higher NSA scores were associated with increased survival rates (log rank = 19.7, p < .0001) and longer median survival (88 days versus 16 days for lower scorers). Higher NSA scores also predicted a higher rate of ventilator independence. Conclusions: Neurologic function in sedated patients (and not APACHE III scores) can be used to stratify aged individuals with respiratory insufficiency on the basis of expected outcome.
Comparative Study of the Daily Lifestyle of Patients with Meniere's Disease and Controls
Authors: Onuki Junichi , Takahashi Masahiro , Odagiri Kyoko , Wada Ryoko , Sato Ririko 
Published: October 2014

Objectives: This study was performed to investigate the possibility that daily lifestyle may have a causal relationship with Meniere's disease. Methods: We conducted a questionnaire study of daily lifestyles among groups of patients with Meniere's disease and those with low-frequency hearing loss, and compared the results with those of control groups of local residents matched individually by gender and age. Results: The Meniere's disease group diverged most widely from the control groups in their behavior patterns. Significant divergence was especially indicated in their engrossed, self-inhibiting, and time-constrained behaviors. Although the low-frequency hearing loss group also exhibited similar tendencies toward engrossment and in their feeling pressed for time, their self-inhibiting behavior was less pronounced. There was no major difference between the endolymphatic hydrops patient groups and the control groups on other items in the study such as daily lifestyle, environmental stress, and means of relaxation. Conclusions: The results of the present study strongly suggest that there may be a link between an individual's specific behavior patterns and the onset of Meniere's disease.