bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carotid Blowout in Patients with Head and Neck Cancer
Authors: Powitzky Rosser , Vasan Nilesh , Krempl Greg , Medina Jesus 
Published: October 2014

Objectives The objective was to review the clinicopathologic features of carotid blowout syndrome (CBS) in patients with head and neck cancer (HNC) and present a management algorithm. Methods We reviewed all HNC patients with a diagnosis of CBS seen at our tertiary cancer hospital from 1994 to 2009 and performed a retrospective review of all English-language studies documenting CBS cases within the past 15 years. Results Eight patients with HNC developed CBS at our institution, and another 132 HNC patients were presented in 21 studies. Patients with CBS typically have a history of radiotherapy (89%), nodal metastasis (69%), and neck dissection (63%). This disease usually occurs proximal to the carotid bifurcation and is commonly associated with soft tissue necrosis in the neck (55%) and mucocutaneous fistulas (40%). Half of CBS patients present with sentinel bleeding, but 60% of patients will develop a life-threatening hemorrhage requiring emergent intervention. Over 90% of patients with CBS were treated with endovascular therapy, and surgical ligation was rarely indicated. The morbidity and mortality rates of patients with CBS are significant; only 23% have survived without evidence of disease. Conclusions Carotid blowout syndrome is uncommon and can be rapidly fatal without prompt diagnosis and intervention. Although endovascular treatment within the carotid system can have a significant risk of mortality and neurologic morbidity, it has become the treatment of choice for CBS.
Effect of Burow's Solution on the Guinea Pig Inner Ear
Authors: Suzuki Mitsuya , Kashio Akinori , Sakamoto Takashi , Yamasoba Tatsuya 
Published: October 2014

Objectives We examined the changes in the inner ear hair cells following intratympanic injection of Burow's solution. Methods Thirty-one albino guinea pigs with a normal Preyer's reflex were used. Burow's solution was applied and allowed to remain on the round window membrane for 30 minutes (30-minute group), 1 hour (1-hour group), or 2 hours (2-hour group). Seven days later, the left temporal bone was removed. Auditory brain stem responses were recorded at 4, 8, and 20 kHz before application of Burow's solution and again immediately before decapitation. The cochlea and utricle were dissected, stained with rhodamine-phalloidin, and examined under a fluorescence microscope. Results The postoperative auditory brain stem response thresholds at 20 kHz in the 1-hour group and those at 8 and 20 kHz in the 2-hour group were increased significantly compared to the baseline thresholds. Surface preparations of the organ of Corti revealed no hair cell loss in the 30-minute group, loss of outer hair cells in the lower half of the basal turn in half of the animals in the 1-hour group, and loss of outer hair cells in the basal turn in almost all animals in the 2-hour group. In the 2-hour group, the microthin sections of the round window membrane showed degeneration of the outer epithelium. Conclusions The retention of Burow's solution on the round window membrane for 2 hours induces degeneration of the outer epithelium and damage to the cochlear outer hair cells.
Management of Complex Cases of Petrous Bone Cholesteatoma
Authors: Pandya Yash , Piccirillo Enrico , Mancini Fernando , Sanna Mario 
Published: October 2014

Objectives: In a retrospective analysis of a quaternary referral neuro-otologic private practice, we identify complex cases of petrous bone cholesteatoma (ie, cases with encasement of vital structures such as the internal carotid artery, jugular bulb, and sigmoid sinus, with further extension to the clivus, sphenoid sinus, or rhinopharynx), review surgical approaches and techniques of management of vital structures, and propose the ideal surgical management. Methods: We performed a retrospective case study of 130 cases of petrous bone cholesteatoma submitted to surgery between 1979 and 2009 to identify the complex cases and their classification, approach used, outcomes, and recurrences. Results: Of 130 cases, 13 were complex. Facial palsy was the presenting feature in 11 cases, 7 of which presented with grade VI palsy. A long duration of facial palsy (more than 3 years) was seen in 5 cases. Clival involvement was seen in 6 cases; 1 case extended to the sphenoid sinus, and 1 to the rhinopharynx. The internal carotid artery was encased in 11 cases in the vertical and the horizontal parts. The jugular bulb was involved in 7 cases. Modified transcochlear approaches or infratemporal fossa approaches were used in all cases. There were no recurrences. Conclusions: Classification is fundamental to choosing the right surgical approach. Transotic and modified transcochlear approaches hold the key to treating complex cases. Infratemporal fossa approach type B has to be used for extension into the clivus, sphenoid sinus, or rhinopharynx. Internal carotid artery, jugular bulb, and sigmoid sinus involvement should be identified before operation.
Rationale for Targeting Pepsin in the Treatment of Reflux Disease
Authors: Johnston Nikki , Wells Clive W. , Samuels Tina L. , Blumin Joel H. 
Published: October 2014

Objectives: We undertook to 1) obtain unequivocal evidence to confirm or rebut our initial observations that pepsin is taken up by hypopharyngeal epithelial cells by receptor-mediated endocytosis, 2) investigate whether uptake of pepsin at pH 7, in nonacidic refluxate, is of pathological significance, and 3) test our hypothesis that inactive but stable pepsin (<pH 8) taken up by hypopharyngeal epithelial cells causes damage by becoming reactivated inside the cell. Methods: Human posterior cricoid biopsy specimens and cultured hypopharyngeal FaDu epithelial cells were used to perform competitive binding studies and to investigate colocalization of pepsin with clathrin, Rab-9, and TRG-46. FaDu cells were exposed to pepsin (both irreversibly and reversibly inactivated) in the presence and absence of wortmannin and dimethyl amiloride and analyzed by electron microscopy, MTT cytotoxicity assay, and Stress and Toxicity SuperArray. Results: Pepsin is unequivocally taken up by hypopharyngeal epithelial cells by receptor-mediated endocytosis. Uptake of pepsin at pH 7, in nonacidic refluxate, causes mitochondrial damage and changes the expression of several genes implicated in stress and toxicity. Irreversible, but not reversible, inhibition of peptic activity prevents these changes. Conclusions: Pepsin, at pH 7, in nonacidic refluxate, causes damage by becoming reactivated inside the cell. Irreversible inhibitors of peptic activity hold promise as a new therapy for reflux.
In vitro and in vivo Effects of D-Allose: Up-Regulation of Thioredoxin-Interacting Protein in Head and Neck Cancer Cells
Authors: Hoshikawa Hiroshi , Mori Terushige , Mori Nozomu 
Published: October 2014

Objectives: This study was aimed to investigate the relationship between the antiproliferative effects of D-allose and the up-regulation of thioredoxin-interacting protein (TXNIP) in head and neck cancer cells. Methods: For the in vitro study, 5 oral squamous cell carcinoma cell lines (Ca9–22, HSC-3, HSC-4, SAS, and KON) were treated with 25 mmol/L D-allose. For the in vivo study, HSC-3 cells were used in a xenograft model with female athymic nude mice (BALB/c nu/nu; 5 to 6 weeks old). Results: Inhibition of cell growth by D-allose was noted in HSC-3 and Ca9–22 cells, along with significant induction of TXNIP. Although TXNIP up-regulation was also evident, albeit to a lesser extent, in the remaining cell lines, D-allose did not inhibit their growth. With the HSC-3 line, the cell survival fractions decreased and TXNIP expression increased in a D-allose dose—dependent manner. The antiproliferative effects were partially suppressed by concomitant D-glucose treatment, which also reduced TXNIP expression. In the in vivo experiment, the tumor volume at day 15 after D-allose treatment was reduced to 61% of that of the control group. Conclusions: This study showed that D-allose exerts growth inhibitory effects on head and neck cancer cells in vitro and in vivo. The sugar may act as an antiproliferative agent via TXNIP induction and thus may be useful as a novel anticancer drug.
Expression and Distribution of Hyaluronic Acid and CD44 in Unphonated Human Vocal Fold Mucosa
Authors: Sato Kiminori , Umeno Hirohito , Nakashima Tadashi , Nonaka Satoshi , Harabuchi Yasuaki 
Published: October 2014

Objectives: The tension caused by phonation (vocal fold vibration) is hypothesized to stimulate vocal fold stellate cells (VFSCs) in the maculae flavae (MFe) to accelerate production of extracellular matrices. The distribution of hyaluronic acid (HA) and expression of CD44 (a cell surface receptor for HA) were examined in human vocal fold mucosae (VFMe) that had remained unphonated since birth. Methods: Five specimens of VFMe (3 adults, 2 children) that had remained unphonated since birth were investigated with Alcian blue staining, hyaluronidase digestion, and immunohistochemistry for CD44. Results: The VFMe containing MFe were hypoplastic and rudimentary. The VFMe did not have a vocal ligament, Reinke's space, or a layered structure, and the lamina propria appeared as a uniform structure. In the children, HA was distributed in the VFMe containing MFe. In the adults, HA had decreased in the VFMe containing MFe. In both groups, the VFSCs in the MFe and the fibroblasts in the lamina propria expressed little CD44. Conclusions: This study supports the hypothesis that the tensions caused by vocal fold vibration stimulate the VFSCs in the MFe to accelerate production of extracellular matrices and form the layered structure. Phonation after birth is one of the important factors in the growth and development of the human VFMe.
Postoperative Morbidity in Traditional versus Coblation Tonsillectomy
Authors: Gustavii Nils , Bove Mogens , Dahlin Christer 
Published: October 2014

Objectives The aim of this study was to compare levels of postoperative pain after traditional (cold steel with bipolar cautery) and Coblation tonsillectomies. Methods Patients with recurrent or chronic tonsillitis, including tonsillar hyperplasia, were randomized to undergo tonsillectomies using either a traditional cutting technique or the Coblation technique. Patients and staff on the relevant wards were blinded regarding patient allocation. Pain, odynophagia, and activity limitations were recorded on a visual analog scale. Analgesics were self-administered, and daily analgesic consumption by patients was reported. All complications were also registered. Results Fifty-seven patients (between 6 and 57 years of age) completed the study. No significant difference was found between the two techniques with regard to reported pain, odynophagia, activity limitations, or use of analgesics. A slight tendency toward decreased pain and decreased use of analgesics in the Coblation group reached statistical significance only when the adult patients were analyzed separately. Two cases of hospital readmission occurred because of postoperative bleeding following Coblation tonsillectomies. Conclusions Overall, the two methods are equivalent in terms of postoperative pain, including the use of analgesics. The risk of postoperative bleeding after the Coblation method requires further evaluation with specifically designed studies.
Midline Cervical Cleft: A Rare Congenital Anomaly
Authors: Renukaswamy Gayathri Mandya , Soma Marlene A. , Hartley Benjamin E. J. 
Published: October 2014

Objectives: A midline cervical cleft (MCC) is a rare congenital anomaly due to failure of fusion of the first and second branchial arches during embryogenesis. It may present as a midline defect of the anterior neck skin with a skin projection or sinus, or as a subcutaneous fibrous cord. This report evaluates the clinical features and surgical management of an MCC. Methods: We analyzed a series of 4 patients with an MCC successfully treated at Great Ormond Street Hospital for Children in London. Results: Three male patients and 1 female patient between 4 and 11 months of age were found to have an MCC. Each patient presented with an erythematous, fibrous band of tissue extending between the chin and the suprasternal notch. Treatment comprised surgical excision of the lesion and Z-plasty repair. We present the embryology, common clinical presentation, investigations, differential diagnosis, and histology, along with a literature review, of this uncommon malformation of the anterior neck. Conclusions: An MCC is a differential diagnosis to consider when assessing a child with a midline cervical lesion. Early surgical excision with Z-plasty repair of the soft tissue defect is the treatment of choice to prevent long-term complications.
Bioengineered Trachea with Fibroblasts in a Rabbit Model
Authors: Okano Wataru , Nomoto Yukio , Wada Ikuo , Kobayashi Ken , Miyake Masao , Nakamura Tatsuo , Omori Koichi 
Published: October 2014

Objectives: Although our group has had mostly successful results with clinical application of a tracheal prosthesis, delayed epithelial regeneration remains a problem. In our previous studies using rats, it was demonstrated that tracheal fibroblasts accelerated proliferation and differentiation of the tracheal epithelium in vitro and in vivo. The purpose of this study was to evaluate the effects of fibroblasts on epithelial regeneration in larger tracheal defects in rabbits. Methods: We developed a bioengineered scaffold, the luminal surface of which was coated with fibroblasts. This scaffold was implanted into tracheal defects in 12 rabbits (bioengineered group), and scaffolds without fibroblasts were implanted in 12 rabbits (control group). The regenerated epithelium was histologically examined by light microscopy, scanning electron microscopy, and immunohistochemical studies. Results: In the bioengineered group, a stratified squamous epithelium was observed on the surface 7 days after transplantation. However, in the control group, the scaffolds were exposed. Fourteen days after implantation, a columnar ciliated epithelium was observed in the bioengineered group. The average thickness of the regenerated epithelium in the bioengineered group was significantly greater than that in the control group. Conclusions: This study indicated that fibroblasts had a stimulatory effect that hastened regeneration of the epithelium in large tracheal defects.
Eye Movements in Response to Electrical Stimulation of the Lateral and Superior Ampullary Nerves
Authors: Guyot Jean-Philippe , Sigrist Alain , Pelizzone Marco , Feigl Georg C. , Kos Maria Izabel 
Published: October 2014

Objectives: Recently, we demonstrated that it was possible to elicit vertical eye movements in response to electrical stimulation of the posterior ampullary nerve. In order to develop a vestibular implant, a second site of stimulation is required to encode the horizontal movements. Methods: Three patients with disabling Meniere's disease were included in the study. Before a labyrinthectomy via a standard transcanal approach was performed, their lateral and anterior ampullary nerves were surgically exposed under local anesthesia through a procedure we recently developed. The attic was opened, the incus and malleus head were removed, and a small well was drilled above the horizontal portion of the facial nerve canal to place an electrode. This electrode was used to deliver balanced biphasic trains of electrical pulses. Results: The electrical stimuli elicited mainly horizontal nystagmus without simultaneous stimulation of the facial nerve. Conclusions: It is possible to stimulate electrically the lateral and superior ampullary nerves without simultaneous stimulation of the facial nerve. Because the nerves run close to each other, electrical stimulation provoked eye movements that were not purely horizontal, but also had some vertical components. Nevertheless, this site can be used to encode horizontal movements, because central adaptation may correct unnatural afferent vestibular cues delivered by a prosthetic sensor. The range of stimulus intensities that produced a response was broad enough for us to envision the possibility of encoding eye movements of various speeds.
Systematic Review of Endoscopic Airway Findings in Children with Gastroesophageal Reflux Disease
Authors: May Jason Glenn , Shah Priyanka , Lemonnier Lori , Bhatti Gaurav , Koscica Jovana , Coticchia James M. 
Published: October 2014

Objectives: We performed a systematic review of published literature correlating findings on endoscopic evaluation of the larynx and trachea in the pediatric population with the incidence of gastroesophageal reflux disease. Methods: Eight articles were identified through a structured PubMed search of English-language literature using the key terms laryngopharyngeal reflux, extraesophageal reflux, and gastroesophageal reflux. A systematic review was performed relating the presence of reflux in the pediatric population to findings on endoscopic airway evaluation. A covariant analysis was performed, and each study was weighted according to the number of available samples in that study as a fraction of the total. Overall odds ratios and confidence intervals were computed for each endoscopic finding on the basis of the documented absence or presence of gastroesophageal reflux disease. Results: A correlation was seen between the endoscopic findings and the presence of reflux. Conclusions: Arytenoid, postglottic, and vocal fold edema and erythema, lingual tonsil hypertrophy, laryngomalacia, and subglottic stenosis are among the endoscopic findings most frequently identified in patients with gastroesophageal reflux disease. Certain findings commonly encountered on endoscopic evaluation of the larynx and trachea in children who present with respiratory symptoms do indeed demonstrate a correlation with the presence of laryngopharyngeal reflux disease and may indicate the need for antireflux therapy.
Use of Intraoperative Laryngeal Electromyography to Evaluate Stridor in Children with Arthrogryposis
Authors: Scott Andrew R. , Kudak Brent A. H. , Skinner Stanley , Sidman James D. 
Published: October 2014

Objectives: Arthrogryposis is a rare, congenital condition characterized by joint contractures of the extremities with muscle weakness and fibrosis. The otolaryngological manifestations of this disorder may include stridor, chronic aspiration, and Pierre Robin sequence, among others. Prior reports of vocal fold immobility associated with arthrogryposis have attributed it to recurrent laryngeal nerve paralysis, rather than to cricoarytenoid joint restriction. The objective of this study was to determine whether children with arthrogryposis and vocal fold immobility demonstrated laryngeal electromyography (L-EMG) findings consistent with recurrent laryngeal nerve paralysis or with cricoarytenoid joint restriction. Methods: A retrospective, institutional chart review of children with otolaryngological manifestations of arthrogryposis was performed; 6 children were identified. Three patients had vocal fold immobility documented by flexible laryngoscopy. These 3 children were prospectively evaluated with direct laryngoscopy and intraoperative L-EMG. Results: The 3 children with arthrogryposis and vocal fold dysfunction had laryngoscopy-confirmed vocal fold immobility or significant restriction of motion. The intraoperative L-EMG tracings obtained from all 3 patients demonstrated motor unit action potentials without evidence of denervation. Conclusions: This series, albeit small, suggests that the vocal fold dysfunction related to arthrogryposis may be attributable to cricoarytenoid joint restriction or poor laryngeal coordination, rather than to nerve paralysis, as originally postulated.
Revision Rates after Endoscopic Sinus Surgery: A Recurrence Analysis
Authors: Mendelsohn Daniel , Jeremic Goran , Wright Erin D. , Rotenberg Brian W. 
Published: October 2014

Objectives: Chronic rhinosinusitis with nasal polyposis is often refractory to medical and surgical management, especially in patients with asthma and aspirin intolerance. We used a contemporary database to investigate recurrence and revision surgery rates following endoscopic sinus surgery. Methods: We performed a cohort study using a survival analysis technique. Records were reviewed of 549 patients with nasal polyposis who underwent endoscopic sinus surgery over a 10-year period. The main outcome measure was disease-free and surgery-free survival following endoscopic sinus surgery, investigated with Kaplan-Meier analyses. Results: Patients with Samter's triad were significantly more likely to have a recurrence and undergo a second surgery following recurrence (risk-odds ratio, 2.7; 95% confidence interval, 1.5 to 3.2; p < 0.01) than were patients without asthma or with only asthma from the triad. The presence of initial frontal sinus disease also increased the likelihood of revision surgery (risk-odds ratio, 1.6; 95% confidence interval, 1.2 to 1.8; p < 0.05). Conclusions: This is the first study to use survival analysis to document revision surgery rates following endoscopic sinus surgery. Revision surgery occurs at a high rate, especially in patients with asthma, Samter's triad, or frontal sinus disease. Patients should routinely be informed during clinical consultations about the likelihood of recurrence. Early intervention for frontal sinus disease may be considered.
Audioprofile-Directed Successful Mutation Analysis in a DFNA2/KCNQ4 (p.Leu274His) Family
Authors: de Heer Anne-Martine R. , Schraders Margit , Jaap Oostrik , Hoefsloot Lies , Huygen Patrick L. M. , Cremers W. R. J. 
Published: October 2014

Objectives: We undertook to show that in a family with nonsyndromic autosomal dominant sensorineural hearing loss, genetic analysis can be successful when there is a match with a specific DFNA audioprofile. We also provide an update of relevant DFNA2/ KCNQ4 audioprofiles and report the results of automatic audioprofile analysis using the Internet program AudioGene. Methods: Audiometric data and blood samples were obtained from the family W08-0384. Based on the audiograms of the affected participants, mutation analysis of KCNQ4 was started. Original audiometric threshold data were collected for all identified KCNQ4-related DFNA2 families. The Internet computer program AudioGene, recently developed for automatic audioprofile analysis, was accessed. Results: The family's audioprofile and the program AudioGene predicted the DFNA2/ KCNQ4 locus. Mutation analysis of KCNQ4 revealed a c.821T>A (p.Leu274His) mutation of the KCNQ4 gene. This mutation has been previously identified in a Dutch family. Genetic analysis revealed a common haplotype in these two families over a region including the KCNQ4 gene. Conclusions: Familiarity with the audioprofiles of DFNA traits may lead to successful mutation analysis of the gene involved, even in a small family in which genetic linkage analysis is not an option. Alternatively, the specially developed program AudioGene can be accessed on the Internet to perform automatic audioprofile analysis of a family's (audiological) phenotype.