bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unilateral Vocal Cord Paralysis in Children: Our Experience
Authors: Rooney Megan , Sidman James D. , Grischkan Jonathan M. , Tibesar Robert J. , Lander Timothy 
Published: September 2011

ObjectiveReview presentations, etiology, management, and outcomes of unilateral vocal cord paralysis (UVCP) managed at a single institution over a 10‐year period.MethodRetrospective review at a tertiary care pediatric hospital. Forty‐two patients less than 18 years old presented with UVCP between 2002 and 2011. Interventions included injection laryngoplasty, ansa cervicalis to recurrent laryngeal nerve anastomosis (AC‐RLNA), and cordotomy. Outcomes measured were vocal cord motility and reports of feeding, aspiration, stridor, and voice.ResultsEtiology of UVCP in the 42 patients included: surgical injury (n = 23), birth trauma (n = 10), prolonged intubation (n = 3), neurological origin (n = 2), vincristine chemotherapy (n = 2), and idiopathic (n = 2). Sixteen of the 42 (38%) patients fully recovered vocal cord mobility after an average of 6.03 months. Nine patients underwent injection laryngoplasty with either Gelfoam or Radiesse Voice and saw improvement of symptoms for a median of 2 or 4 months respectively. Two patients underwent AC‐RLNA with symptom improvement or resolution beginning 6 months postoperatively. Fifteen patients did not recover motion but were asymptomatic and did not require intervention.ConclusionChildren with UVCP face airway compromise, chronic aspiration, exercise intolerance, and voice abnormalities. This study favors conservative management in the majority of cases and waiting up to 1 year prior to intervention. When spontaneous recovery does not occur, injection laryngoplasty and AC‐RLNA can improve symptoms for pediatric patients.
Velopharyngeal Insufficiency Repair Outcomes in Patients with Velocardiofacial Syndrome
Authors: Hall Joseph E. , Muckala Jennifer , Sowder Derrick , Wooten Christopher , Goudy Steven L. 
Published: September 2011

ObjectiveAnalyze outcomes of operations for velopharyngeal insufficiency (VPI) in patients with velocardiofacial syndrome (VCFS). We hypothesize that patients with more severe phenotypic features of VCFS have greater VPI and are more likely to require revision VPI surgery.MethodRetrospective chart review. Demographic data, VCFS characteristics, anatomical variations, perceptual speech investigation, nasal endoscopy, acoustic nasometry, and operative intervention data were collected for each patient with VCFS and VPI at Vanderbilt University Medical Center. Sixteen patients with VCFS were reviewed.ResultsAverage age was 7.38 years, with 8 female patients. Surgery was necessary in 12 of 16 patients (75%). Eight patients (50%) underwent pharyngeal flap, 2 patients (12.5%) underwent Furlow palatoplasty, and 2 patients (12.5%) underwent sphincter pharyngoplasty. Six patients had heart anomalies (37.5%). Eight patients (50%) had hearing loss (average loss of 31 dB), and 3 patients had significant hypocalcemia (18.8%). Two patients had submucous clefts (12.5%), while 1 patient had cleft palate (6.3%). Two patients (12.5%) required revision operations. Both patients requiring revision had Tetralogy of Fallot, mild/moderate conductive hearing loss, and moderate to severe hypernasality preoperatively.ConclusionVPI is common in VCFS, and most patients require surgical intervention. VCFS patients presenting with a more severe phenotype as exhibited by increasing severity of heart disease, hearing loss, and hypernasality are more likely to require revision surgery to correct VPI.
A Case of Juvenile Angiofibroma Confined to the Vidian Canal and Sphenoid Sinus
Authors: Siva Thiru , Martinez‐Devesa Pablo , Paul Ciba A. 
Published: September 2011

ObjectiveIn this descriptive case we highlight the need for vigilance in investigating patients with typical demographic but without clinical signs of juvenile angiofibroma on nasendoscopy. We also examine the management of these cases where there is intimate relationship to the optic nerve and carotid artery.MethodWe use case records, correspondences, radiological investigations, radiographic images, and intraoperative images and videos to outline the disparity between clinical signs and pathology in this individual case.ResultsThe CT imaging of this patient demonstrates intracanulicular juvenile angiofibroma within the vidian canal without an intranasal component. This was safely but incompletely removed via an endonasal approach with preoperative embolization. Surveillance imaging allowed detection of residual tumor, which may be removed via a mid‐facial degloving approach at a subsequent procedure.ConclusionVigilance should be exercised when assessing and investigating patients with subtle signs and symptoms but typical demographic for intra‐nasal juvenile angiofibroma. Safe endoscopic removal after embolization can be performed with open surgery reserved for residual or recurrences noted on surveillance imaging.
A Novel Lid Crease Approach to Supraorbital Mucoceles
Authors: Desai Lajja , Chang Eugene H. , Allen Richard C. 
Published: September 2011

Objective1) Review various approaches to lateral frontal supraorbital mucoceles (endoscopic, open: bicoronal, hemicoronal with osteoplastic flap, subfrontal, and supraciliary approach). 2) Describe a hybrid lid crease approach that allows the direct excision of the mucocele lining and harvest of a pericranial flap through a minimally invasive well‐hidden blepharoplasty incision.Method1) Literature review of current endoscopic and open approaches for the removal of frontal/supraorbital mucoceles. 2) Description of surgical technique of the lid crease approach, harvest of pericranial flap, and a representative case with radiology, pathology, preoperative photos, intraoperative photos, postoperative photos, and follow‐up.ResultsOpen approaches to the frontal sinus are successful in the removal of lateral frontal/supraorbital mucoceles. However, disadvantages include large scars and increased operative and recovery time. Endoscopic approaches are also successful but can be limited in lateral frontal lesions. We describe a novel approach via a lid crease incision. This approach provides direct access to the frontal sinus with complete removal of the mucocele lining. In addition, a pericranial flap can be harvested to obliterate the frontal sinus. In our case, one month postoperative photos show a well‐hidden scar and 9‐month follow‐up does not show recurrence of disease.ConclusionThe hybrid lid crease approach combines the advantages of direct removal of the mucocele lining in a well‐hidden blepharoplasty incision. Although long‐term follow‐up is required to validate this technique, our preliminary data suggests this technique combines the advantages of both open and endoscopic approaches.
Application of Transepithelial Brush Biopsy for Oral Mucosal Lesions
Authors: Seltzer Paul , Loewenstein Ronald K. , Carroll Deborah J. , Buechler R. Bruce 
Published: September 2011

ObjectiveFor cases with suspicious lesions in the oral cavity, this study presents an understanding and evaluation of the clinically relevant information that can be provided from oral mucosal brush biopsy in making treatment plan decisions.MethodBetween 2008 and 2010, patients with suspicious lesions were evaluated with an oral mucosal brush biopsy prior to making treatment plans. Decision tree analysis was performed, and clinical relevancy of the information was provided by the pathologist. Clinical interventions with the oral cytology findings were correlated.ResultsDuring the evaluation period, 38 patients used the test. The oral mucosal brush biopsy provided the following clinically relevant information: 31% contained dysplasia or abnormal cells, 2% fungal organisms, 33% inflammation, 33% no cellular abnormality, and 1% other findings. In cases where inflammation was identified in conjunction with absence of abnormal or dysplastic cells, patients were placed on an observation protocol. In cases where the brush biopsy showed abnormal cells, the patient was scheduled for a surgical biopsy. A decision tree will be presented.ConclusionAn oral mucosal brush biopsy can provide clinically relevant information about lesions prior to treatment decisions. The information provided from brush biopsy can be used as one of the factors considered with other clinical information to assist doctors in making definitive selections in a clinical management plan.
Aesthetic Outcome of Rhinophyma Using Diode Laser
Authors: Natt Ravinder Singh , Tahery Jawed , Zakaria Rasheed 
Published: September 2011

ObjectiveDetermine if rhinophyma can be treated with the diode laser, a modality never used before in the United Kingdom for this condition.MethodA 1470 nm‐wavelength diode laser with 220‐micron bare fiber was used. The fine diameter fiber allows energy to be delivered in a very small area. The probe is used “freehand” to sculpt the nasal contour to aesthetic requirements using a microscope, as it is not fixed to a rigid hand‐piece.ResultsProblems with hemostasis were not encountered, as there is no bleeding or break in the continuity of the skin. Patients were discharged with topical mupirocin ointment (Bactroban; GlaxoSmithKline, Uxbridge, UK) applied under a loose dressing. Patients were followed up on a weekly basis in the outpatient clinic for 6 weeks for inspection of the external nose, decrusting, and application of mupirocin ointment.ConclusionDiode laser therapy appears to be an effective method of treating rhinophyma, avoiding postoperative bleeding and associated complications that characterize surgical resection without sacrificing the cosmetic result.
Allergic Fungal Sinusitis Presenting with Bilateral Abducens Nerve Palsy
Authors: Gudis David , Palmer James 
Published: September 2011

Objective1) Report a very unusual presentation of allergic fungal sinusitis. 2) Alert the practicing clinician to consider allergic fungal sinusitis in the differential diagnosis of unilateral or bilateral cranial neuropathies.MethodWe report a case from 2010 of a 39‐year‐old man presenting initially with bilateral abducens nerve palsy and subsequently found to have allergic fungal sinusitis with skull base erosion. The patient underwent an endoscopic approach and resection of the lesion, which extended intracranially into the epidural space.ResultsAn endoscopic image‐guided resection of the skull base lesion was successfully performed in the patient, with intraoperative findings consistent with allergic fungal sinusitis. Pathology and microbiology results revealed aspergillus fumigatus. Postoperatively the patient recovered well with complete resolution of his left abducens nerve function and no CSF leak. AFS, reportedly present in as many as 5%‐10% of patients with chronic rhinosinusitis, can present with local destruction and extensive involvement of adjacent critical structures in immunocompetent patients. This is the second known case of fungal sinusitis presenting with bilateral abducens nerve palsy, and the first in an otherwise asymptomatic healthy patient.ConclusionAllergic fungal sinusitis has repeatedly been demonstrated to cause aggressive local destruction, often out of proportion to patient symptomatology. This case contributes to the literature an exceedingly rare initial presentation of this pathology, alerting the clinician to consider AFS in the differential diagnosis of unilateral or bilateral cranial neuropathies.
Antrochoanal Polyp Originating from Inferior Turbinate
Authors: Anfuso Anthony J. , Ramadan Hassan H. 
Published: September 2011

ObjectivePresent a case of an unusual presentation of an antral choanal polyp that originates from the left inferior turbinate and does not extend into the maxillary sinus. Literature review shows only 3 prior cases where an antrochoanal polyp originated from the inferior turbinate.MethodThis is a case presentation of an 81‐year‐old woman who presented with a left sided nasal mass. Her workup included CT scan and MRI of the sinuses. The nasal mass was removed endoscopically and was sent for review by our pathologists.ResultsIn this elderly female, physical examination showed a dark nasal mass filling the entire nasal cavity. CT and MRI showed a left‐sided nasal soft tissue mass with lateral displacement of the medial wall of the left maxillary antrum. The preoperative diagnosis included inverted papilloma, benign nasal polyp, and squamous cell carcinoma. The patient was taken to the operating room where it was found that the mass originated from inferior turbinate and spanned its entire length. It was removed from this attachment and delivered nasally using endoscopic sinus instruments. Surprisingly, pathology revealed antrochoanal polyp.ConclusionClassically, an antrochoanal polyp originates within the maxillary antrum. We present this case to illustrate that the antrochoanal polyp can originate from the inferior turbinate and should be considered in a patient with a unilateral nasal mass distinct from the maxillary sinus.
Auto‐erosion of the Uncinate Process in Cystic Fibrosis
Authors: McClay John E. , Rihani Jordan J. 
Published: September 2011

ObjectiveReport a phenomenon of auto‐erosion of the uncinate process and medial maxillary wall in children with cystic fibrosis.MethodRetrospective chart review with IRB approval. Setting: Tertiary care children’s medical center. Patients: Children evaluated from 1995 to 2010 with cystic fibrosis and chronic sinusitis who were noted to have auto‐erosion of the uncinate process on endoscopic and radiographic evaluations.ResultsSix out of 62 (10%) children evaluated from 1995 to 2010 with cystic fibrosis and sinusitis without previous sinus surgery at a tertiary children’s hospital were noted to have auto‐erosion of the uncinate process and medial maxillary wall. Auto‐erosion appears to occur from expansion, pressure, and demineralization of the bones of the uncinate process and medial maxillary wall.ConclusionAuto‐erosion of the uncinate process is seen in children with sinusitis and cystic fibrosis. Auto‐erosion appears to be a non‐surgical self‐ventilating phenomenon associated with improvement of maxillary sinus disease on computed tomography.
Atypical Presentations of Pleomorphic Adenoma
Authors: Ballin Annelyse Cristine , Carvalho Bettina , Bettega Marcelo , Ballin Carlos‐Roberto , Bettega Silvio , Mocellin Marcos 
Published: September 2011

ObjectiveReport 2 cases of pleomorphic adenoma with different clinical presentations and unusual locations—the uvula and inferior nasal turbinate (INT)—and discuss the variety of presentings in this type of tumor.MethodReport of 2 cases of pleomorphic adenoma in unusual places.ResultsCase 1: For 20 years, the patient complained of frequent choking and progressive growth of lesions in the uvula, then underwent uvuloplasty with total excision of the lesion. Case 2: The patient complained of progressive nasal obstruction in the right nasal cavity and had septoplasty and turbinectomy performed. CT of the paranasal sinuses revealed an extensive mass of inferior nasal turbinate to the right choana. An endoscopic right turbinectomy procedure was conducted. The pathology suggested pleomorphic adenoma.ConclusionPleomorphic adenoma located either in the uvula or the inferior nasal turbinate are rare. This neoplasm should always be considered in the differential diagnosis of head and neck injuries so that early surgical treatment might prevent its progression to malignancy.
Chronic Invasive Sinonasal Mucormycosis: A Case Series
Authors: Al Masaoudi Laila Musabah , Al Mujaini Abdulla , Balkhair Abdullah , Al Azri Faisal , Al Badaai Yahya Nasser 
Published: September 2011

ObjectiveMucormycosis infection of the paranasal sinuses is a rare disease that usually presents as an acute fulminant infection in immunocompromised patients. However, the chronic form of mucormycosis can be seen as well as an indolent and slowly progressive disease.MethodCase series of four patients diagnosed with chronic sinonasal mucormycosis.ResultsA series of four consecutive patients treated at a tertiary care center with diagnosis of sinonasal mucormycosis based on histopathological and microbiological confirmation. The duration of symptoms before presentation varied from eight days to four months. Three patients were immunocompromised. Of these, two were rhino‐orbito‐cerebral form. Mucormycosis was successfully treated with endoscopic surgical debridement and antifungal therapy. Complete resolution reported in two patients and partial response in two patients.ConclusionChronic invasive sinonasal mucormycosis is an increasingly diagnosed form of invasive fungal rhinosinusitis, which necessitates further study to understand the natural history of the disease.
Clinical Scores Evaluation for Brazilian CRS Patients
Authors: Tamashiro Edwin , Adelino Odair Aparecido , Valera Fabiana C. P. , Antunes Marcelo Barros , Anselmo‐Lima Wilma T. 
Published: September 2011

ObjectiveEvaluate if the clinical measures SNOT‐22 and UPSIT are efficient in monitoring treatment in Brazilian patients with CRS.MethodA total of 16 patients with CRS were treated with topical mometasone (200 microgram BID) for 2 months. SNOT‐22, sense of smell score in SNOT‐22, UPSIT, Lund‐Mackay (for CT) and Lund (for endoscopy) scores were evaluated before and after treatment. Multi‐variable correlation tests were used to compare the differences between scales.ResultsImprovement in UPSIT scores correlated negatively to the sense of smell score in SNOT‐22, (R2: 0.50; P =. 0367), demonstrating to be a good tool to quantify smell problems. On the contrary, UPSIT did not correlate with CT and endoscopy scores. Improvement in SNOT‐22 scores correlated significantly to improvement in endoscopy scores (R2: 0.49; P =. 0297), but not to CT and UPSIT scores.ConclusionUPSIT is a valuable tool to measure smell changes and monitor the effect of clinical treatment in patients with CRS. SNOT‐22 correlated positively to intranasal polyp formation rather than sinusal opacity on CT scans.
Clinical Study of 1304 Patients with Epistaxis for Recent 5 Years
Authors: Yukitatsu Yoriko , Oka Hideki , Takebayashi Hironori , Tsuzuki Kenzo , Sakagami Masafumi 
Published: September 2011

ObjectiveEpistaxis is one of the most common symptoms encountered in the ENT clinic. In this study, we reviewed our recent clinical experience of patients with epistaxis and discussed important lessons for the management of cases of epistaxis.MethodBetween 2005 and 2009, 1304 patients with epistaxis were treated at our department. There were 795 men and 509 women. Mean age was 57 years (range, 0‐99 years). Clinical features: situations at the first visit; pathogenesis; bleeding points; methods of treatments; and clinical courses were retrospectively investigated.ResultsThe 700 patients (54%) first visited in the nighttime. The most common condition was hypertension in 388 patients (30%) followed by cardiovascular disease in 262 patients (20%). The 630 patients (48%) were on medication with hypotensors and/or antithrombotic drugs. Kiesselbach’s plexus was the mostly observed, as it was observed in 679 patients (52%). In 225 patients (17%), bleeding point was not confirmed. The 424 patients (33%) were primarily treated by anterior packing, followed by electrocauterization in 365 patients (28%). Re‐bleedings within 14 days after the primary treatments were found in 181 patients (14%). Hospitalized surgical treatments were required in 3% (6/181 patients).ConclusionOutpatient therapy is usually enough to arrest hemorrhage in major cases. However, we have encountered patients with repeating arterial pulsing bleedings who require emergent hospitalized surgical therapy. Risk of re‐bleeding within a day should be considered if patients had uncertain bleeding point and circulatory diseases.
Dacryocystorhinostomy Endoscopic Endonasal Surgery: Analysis of 17 Cases
Authors: Mosciaro Manuela Salvador , Teixeira Alex , Andreiuolo Fernando , Dias Priscilla Sequeira , Ferreira Terceiro Denivaldo R. , Barbosa Leite Jorge da Cunha , de Arajuo Melo Maria‐Helena 
Published: September 2011

ObjectiveNasolacrimal duct obstruction is a common change clinically manifested by the presence of epiphora and/or dacryocystitis. The objective is to analyze the technique and evaluate the success of endoscopic endonasal dacryocystorhinostomy to remove obstructions in the lacrimal ducts, using the same surgical technique for all cases.MethodThis is a retrospective study. All 17 surgeries were performed from May 2006 to January 2011. Variables of interest were age, gender, duration, clinical presentation, etiology, surgical technique, use of silicone tubes, complications, and postoperative success. Successful surgery: absence of symptoms and tear flow after 7 months of follow‐up.ResultsAlthough drug therapy may resolve the symptoms, the definitive approach consists of surgical procedure to restore patency of the lacrimal drainage system. We noticed that females were predominant (70.59%). There were 11 women, 1 girl, and 5 boys ages 3 to 71 years (average age range, 40.11 years) submitted to surgery performed by unciform process incision and posterior flap of lacrimal sac. The most involved side was the right (n = 11). Etiology was idiopathic, and the most predominant clinic was dacryocystitis. Silicone tube was used in 2 cases. We obtained a primary success of 94.11%. Complication: major bleeding in 1 case (anterior tamponade).ConclusionPrimary success rate in most cases. Endoscopic surgery is a safe technique with excellent results for nasolacrimal duct obstruction. It is an excellent surgical option for otorhinolaryngology residents in university hospitals.
Effect on O‐Methylated Catechin for Allergic Rhinitis
Authors: Ishizaki Hisayoshi , Maeda‐Yamamoto Mari 
Published: September 2011

ObjectiveBenihuuki is a kind of Japanese green tea with high O‐methylated catechin content. The purpose of this study is to demonstrate the effect of Benihuuki on allergic rhinitis induced by cedar pollen. We evaluate the effect of Benihuuki and Yabukita without O‐methylated catechin.MethodTwo kinds of Benihuuki and Yabukita green tea were prepared for allergic rhinitis induced by cedar pollen. The subjects were asked to drink tea 2 times a day, following tea making instruction. The effect of those green teas was evaluated with immunological examination, blood sample test, and rhinomanometry.ResultsBoth Benihuuki and Yabukita were effective for the improvement of nasal obstruction. Benihuuki has more potential for improvement of nasal obstruction. Improvement of life disability caused by allergic rhinitis was more significantly demonstrated in Benihuuki.ConclusionBenihuuki was proven to have high potential for treatment of nasal obstruction due to allergic rhinitis caused by cedar pollen provocation. Benihuuki is one beneficial way to protect against allergic rhinitis induced by cedar pollen.