bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stability of Midface Fracture Repair Using Absorbable Plates
Authors: Pereira Lucio M. , Zuliani Giancarlo , Abu‐Hamdan Maher D. , Carron Michael 
Published: September 2011

ObjectiveDetermine if the KLS Martin Sonic Weld system provides plate‐screw construct stability in human skulls even when placed at acute angles at the midface buttresses. The strength of the construct will be compared with absorbable miniplates with screws placed at 90‐degree angles.MethodTen skulls will be prepared by creating midface osteotomies bilaterally. All screws will be placed at 90 degrees on the control side. The contralateral side will be plated with the absorbable system at more acute angles. The data will be compared as matched pairs within each specimen and statistically analyzed.ResultsFractures fixated with the ultrasonic absorbable plating system placed with screws at all tested angles will fail at similar to our control plates placed at 90 degrees. This will allow the surgeon to successfully reduce fractures in the midface fragments in difficult to reach areas and possibly cut down on operative time and improve the chance of achieving a long lasting adequate reduction.ConclusionThere is no difference in the strength of the plate‐screw construct using the ultrasonic plate‐pin system between pins placed at the conventional 90° or at more acute angles. This is likely a function of the design of the plating system.
Otologic Disease in Polyostotic Fibrous Dysplasia and McCune‐Albright Syndrome
Authors: DeKlotz Timothy , King Kelly , Collins Michael T. , Zalewski Christopher K. , Kim Hung Jeff J. , Brewer Carmen C. 
Published: September 2011

Objective1) Characterize the spectrum of otologic disease in patients with polyostotic fibrous dysplasia (PFD) and McCune‐Albright Syndrome (MAS). 2) Correlate audiometric analysis with temporal bone computed tomography (CT) findings in this cohort.MethodA retrospective review was performed in a cohort of PFD/MAS (n = 123) followed in a longitudinal natural history protocol. Patients with craniofacial involvement and those who underwent comprehensive otologic evaluation, audiologic analysis, and cranial CT imaging evaluation were included.ResultsComplete evaluations were available for 107 patients. Fibrous dysplasia (FD) of the temporal bones was identified in the majority (71%). Clinically significant hearing loss (.5/1/2/4 kHz PTA >20 dB HL) was identified in 30 ears (20%). A conductive loss (70%) was more frequent than a sensorineural loss (30%) and overall was primarily mild (70%). External auditory canal stenosis, epi‐tympanic involvement, and internal auditory canal involvement based on CT were found to be rare potential contributors to overall hearing loss (n = 10 ears). While canal cholesteatoma can be a major complication, it was only identified in one patient.ConclusionFD of the temporal bones in patients with PFD/MAS was common. Clinical manifestations depend on the location and degree of skeletal involvement. Otologic problems and hearing loss were present in a minority and were generally mild. Serious complications were rare. Conservative management may often be the best plan of care.
Prevalence of Profound Hearing Loss and Cophosis in 1015 Patients from the Chronic Otitis Media Outpatient Clinic in Brazil
Authors: Migliavacca Raphaella , Manica Denise , Rosito Leticia S. , Da Costa Sady S. , Dornelles Cristina 
Published: September 2011

ObjectiveAn issue that has recently gained attention is, in addition to conductive hearing loss, sensorineural hearing loss (SNHL) due to chronic otitis media (COM). The objective of this study is to evaluate the prevalence of profound hearing loss and cophosis in chronic otitis media patients with or without cholesteatoma.MethodTransversal study. We studied 1015 patients from the Chronic Otitis Media Outpatient Clinic of the Hospital de Clínicas in Porto Alegre, evaluated between August 2000 and January 2011. The inclusion criterion was presence of COM, with or without cholesteatoma. The main outcome was the presence of profound hearing loss and cophosis.ResultsA total of 1015 patients were evaluated. Ages varied between 2 and 87 years, with an average age of 28.36 ± 18.85 years; 50% of them were females, and 371 had cholesteatoma. Of all samples, 16 had profound hearing loss or cophosis (1.57%). Considering only our deaf samples, ages varied between 10 and 74 years, with an average age of 44.23 ± 19.20 years; 11 patients (68.8%) were females, and 7 had cholesteatoma. The prevalence of profound hearing loss or cophosis in patients with and without cholesteatoma was 1.3 and 2.2%, respectively. Cholesteatoma determined an estimated risk of 1.69 for very significant hearing loss.ConclusionCOM can affect round and oval windows and others sites of the inner ear. The prevalence of profound hearing loss and cophosis strongly associated with COM was only 1.4% in our sample. Patients with cholesteatoma have 1.7 times more chance of profound deafness/cophosis due to COM than patients without cholesteatoma.
Repair of Temporal Bone Defects with Bone Cement: Our Experience
Authors: Pérez‐Fernández C. Aranzazu , Contreras J. Diego , Rodríguez‐Francos M. Isabel , García‐Sevilla Tomás , Calatayud Vincente , Cervan Fernando 
Published: September 2011

ObjectiveThe defects of temporal bone are classified according to their causative factor. Definitive repair of the defect is paramount to prevent potentially devastating complications. There are different approaches, and multiple materials have been used to repair the defects. We describe our experience using bone cement.MethodMedical records of consecutive patients with spontaneous defect of the temporal bone were reviewed. A retrospective review was performed over a 5‐year period. Clinical presentation, diagnosis process, intraoperative findings, operative technique, and postoperative follow‐up. The surgical technique was reviewed as well as the wound healing and structural integrity results.ResultsFive of the 7 patients were women (4 spontaneous cerebrospinal fluid otorrhea, 1 colesterine granuloma, and 2 after mastoidectomy). Ages ranged from 42 to 63 years. Four patients presented with meningitis. The location and the extent of the defect were detected by computed tomography in all cases. The most common defect sites were located over the tegmen mastoideum and tegmen tympany. All the tegmen defects were repaired using a middle fossa approach with bone cement. All patients had complete resolution of the problem without adverse effects.ConclusionSurgical management using a middle fossa craniotomy is outlined. The bone cement is hard within minutes of application. This procedure offers a simple and reliable method for repairing the tegmen defects with a high cure rate.
Results of Revision Tympanoplasty for Chronic Non‐cholesteatomatous Otitis Media
Authors: Lesinskas Eugenijus , Stankeviciute Vilma 
Published: September 2011

ObjectiveEvaluate the success rate for revision tympanoplasty using different graft materials, to compare results of primary and retympanoplasty using the same technique, and to analyze the effect of potential influencing factors on closure of tympanic membrane (TM) and hearing outcome.MethodPatients who underwent tympanoplasty (n = 617) or re‐tympanoplasty (n = 94) for chronic otitis media without cholesteatoma. The different data were analyzed. The temporal fascia, perichondrium, and cartilage‐perichondrium composite grafts were used. Ossiculoplasty was performed as needed. The interrelation between preoperative parameters, postoperative morphological outcomes, and functional outcomes was analyzed.ResultsSuccessful closure rates of the TM perforation were 93.6% and 90.2% in the primary and revision tympanoplasty groups. Graft take rate and hearing results did not depend on graft material. Structural changes were found more frequently in the re‐tympanoplasty group (63.4%, compared with 29.5% of primary cases). Ossiculoplasty was performed more often in revision cases (24.4%, compared with 11.4% of primary cases). Successful hearing (ABG within 20 dB) for primary tympanoplasties was achieved in 81.1% and for re‐tympanoplasty in 69.5% (P <. 01). There were no interrelation between any estimated parameters and the graft take rate for either primary or revision tympanoplasty.ConclusionPatients who underwent tympanoplasty (n = 617) or re‐tympanoplasty (n = 94) for chronic otitis media without cholesteatoma. Different data were analyzed. The temporal fascia, perichondrium, and cartilage‐perichondrium composite grafts were used. Ossiculoplasty was performed as needed. The interrelation between preoperative parameters, postoperative morphological outcomes, and functional outcomes was analyzed.
Retrograde Guided Balloon Dilatation Eustachian Tuboplasty
Authors: Testa Jose Ricardo Gurgel , Tamiso Arnaldo B. , Paris Oswaldo , Testa Tatian , Balsalobre Filho Leonardo L. , de Oliveira Penido Norma 
Published: September 2011

ObjectiveEvaluate a new option for treatment of patients with Eustachian tube stenosis.MethodProspective surgical study. Three patients with unilateral intractable Eustachian tube stenosis (after surgical procedures) underwent retrograde illumination with Relieva Luma Sentry from middle ear to nasopharyngeal area and with endoscopic nasal approach to balloon dilatation to that area under general anesthesia. The procedures were done between 2010 and 2011.ResultsBy following the light that was dissected through the stenosis tissue until we could have the Relieva Luma Sentry, we then inserted it retrograde inside a sphenoid balloon catheter and inserted the balloon inside a tubal lumen. After that, the balloon was inflated for 2 minutes with 10 atm to tubal dilatation. The approach to the middle ear was done transtympanically. Balloon catheters had success in dilatation in all cartilaginous Eustachian tubes. Balloon dilatation was not difficult to perform. Patients reported a very good improvement of hearing levels and a good dilatation comparing the tomography before and two months after the procedure.ConclusionRetrograde guided balloon dilatation of the nasopharyngeal Eustachian tube ostia showed good results. Larger studies are now needed to show the real role of this surgery.
The Differences in Management of Isolated Orbital Floor Fractures
Authors: Alinasab Babak , Stjärne Pär 
Published: September 2011

ObjectiveTo evaluate 1) differences in opinion between the subspecialties and surgeons from Sweden and the United States in the management of branchio‐oculo‐facial syndrome (BOF); 2) if the surgeons handle these cases based on their own individual criteria; 3) the correlation between the management of the patients with BOF and late sequels upon eye examination.MethodEleven patients with BOF were selected from the records in the Department of ENT and Head & Neck Surgery, Karolinska University Hospital. They were presented to surgeons from different countries and subspecialties who gave their opinion regarding the need for surgery and risk for late enophthalmus.ResultsIn only 48% of the cases the surgeons were in agreement of the management of the patients regarding whether or not to operate. In evaluating the risk for late enophthalmus the surgeons were in agreement in 51% of the eleven cases. The surgeons from the United States found need of surgery 13% more than the surgeons from Sweden.ConclusionThe management of BOF appears to be based on both individual and local traditions. There are considerable differences in the management of BOF, due to lack of reliable consensus. Guidelines based on randomized prospective study in BOF are required.
Role of Pathogens in Ossicular Prosthesis Problems
Authors: Wingkun Niel‐Jeremy G. , Ojano‐Dirain Carolyn P. , Fulton Edward , Antonelli Patrick J. 
Published: September 2011

ObjectiveMicrobial biofilms are commonly found on ossicular chain reconstruction prostheses (ORPs). They have been implicated as a cause of suboptimal hearing outcomes. The purpose of this study was to determine which middle ear pathogens might be involved with ORP biofilms and ORP problems, such as scarring or extrusion.MethodORPs were explanted at the time of revision surgery and analyzed for microbial colonization using quantitative polymerase chain reaction (qPCR) with pathogen‐specific primers for Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Candida albicans, Candida parapsilosis, and Aspergillus niger. Results were correlated with the otologic status.ResultsThe majority of ORPs (19 of 21) tested positive for at least one pathogen. On average, each ORP tested positive for the presence of 2 pathogens. Twelve tested positive for S aureus, 10 for H influenzae, 9 for P aeruginosa, and 1 for S pneumoniae. No samples revealed C albicans, C parapsilosis, or A niger. Hearing, cholesteatoma, presence of effusion, extent of middle ear scarring, and extrusion did not appear to correlate with the presence of specific pathogens.ConclusionORPs commonly harbor polymicrobic bacterial colonies or biofilms. Fungal pathogens are not commonly found on ORPs. While the presence of these biofilm‐forming organisms is evident, it is unclear whether these pathogens play a role in unfavorable outcomes with middle ear reconstruction.
Spontaneous Cerebrospinal Fluid Leak through the Posterior Aspect of the Petrous Bone
Authors: Nadaraja Garani S. , Monfared Ashkan , Jackler Robert K. 
Published: September 2011

ObjectiveSpontaneous cerebrospinal fluid (CSF) leak through the posterior fossa aspect of the petrous bone (PF) is very rare. A case series allows analysis of possible etiologies and how they may differ from the more common middle fossa (MF) route of leakage.MethodA series of 3 patients with PF spontaneous temporal bone CSF leaks is described. High‐resolution imaging (CT & MRI) and intraoperative observation characterize the anatomical characteristics of the pathway.ResultsThis series of patients did share the demographics typically found in the MF leak population. Two patterns of PF CSF leak were identified: large unilateral with cerebellar encephalocele and bilateral small defects just lateral to the endolymphatic sac. Two out of our 3 patients presented with simultaneous MF and PF leaks suggesting the possibility of a shared etiology, at least in some cases, with a role for increased intracranial pressure.ConclusionIn spontaneous CSF leaks it is important to evaluate the posterior petrous bone along with the tegmen. The concomitant appearance of MF with PF leaks points out the risk that repair via MF craniotomy could fail to identify a leakage site in the vicinity of the endolymphatic sac.
Stress Hormone Sensitivity and Endolymphatic Hydrops
Authors: Kitahara Tadashi , Maekawa Chie , Inohara Hidenori , Okazaki Suzuyo , Horii Arata , Kamakura Takefumi 
Published: September 2011

ObjectiveMénière’s disease is peculiar to humans, and attacks of this affliction can occur under conditions of stress. The present study aimed to assess the link between inner ear hydrops in Ménière’s disease and vasopressin, an anti‐diuretic stress hormone with a potential role in inner ear fluid homeostasis.MethodWe obtained blood samples from Ménière disease patients to examine plasma vasopressin (pAVP) and obtained inner ear tissue during endolymphatic sac surgery to examine vasopressin type‐2 receptor (V2R) in the endolymphatic sac. We examined pAVP and the relative V2R mRNA expression in the endolymphatic sac using real‐time PCR.ResultsA significant negative correlation was revealed between pAVP and inner ear V2R (P =. 014). We also examined relative cyclic AMP (cAMP) activity in the endolymphatic sac using tissue culture and cAMP assay. Both pAVP (1.6 times vs controls; P =. 048) and inner ear V2R mRNA expression (41.5 times vs controls; P =. 022) were significantly higher in Ménière patients. cAMP activity was basally upregulated (2.1 times vs controls) and cAMP sensitivity to vasopressin application was largely elevated (4.9 times vs controls) in Ménière patients.ConclusionWe concluded that in the pathogenesis of inner ear hydrops resulting in Ménière attacks, pAVP elevation probably as a result of stress may present a matter of consequence, but susceptibility of the V2R‐overexpressed and cAMP‐hypersensitized inner ear to pAVP elevation might be essential as a basis of this disease.
Symptom‐Based Intratympanic Dexamethasone for MénièreDisease
Authors: McRackan Theodore R. , Pearce Elizabeth C. , Bennett Marc L. , Labadie Robert F. 
Published: September 2011

ObjectiveUnderstand the effectiveness of intratympanic (IT) dexamethasone for Ménière disease when given on an as‐needed basis for worsening symptoms.MethodRetrospective cohort of 115 patients with AAO‐HNS criteria for definite Ménière disease who had failed lifestyle modifications and medical therapy. All patients received initial IT dexamethasone treatment. If unsuccessful in controlling symptoms, patients then chose further IT dexamethasone injections or ablative therapy (IT gentamicin or endolymphatic sac surgery).ResultsOf the 115 patients in this study, 92 (80.0%) reported satisfactory control of their Ménière disease symptoms with IT dexamethasone while 18 (20.0%) chose to receive ablative therapy. In those patients controlled with IT dexamethasone 58 (63.0%) were controlled with 3 or less injections, 28 (30.4%) were controlled with 4 to 10 injections, and 6 (6.5%) were controlled with more than 10 injections. Of those patients who chose ablative therapy, 8 (34.8%) chose IT gentamicin and 15 (65.2%) chose endolymphatic sac surgery. Age, sex, and duration of symptoms were not statistically associated with failed IT dexamethasone therapy (all P >. 05).ConclusionWhile multiple injections may be required, IT dexamethasone appears to be an effective alternative to ablative therapy in controlling symptoms in the majority of patients and can be used on an as‐needed basis when a patient’s symptoms significantly worsen.
Systematic Screening for KCTD12 Mutations Tinnitus
Authors: Kleinjung Tobias , Langguth Berthold , Sand Philipp 
Published: September 2011

ObjectiveWith regard to inhibition, GABAB receptors have been implicated in frequency‐dependent depression of transmitter release affecting synaptic plasticity. We speculated that genetic variation in potassium channel T1 domain‐containing 12 protein (KCTD12), a recently identified constituent of GABAB receptors, may predispose to over‐excitability as experienced by tinnitus subjects.MethodA total of 81 white outpatients with a diagnosis of chronic tinnitus were systematically screened for mutations in the KCTD12 N‐terminal, cytoplasmic tetramerisation domain by direct sequencing.ResultsNo novel variants were identified. We confirmed the presence of one synonymous substitution, rs34544607 (T178T), and one noncoding variant in the gene’s 3′UTR, rs41287030. When genotypes were grouped assuming dominance of the minor alleles, no significant genotype or compound genotype effects were observed on tinnitus severity by scores on the Tinnitus Questionnaire.ConclusionThis is the first study to have addressed KCTD12 mutations in chronic tinnitus. Further investigations are invited in larger samples and in controls to assess a possible modulatory role of the above exonic variants on tinnitus susceptibility, or on related phenotypes.
The Effect of Depressor Septi Nasi Cutting on the Nasal Tip
Authors: Toutounchi Javad Seyed , Salari Behzad , Nezami Nariman , Toutounchi Neghisa , Banaem Samira Moghaddam 
Published: September 2011

ObjectiveThe nasal tip is an important aesthetic feature of the face and its surgery is the most interesting and challenging part of a rhinoplasty. The aim of this study was to evaluate the effect of cutting the depressor septi nasi muscle on the nasal tip rotation and projection.MethodThis clinical trial was carried out from 2008 to 2010 in Imam Reza hospital of Tabriz. Forty primary rhinoplasty patients who required nasal tip modifications underwent rhinoplasty including cutting of depressor septi nasi. The nasal tip rotation and projection and patient satisfaction were evaluated before and 6 months after the operation.ResultsThe mean age of patients was 24.10 ± 5.37 years with male to female ratio of 13/27. Following rhinoplasty including depressor septi nasi muscle cutting, nasal tip rotation and projection, and patient satisfaction were improved in 58%, 70%, and 85% of patients, respectively (P <. 001 for all).ConclusionRhinoplasty by cutting and repositioning of depressor septi nasi muscle has effectively improved the nasal tip rotation and projection and patient satisfaction.
The Effect of DizzyFIX in the Treatment of Benign Paroxysmal Positional Vertigo
Authors: Son Won‐Sang , Su Lee Jang , In Kim Young , Park Byung‐Cheol , Kim Wee‐Hwang 
Published: September 2011

ObjectiveThe treatment of benign paroxysmal positional vertigo (BPPV) is a repositioning maneuver in order to remove otolithic debris. We use a new device (the DizzyFIX) to assist in the performance of the modified Epley maneuver (MEM). The purpose of this study is to find out the effect of the dizzyFIXR in the treatment of BPPV.MethodSixty cases of posterior semicircular canal BPPV were studied. All patients were treated by MEM. They were divided into 2 groups. The first group (group A, 30 patients) was only MEM group. The second group (group B, 30 patients) was instructed to use the dizzyFIXR in MEM.ResultsIn group A and B, dizziness handicap inventory(DHI) scores were found in pre‐ and post‐MEM. (The DHI scores pre‐ and post‐MEM in group A were 40.12 ± 6.58 and 19.42 ± 3.29, p in group A were 6.5 ± 0.5 and 3.4 ± 0.4, and in group B were 6.7 ± 0.4 and 2.2 ± 0.3, P <. 05) was noted.ConclusionFrom the analysis of this study, the use of this new device to assist in the performance of MEM for the treatment of posterior BPPV may be effective to relieve anxiety related to unsteadiness in BPPV patients and to increase satisfaction of MEM in BPPV patients.
Three‐Dimensional Reconstruction of Auricles by HRCT
Authors: Chen Chin‐Kuo , Huang Kuo‐Wei , Tsai Men‐Shen , Chang Kai‐Ping 
Published: September 2011

ObjectiveThe purpose of this study was to compare the dimensional measurements and surface topography of geometry reconstructed from high‐resolution computerized tomography (HRCT) of temporal bone with the same natural ears.MethodHRCT of temporal bone was performed using simultaneous acquirement of 64 sections with a slice thickness of 0.5 mm. Corresponding image data were uploaded into software Amira 4.1 for segmentation and three‐dimensional reconstruction. A comparison of the surface topography of the CT reconstructed ear and the natural ear was made.ResultsThis prospective study included 10 subjects, including 5 males and 5 females with normal hearing and no previous otologic disorders. A significant correlation of coefficients of various measurements on reconstructed auricles and natural auricles was made. The shape and volume of reconstructed ears by Amira was identical to the natural ear.ConclusionThe shape and volume of reconstructed auricles by Amira was identical to the natural ears. CT may be appropriate to fabricate a prosthesis through non‐invasive techniques. The use of this technique in clinical practice may be in production of a prothesis.