bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low Temperature Results in Decreased Tension in Decellularized Human Nasal Mucosa
Authors: Chu Yueng-Hsiang , Wu Chin-Chen , Wu Ching-Hsiang , Wang Hsing-Won 
Published: February 2010

Background Cooling may induce nasal obstruction. In our previous study, we showed low temperature induced a rapid relaxation of isolated human nasal mucosa and it was independent of vasoconstriction. The aim of this study was to elucidate the mechanism responsible for such findings. Methods Nasal mucosa strips were prepared from inferior turbinate samples. Decellularization of human nasal mucosa was achieved by treatment with sodium dodecyl sulfate 0.1% for 15 hours at 37°C in a shaking water bath. Then, the effect of cooling (37-10°C) on the isometric tension change of decellularized nasal mucosa was evaluated. In addition, the presence of elastic fibers within the nasal mucosa was identified in both histological section and scanning electron microscope. Results Results indicated cooling induced a relaxation response of isolated decellularized human nasal mucosa and it was similar to that of intact nasal mucosa. The elastic fibers formed in wavy lines and were distributed throughout the submucosal layer. Conclusion Cooling induced a similar relaxation response both in the absence or in the presence of cellular components in isolated human nasal mucosa, suggesting that this response is mediated by the abundant extracellular matrix.
Nitric Oxide Metabolites as Biomarkers for follow-up after Chronic Rhinosinusitis Surgery
Authors: Deroee Armin Farajzadeh , Naraghi Mohsen , Sontou Alain Fabrice , Ebrahimkhani Mohammad Reza , Dehpour Ahmad Reza 
Published: February 2010

Background Nitric oxide (NO) has a variety of effects on the pathophysiology of the nasal cavity and seems to play an important role in inflammation. It is increased in the common cold but decreased in acute and chronic rhinosinusitis (CRS). Exhaled NO increases after endoscopic sinus surgery in CRS. In our previous study we showed that NO metabolite (nitrate and nitrite) levels are increased in the sinus cavity of CRS patients. We hypothesized that NO metabolite levels are increased to normal in the nasal lavage of CRS patients after endoscopic sinus surgery and NO metabolites in the nasal lavage can be used as indicators of the disease status after surgery. Methods This study was performed on 52 patients with CRS who did not respond to medical therapy and who underwent surgery. NO metabolite levels were measured in nasal lavages of the patients before surgery and 2 months after surgery. Results NO metabolite levels (mean ± SEM) were 18.11 ± 3.08 μmol/L and 35.97 ± 4.64 μmol/L in nasal lavages of patients before and after surgery, respectively. The levels of NO metabolites were increased significantly (p < 0.01) after surgery in nasal lavages and patients reported significant improvement based on the visual analog scoring after the operation. Conclusion NO metabolite levels were decreased in nasal lavages of CRS patients and were increased to normal levels after surgery along with improvement of the disease. NO metabolite levels may be used as an indicator for the follow-up of patients after endoscopic sinus surgery.
Endoscopic Anatomy of the Petrous Segment of the Internal Carotid Artery
Authors: Zimmer Lee A. , Hart Catherine , Theodosopoulos Philip V. 
Published: February 2010

Background Exposure of the petrous (C2) segment of the internal carotid artery (ICA; petrous carotid) is necessary to treat lesions that have spread from the intracranial space or adjacent sinonasal region. Recent advancements in endonasal-endoscopic approaches to the anterior skull base raise the possibility of extending these approaches beyond the sinonasal cavity. In this cadaveric study, we evaluate the feasibility and extent of exposure of the petrous carotid artery via a combined endoscopic endonasal approach. Methods Endoscopic dissection was performed in four formalin-fixed cadaver heads (eight sides). An endoscopic, endonasal, transmaxillary approach was used to identify the cervical and petrous carotid artery. Results With the endoscopic endonasal, Caldwell-Luc approach, we could visualize the ventral petrous bone after dissecting the contents of the pterygopalatine fossa and infratemporal fossa. Careful dissection allowed exposure of the petrous carotid artery from the upper cervical carotid to the foramen lacerum. Conclusion In this cadaveric study using an endoscopic endonasal approach for exposure of the petrous carotid artery, combination with the transmaxillary-transpterygopalatine-transinfratemporal approaches permitted exposure of the ventral portion of the artery. The anatomy presented will assist experienced endoscopic skull base surgeons in the removal of lesions involving the ventral skull base.
Factors Contributing to Failure in Endoscopic Skull Base Defect Repair
Authors: Wise Sarah K. , Harvey Richard J. , Neal Jeffrey G. , Patel Sunil J. , Frankel Bruce M. , Schlosser Rodney J. 
Published: February 2010

Background Endoscopic repair of skull base (SB) defects is successful in over 90% of cases. Certain factors may contribute to failure of SB repair techniques or need for secondary repair. Methods Five-year retrospective review of endoscopic SB defect repairs performed by a single surgeon. Results Eighty-nine patients undergoing 110 procedures to repair 97 SB defects were evaluated. Etiology of defects included surgical/iatrogenic (64%), spontaneous (17%), traumatic (12%), congenital (6%), and idiopathic (1%). Defects occurred in the sella (41%), sphenoid sinus (18%), ethmoid roof (17%), olfactory cleft (16%), frontal sinus/recess (6%), and middle cranial fossa (2%). Sixty-three patients (71%) underwent primary SB defect repair and 26 patients underwent secondary repair (29%). In revision cases, mean number of prior repair attempts was 1.5 (range, 1-4). Factors potentially contributing to need for secondary SB defect repair included inability to localize SB defect (p =0 008), development of new SB defect, prior sinus or SB surgery (p < 0.001), prior craniotomy (p < 0.001), prior radiation therapy (p = 0.002), and intracranial infection (p = 0.023). SB defects were successfully closed in 83 patients overall (93%), with success achieved in 97% of primary patients and 85% of secondary patients. Of failures, 3 patients required craniotomy for defect closure, 2 patients underwent permanent cerebrospinal fluid (CSF) diversion, and 1 patient has persistent CSF rhinorrhea. Conclusion Although endoscopic repair of SB defect remains largely successful, certain factors should alert the surgeon to the potential for failure of repair or need for secondary SB defect repair.
Endoscopic Transnasal Transethmoid Ligation of the Anterior Ethmoid Artery
Authors: Camp April A. , Dutton Jay M. , Caldarelli David D. 
Published: February 2010

Background The current otolaryngologic literature is lacking in basic science investigation regarding endoscopic anterior ethmoid artery (AEA) ligation as part of the armamentarium for epistaxis control. This investigation provides the anatomic rationale for endoscopic ligation of the AEA in the surgical treatment of epistaxis. In addition, it provides tools for identification of this vessel during routine endoscopic sinus surgery. Methods This descriptive cadaver study investigates the feasibility of endoscopic transnasal transethmoid dissection; anatomic description; and clip ligation within the periorbital space of 16 AEA specimens. A careful assessment for skull base penetration and disruption was performed. Results All 16 anterior ethmoid arteries were readily identified and successfully clipped. The anatomy was carefully observed and described for each specimen, and no inadvertent skull base penetration occurred. Conclusion This study confirms that endoscopic ligation of the AEA is a safe and feasible technique for the control of epistaxis. Additionally, this anatomic knowledge is beneficial during routine endoscopic sinus surgery if AEA injury should occur. Further evaluation is necessary for clinical application of this technique in the treatment of epistaxis.
Treatment Results of Sinonasal Inverted Papilloma: An 18-Year Study
Authors: Sham C.L. , Woo John K.S. , Van Hasselt C. Andrew , Tong Michael C.F. 
Published: February 2010

Background This article reviews our treatment results of sinonasal inverted papilloma (SNIP) over the past 18 years. A retrospective observational study was performed. Methods Fifty-six patients with SNIP seen between 1990 and 2008 with follow-up of >2 years were retrospectively analyzed. Results Forty patients (71%) had primary endoscopic resection and 16 patients (29%) had endoscopic-assisted external approaches. Ten patients (18%) had small nasoethmoid residual disease resectable under local anesthesia in the outpatient department. Eight patients (14%) had recurrences requiring revision under general anesthesia, most of which were maxillary and frontal disease requiring additional external approaches. Comparing patients with and without a history of previous surgery (36% versus 64% of all patients), the former had a higher chance of requiring external approaches during the primary resection (45% versus 29%), a higher recurrence rate (45% versus 25%), and a higher chance of external approaches for revision (44% versus 22%). All the first recurrences were at the original tumor site. Eighty-nine percent of the first recurrences were diagnosed within the first 2 years postoperation. Conclusion Thirty-two percent of our patients had recurrence after their primary resection. Recurrences in the nasoethmoid area are usually small and resectable endoscopically under local anesthesia in the outpatient department whereas those inside the maxillary and frontal sinuses are likely to require additional external approaches under general anesthesia. A minimum of 2 years of follow-up is recommended for the preliminary report on the treatment results of this condition. Lifelong follow-up is recommended for possible late recurrences and metachronous multifocal disease.
The Utility of Cadaver Dissection in Endoscopic Sinus Surgery Training Courses
Authors: Zuckerman Jodi D. , Wise Sarah K. , Rogers G. Aaron , Senior Brent A. , Schlosser Rodney J. , DelGaudio John M. 
Published: February 2010

Background Understanding paranasal sinus anatomy is crucial for successful outcomes in endoscopic sinus surgery (ESS). This study was designed to evaluate subjective and objective differences in ESS cadaver dissections among participants of varying experience levels in association with the use of image guidance and computer-aided technologies in a physician training cadaver dissection laboratory. Methods Participants in a 2-day cadaver dissection course completed daily predissection surveys evaluating subjective comfort with ESS. Pre- and postdissection computer tomography (CT) scans assessed completeness of dissection. Images were analyzed for maxillary antrostomy, frontal and sphenoid sinusotomy, residual ethmoid cells and partitions, and residual frontal recess cells. Results Fifty-one sides were dissected. Participant comfort increased significantly from day 1 to 2 for overall ESS (p = 0.001) and for individual sinuses (p < 0.001 to p = 0.047). Participants with more years in practice had fewer unopened ethmoid cells (p = 0.015) and frontal recess cells (p = 0.014) on dissection day 1. Participants with increased comfort in ethmoid dissection had fewer retained ethmoid partitions on day 1 (p = 0.017). Observed differences on dissection day 1 for unopened ethmoid and frontal recess cells and retained ethmoid partitions were not present on day 2. No significant differences were found based on use of image guidance for any parameter. Conclusion Surgeons with increased comfort and more years in practice had more complete endoscopic cadaver dissections initially. Differences among participants diminished on dissection day 2, indicating the ability to review postdissection CT scans may improve surgeon comfort level and completeness of dissection.
Repair of Nasal Septal Perforation with “Cross-Stealing” Technique
Authors: Islam Ahmet , Celik Hatice , Felek Sevim Asian , Demirci Munir 
Published: February 2010

Background The aim of this study was to reveal the efficacy of the “cross-stealing” technique in the repair of nasal septal perforation. Methods In a prospective clinical investigation, 10 patients with the complaints of crusting, bleeding, whistling, nasal obstruction, and pain and in whom septal perforation was detected underwent surgery by endonasal approach between April 2006 and January 2008. During surgery, the inferior-based mucoperichondrial flap was prepared on one side, the superior-based mucoperichondrial flap was prepared on the other side of the nasal septum, and they were passed to the opposite side through perforation. Interpositional graft was placed between flaps and sutured. Patients were followed for a minimum of 5 months before the evaluation of the results. Results Complete closure was observed in 7 of 10 (70%) patients and partial closure was observed in 1 patient. In 2 patients perforation was not closed and its size remained unchanged. Conclusion The cross-stealing technique is advantageous in anterior-located septal perforations in that it can be performed endonasally and it is physiological. Because flaps are prepared in a vertical direction, it can be used only in small and middle-sized perforations, which restricts its use.
Evidence of Association of Interleukin-1 Receptor-Like 1 Gene Polymorphisms with Chronic Rhinosinusitis
Authors: Castano Roberto , Bossé Yohan , Endam Leandra Mfuna , Desrosiers Martin 
Published: February 2010

Background Chronic rhinosinusitis (CRS) is a common complex respiratory disease, with a potential genetic component to its development. The protein encoded by the Interleukin-1 receptor-like 1 (IL1RL1) gene is an important effector molecule of T-helper type 2 responses and may potentially be involved in the persistent inflammatory process observed in CRS. We investigated whether certain polymorphisms in the IL1RL1 gene are differentially present in patients with surgery-unresponsive CRS and in control subjects. Methods DNA extracted from an existing population of 206 adult patients with surgery-unresponsive CRS and 196 postal-code-matched controls was used. A set of 15 tagging single nucleotide polymorphisms (SNPs) was selected from the HapMap data set and genotyped. DNA sequencing was performed in a subgroup of 15 CRS patients. Results Statistically significant allelic associations with CRS were noted for 5 SNPs (rs10204137, p = 0.04; rs10208293, p = 0.03; rs13431828, p = 0.008; rs2160203, p = 0.03, and rs4988957, p = 0.03). The analysis showed a consistent significant protective effect against CRS for all the SNPs, yielding an odds ratio (OR) ranging from 0.56 to 0.72. The loci rs13431828 showed the highest association with CRS (p = 0.008; OR = 0.56; 95% CI, 0.36–0.86). A subanalysis revealed that the observed associations were stronger among patients with more severe disease. Sequencing identified five additional known nonsynonymous coding SNPs in linkage disequilibrium with genotyped SNPs. Conclusion Pending replication of these results, this study suggests that polymorphisms within the IL1RL1 gene may be associated with CRS, conferring a protective effect, particularly among those with severe disease.
Grafting the Olfactory Epithelium to the Olfactory Bulb
Authors: Yagi Sayaka , Costanzo Richard M. 
Published: February 2010

Background Impaired olfactory function leads to a decrease in the quality of life for many patients. Surgical treatment options are limited, especially for those suffering from hyposmia or anosmia after posttraumatic injury to the olfactory nerves. Stem cells located in the olfactory epithelium (OE) have the capacity to grow new neurons, making the OE an ideal candidate for restorative tissue grafting. This study was performed to determine if strips of OE survive transplantation directly to the olfactory bulb (OB). Methods Transgenic mice, expressing a green fluorescent protein (GFP), were used to obtain the donor graft tissue. Strips of OE from GFP donor mice were transplanted directly to sites in the OB and cerebral cortex (CC; control sites) of wild-type mice. Graft survival rates at 30 days were determined for transplant sites in the OB and CC. Results Strips of OE from transgenic mice survived transplantation to the OB and continued to express the GFP marker protein. The 30-day survival rate in the OB (83%, 5 of 6 grafts) was the same as in the CC (10 of 12 grafts). The morphology of the graft revealed characteristics found in normal OE. Conclusion We showed that strips of OE can be successfully grafted to both the OB and CC. Grafts of the OE, if strategically positioned on the ventral surface of the bulb and given access to the nasal cavity, could provide the basis for new surgical treatments to restore olfactory function.
A Model of Airflow in the Nasal Cavities: Implications for Nasal Air Conditioning and Epistaxis
Authors: Bailie Neil , Hanna Brendan , Watterson John , Gallagher Geraldine 
Published: February 2010

Background A friction force is generated when moving air contacts the nasal walls, referred to as wall shear stress. This interaction facilitates heat and mass transfer between the mucosa and air, i.e., air-conditioning. The objective of this research was to study the distribution of wall shear stress within the nasal cavity to identify areas that contribute significantly to air-conditioning within the nasal cavity. Methods Three-dimensional computational models of the nasal airways of five healthy subjects (three male and two female subjects) were constructed from nasal CT scans. Numerical simulations of nasal airflow were conducted using the commercial computational fluid dynamics code Fluent 6 (Ansys, Inc., Canonsburg, PA). Wall shear stress was derived from the numerical simulation. Air-conditioning was simulated to confirm the relationship with wall shear stress. Results Nasal airflow simulations predicted high wall shear stress along the anterior aspect of the inferior turbinate, the anteroinferior aspect of the middle turbinate, and within Little's area. Conclusion The airflow simulations indicate that the inferior and middle turbinates and Little's area on the anterior nasal septum contribute significantly to nasal air-conditioning. The concentration of wall shear stress within Little's area indicates a desiccating and potentially traumatic effect of inhaled air that may explain the predilection for spontaneous epistaxis at this site.
Role of Platelet-Derived Growth Factor in Airway Remodeling in Rhinosinusitis
Authors: Kouzaki Hideaki , Seno Satoshi , Fukui Jun , Owaki Shigehiro , Shimizu Takeshi 
Published: February 2010

Background The purpose of this study was to elucidate the role of platelet-derived growth factor (PDGF) in the pathogenesis of rhinosinusitis. Methods Nasal mucosa and polyps were obtained during surgery in patients with allergic rhinitis, chronic rhinosinusitis (CRS) without asthma, and CRS with asthma. PDGF concentrations in nasal discharge were measured, and the histological distribution and expression levels of mRNA for PDGF and PDGF receptors were examined. PDGF-producing cells were determined by double-staining for PDGF and CD68 or major basic protein. Results The concentration of PDGF was significantly higher in CRS with asthma. An immunohistochemical study showed that PDGF was localized in epithelial cells, gland cells, vascular endothelial cells, and inflammatory cells. Expression of PDGF increased in epithelial cells in all three diseases, in macrophages in CRS without asthma, and eosinophils in CRS with asthma, and PDGF receptors were detected in epithelial cells and submucosal fibroblasts. Increased expression of PDGF mRNA was found in CRS with asthma. Conclusion The results indicate that PDGF is produced by macrophages, eosinophils, and epithelial cells in rhinosinusitis and that it acts on receptors in epithelial cells and fibroblasts. PGDF may be an important cytokine in the pathogenesis of rhinosinusitis by promoting tissue fibrosis and formation of nasal polyps.
Staphylococcal Infection and Toxin Production in Chronic Rhinosinusitis
Authors: Fiky Lobna M. El , Khamis Nagwa , Mostafa Badr El Din , Adly Ahmed M. 
Published: February 2010

Background The association between bacterial colonization and different forms of chronic rhinosinusitis (CRS) has not been well documented. One of the most recent hypotheses is superantigen (SA)-induced inflammation, resulting in up-regulation of lymphocytes to produce cytokines, and other inflammatory mediators that strongly modify the disease. Staphylococcus aureus, frequently encountered in nasal passages, can produce enterotoxins that can act as SAs. Methods A prospective case control study was performed. Sixty-four patients diagnosed with CRS (group 1), CRS with nasal polyps (CRSwNP) (group 2), and 15 control subjects were enrolled. Swabs were taken from the middle meatus of all subjects for identification of S. aureus carriers. Positive carriers were analyzed for the presence of toxic shock syndrome toxin (TSST) 1 using reverse passive latex agglutination as well as polymerase chain reaction. Results The rate of nasal carriage of S. aureus in CRS was 42.8%, that of CRSwNP was 45.4%, and that of the control group was 13.3%. The difference between both groups of CRS and the control group was found to be highly significant (p < 0.001). The detection of TSST-1 was significantly higher (p < 0.001) in both groups of CRS patients than in the control group. Finally, the difference in colonization of TSST-1 was highly significant (p < 0.001) between the CRS group 1 and CRSwNP group 2 patients. Conclusion Identifying SAs and understanding how they elicit the pathogenic condition in CRS will be central in revealing ways to ameliorate their effects and properly treat these conditions.