bluuebunny/crossref_metadata_2025_split huggingface dataset:
Removal of a Fronto‐Ethmoidal Osteoma Using the Sonopet Omni Ultrasonic Bone Curette: First Impressions
Authors: Pagella Fabio , Giourgos Georgios , Matti Elina , Colombo Andrea , Carena Paolo 
Published: February 2009

AbstractEndoscopic exeresis of sinonasal osteomas usually implicates the use of surgical drills with some disadvantages, as underlined by many authors. A new device that performs an ultrasound bone emulsification has been proposed in recent years for bone removal in various surgical disciplines. In this case report, we present the first clinical ENT experience with this device in removing a fronto‐ethmoidal osteoma, and we briefly discuss our impressions.
Numerical Study of the Aerodynamic Effects of Septoplasty and Partial Lateral Turbinectomy
Authors: Ozlugedik Samet , Nakiboglu Gunes , Sert Cuneyt , Elhan Alaittin , Tonuk Ergin , Akyar Serdar , Tekdemir Ibrahim 
Published: February 2009

AbstractObjectives: To investigate, first, the effects of septal deviation and concha bullosa on nasal airflow, and second, the aerodynamic changes induced by septoplasty and partial lateral turbinectomy, using computational fluid dynamics (CFD).Methods: A three‐dimensional model of a nasal cavity was generated using paranasal sinus computed tomography images of a cadaver with concha bullosa and septal deviation. Virtual septoplasty and partial lateral turbinectomy were performed on this model to generate a second model representing the postoperative anatomy. Aerodynamics of the nasal cavity in the presence of concha bullosa and septal deviation as well as postoperative changes due to the virtual surgery were analyzed by performing CFD simulations on both models. Inspiratory airflow with a constant flow rate of 500 mL/second was used throughout the analyses.Results: In the preoperative model, the airflow mostly pass through a narrow area close to the base of the nasal cavity. Following the virtual operation, a general drop in the maximum intranasal air speed is observed with a significant increase of the airflow through right middle meatus. While in the preoperative model the greatest reduction in pressure is found to be in the localization of anterior septal deviation on the right side and confined to a very short segment, for the postoperative model, it is observed to be in the nasal valve region in both nasal cavities. Following septoplasty and partial lateral turbinectomy, total nasal resistance is reduced significantly.Conclusions: CFD simulations promise to make great contributions to understand the airflow characteristics of healthy and pathologic noses. Before surgery, planning for any specific intervention using CFD techniques on the nasal cavity model of the patient may help foreseeing the aerodynamic effects of the operation and might increase the success rate of the surgical treatment.
Caloric Function After Endolymphatic Sac Surgery
Authors: Ulubil S Arif , Eshraghi Adrien A. , Telischi Fred F. , Angeli Simon I. , Balkany Thomas J. , Joy Jennifer J. 
Published: February 2009

AbstractObjective: To evaluate the effect of endolymphatic sac surgery on vestibular functions using caloric testing on electronystagmography (ENG).Study Design: Retrospective chart review.Methods: The medical records of 21 adult patients with unilateral Ménière's disease who underwent endolymphatic sac surgery between 1998 and 2004 were reviewed. With use of ENG, the absolute value of the caloric response of the operated ear (i.e., the cool + warm irrigation response) and the degree of reduced vestibular response (RVR) rates as indicators of caloric functions were compared before and after surgery. Average follow‐up was 17 (6–52) months.Results: The mean change in RVR after surgery was found to be 2.9%. In total, there were six (28.5%) patients who had an RVR increase more than 10%. Of those, there were three (14.2%) patients who demonstrated an RVR increase more than 20%. Only one (4.8%) patient had an RVR increase more than 30%. Total loss of vestibular function was not observed in any of the patients. There were three (14.2%) patients who exhibited a decrease of more than 10% in their RVR. In two (9%) patients, the contralateral ear was shown to have less vestibular function than the operated side on ENG postoperatively (in one case, the absolute caloric nystagmus response remained the same in the operated ear, and in the other case, the response increased on the surgical side). When we evaluated the absolute caloric responses of the operated ear only, we found no statistical difference between the pre‐ and postoperative values (P = .219). Early results of vertigo control and hearing outcomes were comparable with those in the literature.Conclusion: Endolymphatic sac surgery does not appear to be a vestibular destructive procedure, and it is a therapeutic alternative for patients with Ménière's disease who have failed medical treatment. This is important given the possibility of bilateral disease in some patients.
Management and Outcome of Patients With Mucoepidermoid Carcinoma of Major Salivary Gland Origin: A Single Institution's 30‐Year Experience
Authors: Aro Katri , Leivo Ilmo , Mäkitie Antti A. 
Published: February 2009

AbstractBackground: Mucoepidermoid carcinoma (MEC) is one of the most frequent epithelial malignancies of the salivary glands. Prediction of clinical outcome of MEC is challenging.Material and Methods: We retrospectively reviewed 52 cases of MEC of major salivary gland origin diagnosed at the Department of Otolaryngology–Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland, during a 30‐year period of 1976 to 2005. Criteria used for diagnosis were those of World Health Organization classifications valid at each time point, and criteria for grading were those recommended by Armed Forces Institute of Pathology fascicle (1996). Since 1993, the degree of cell proliferation was used at our institution as an adjunct tool when grading MEC. The majority of cases occurred in the parotid gland (n = 47, 90%) followed by the submandibular gland (n = 5, 10%).Results: We had 39% high‐grade (HG), 14% intermediate‐grade (IMG), and 44% low‐grade (LG) MECs. T categories were T1, n = 18; T2, n = 16; T3, n = 9; T4, n = 9. Forty‐nine (94%) patients were treated with curative intent. These patients underwent surgery, and 24 (49%) patients received postoperative radiotherapy. Follow‐up time varied from 6 months to 9 years. Forty‐five percent of HG‐MEC patients and 67% of IMG‐MEC patients developed locoregional failures or distant metastases during a 3‐year follow‐up as opposed to none of the LG‐MEC patients. Of MEC patients with N0 neck, two HG‐MEC patients and one IMG‐MEC (8%) patient developed regional recurrence during follow‐up.Conclusions: Patient outcome in the different grades of MEC suggests a need for overview of the treatment protocol, especially with regard to LG‐MEC and IMG‐MEC. The apparently unusual occurrence of locoregional failures and metastases in LG‐MEC suggests a restrictive approach in surgical management. However, the frequent occurrence of such failures in IMG‐MEC warrants an aggressive approach with these tumors.
Otolaryngologist–Head and Neck Surgeon‐Performed Ultrasonography for Parathyroid Adenoma Localization
Authors: Gurney Theresa A. , Orloff Lisa A. 
Published: February 2009

AbstractObjective: To demonstrate the efficacy of otolaryngologist–head and neck surgeon‐performed ultrasonography (US) for the preoperative localization of parathyroid adenomas.Methods: A retrospective chart review of all patients evaluated by office‐based US for the localization of surgery‐proven parathyroid adenomas from October 2004 through February 2007.Results: A total of 29 patients underwent preoperative US localization. Twenty‐three (79%) were females, and six (21%) were males. The age of patients ranged from 27 to 85 years of age. The size range of adenomas detected as measured by US was 0.5 to 2.7 cm. Pathology specimen measurements ranged from 0.3 to 3.4 cm. A total of 30 parathyroid adenomas were found. US identified 90% of the parathyroid adenomas to the correct side, left or right. In addition, US localized the parathyroid adenomas to the correct quadrant, superior or inferior, 83% of the time. Challenges in accurate localization were associated with patient obesity, presence of thyroid carcinoma, and multinodular thyroid disease. For comparison, sestamibi scans performed on the same patients localized the parathyroid adenoma to the correct side only 71% of the time and to the correct quadrant 61% of the time.Conclusions: Otolaryngologist–head and neck surgeon‐performed US can accurately identify the location of parathyroid adenomas and is a useful tool for preoperative planning.
Obstructive Sleep Apnea in an Infant With Prominent Glossopharyngeal Muscles: Therapy and Outcome
Authors: Shadfar Scott , Digoy G P. 
Published: February 2009

AbstractWe present a case of prominent glossopharyngeal muscles causing severe obstructive symptoms in a 3‐month‐old child. Preoperative sleep studies and dynamic microdirect laryngoscopy were used in evaluation of the patient. Postoperative sleep studies confirmed a substantial reduction in apneic events after release of the muscle folds. The literature addresses the variant anatomy, and treatment options are discussed. To our knowledge, this is the first case report of prominent glossopharyngeal muscles leading to apneic events. We propose that in patients with prominent glossopharyngeal folds, surgical release may significantly improve symptoms of sleep apnea and in severe cases prevent tracheostomy.
Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy
Authors: McNamar Justin , Montequin Douglas W. , Welham Nathan V. , Dailey Seth H. 
Published: February 2009

AbstractHypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty.Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video.Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics.Conclusion: AP provides improved vocal outcomes by decreasing system noise and decreasing PTP, which may lead to a stronger glottal signal with decreased vocal effort.
Regional Metastases in Well‐Differentiated Thyroid Carcinoma: Pattern of Spread
Authors: Yanir Yoav , Doweck Ilana 
Published: February 2009

AbstractObjectives/Hypothesis: To determine the pattern of spread of WDTC to regional lymph nodes, in patients who presented with clinically positive nodes.Study Design: Retrospective chart review.Materials and Methods: Between October 2001 and December 2006, a total of 27 consecutive patients (12 males, 15 females) with clinical evidence of cervical metastasis of well‐differentiated thyroid carcinoma (WDTC) underwent 28 neck dissections (ND) with a mean follow‐up 33.7 months. Papillary carcinoma was found in 24 patients and follicular carcinoma in 3.All neck dissection specimens were separated during surgery into levels, and analysis was done with respect to the levels of the neck.Clinical and demographic parameters were correlated to the pathologic parameters, including number of pathologic nodes, size of tumor, and the patient's age, with univariate and multivariate analysis.Results: The mean number of pathologic nodes in ND specimen was 6.7. The predominant site of metastasis was level VI (95%), followed by level III (68%), level IV (57%), and level II (54%). Metastases above the XI nerve were found in 7% of the patients. Level V showed 20% of nodal metastasis. A correlation was found between size of primary tumor and number of positive pathologic lymph nodes (P = .02) and an inverse correlation between the age of the patient and the number of pathologic nodes (P = .043).Conclusions: The high incidence of metastatic disease in levels II through VI supports the recommendation for posterolateral and anterior ND in patients with WDTC and clinically positive nodes. The correlation between tumor size, the age of the patient, and the number of positive nodes is an interesting finding that warrants further study.
Cigarette Smoke Activates NFκB and Induces Muc5b Expression in Mouse Middle Ear Cells
Authors: Preciado Diego , Lin Jezhin , Wuertz Beverly , Rose Mary 
Published: February 2009

AbstractObjectives: Cigarette smoke exposure is a significant risk factor in the development of otitis media (OM). Nuclear factor kappa B (NF‐κB) is a ubiquitous transcription factor known to mediate cigarette smoke effects on gene regulation in multiple cell types. The MUC5B mucin gene contains several putative NF‐κB sites in its promoter and is the predominant mucin expressed in human OM. We hypothesized that in vitro stimulation of a recently developed model system, murine middle ear epithelial cells (MEEC), with cigarette smoke condensate (CSC) activates NF‐κB and subsequently induces Muc5b gene expression.Methods: Luciferase reporter assays, electromobility shift assays (EMSA), and quantitative microplate transcription factor assays (TFA) were performed to evaluate NF‐κB activation with CSC in immortalized murine MEEC (mMEEC). Reverse transcriptase polymerase chain reaction (RT‐PCR) assays and quantitative real time RT‐PCR were performed to determine whether time course CSC stimulation upregulates Muc5b mRNA levels in differentiated mMEEC. Luciferase reporter assays were performed to determine whether CSC activates the Muc5b promoter.Results: Reporter assays, EMSA, and TFA demonstrated three‐ to five‐fold dose‐dependent activation of NF‐κB with CSC in mMEEC. CSC stimulation likewise increased Muc5b mRNA abundance and induced reporter activity 1.8‐ to 4.8‐fold in plasmids containing −556 and −255 base pairs upstream of the Muc5b transcriptional start site in mMEEC.Conclusions: CSC activates NF‐κB in immortalized MEEC. Furthermore, this activation correlates with CSC‐induced Muc5b promoter activation and gene expression. Taken together, these results hint that much as in lung cells, the activation of mucins by cigarette smoke is mediated in part by NF‐κB.
Temporal Bone Study of Trisomy 13 Syndrome
Authors: Fukushima Hisaki , Schachern Patricia A. , Cureoglu Sebahattin , Paparella Michael M. 
Published: February 2009

AbstractThe temporal bones of a 23‐week‐old female who had multiple congenital anomalies and bilateral hearing loss with trisomy 13 syndrome were evaluated under light microscopy.In the left cochlea, spiral ganglion cells and cochlear nerve fibers are absent. In the right ear, an abnormal branch of the singular nerve passes between the utricle and lateral semicircular canals and separates the two portions, one to the flattened crista of the lateral semicircular canal, the other to the utricular macula. This is a rare report describing a patient with abnormalities in three nerves, including the facial, vestibular, and cochlear nerves.
Effect of Aging on Blood Flow in Rat Larynx
Authors: Russell John A. , Nagai Hiromi , Connor Nadine P. 
Published: February 2009

AbstractObjective/Hypothesis: Age‐associated muscular changes and fatigue have been shown to affect phonatory function. Reductions in blood flow with aging could translate to reductions in oxidative capacity within laryngeal muscles and increased fatigability. We tested the hypothesis that there would be increased capillary red blood cell (RBC) velocity and a reduction of capillary density in the thyroarytenoid (TA) muscle of senescent rats.Study Design/Methods: Ten male Fisher 344/Brown Norway rats in two age groups were used: young adult (9 mo) and old (28–30 mo). Sixteen additional young and old rats were used in a fluorescent microsphere experiment that examined blood flow rates before and after a surgical manipulation. With use of a specially equipped intravital microscope, in vivo measurements of capillary geometry and flow were obtained, including RBC velocity, capillary density, tortuosity, and number of branch points.Results: There was an age‐related reduction in capillary surface area as evidenced by reduced lineal density of capillaries. In addition, reduced RBC transit time was suggested by the reduction in branch points found with age. There was no change in RBC velocity with aging. The surgical method used to expose the TA muscle for blood flow recordings did not significantly affect resultant blood flow measurements.Conclusions: We developed a method to evaluate in vivo laryngeal microvasculature. We found age‐related changes in microvascular geometry within the TA muscle of the rat that could affect blood flow to this critical muscle of phonation and airway protection. These microvascular changes could contribute to age‐related laryngeal dysfunction.
Outcomes Studies of Epiglottic and Base of Tongue Prolapse in Children
Authors: Yellon Robert F. , Borland Lawrence M. 
Published: February 2009

AbstractObjectives: The purpose of this study was to compare previously reported flexible fiberoptic laryngoscopy (FFL) findings of a grading system for children with epiglottic and base of tongue (EBT) prolapse with findings at follow‐up FFL. Surgical outcomes and tracheotomy decannulation are also reported.Study Design: Retrospective medical record review.Methods: Fourteen children with EBT prolapse had transnasal FFL in the supine position on at least two occasions. Findings were graded for initial versus most recent FFL. The previously published EBT prolapse grading system was reapplied. Mean age was 8.7 years at the last evaluation. Mean interval between initial and most recent FFL was 1.9 years.Results: At follow‐up FFL, six (43%) children had the same grade of EBT prolapse, five (36%) had a milder grade, and three (21%) had a more severe grade. Five (36%) children were decannulated, and nine (64%) children remain tracheotomy dependant. Of nine children who had surgery, four (44%) were decannulated. Eight (89%) of nine children who were not decannulated have a history of developmental delay (P < .03). Twelve (86%) children had gastroesophageal reflux disease, and six (43%) had abnormal swallowing function.Conclusions: The grading system was successfully reapplied to compare initial with follow‐up findings in a cohort of children with EBT prolapse. Gastroesophageal reflux disease and swallowing dysfunction are common in this population. Judicious surgery may have some efficacy for EBT prolapse in selected patients. Many children with EBT prolapse still require tracheotomy, especially those with developmental delay.
Ototoxicity of Triethanolamine Polypeptide (Cerumenex) in the Chinchilla
Authors: Daniel Sam Joseph , Sahmkow Sofia Isabel , Munguia Raymundo , Schloss Melvin , Akache Fadi 
Published: February 2009

AbstractThe use of earwax softeners and cerumenolytics to unblock the external auditory canal is increasing. Although reports on their effectiveness are available, data about their effect on hearing are limited.Objective: To assess the effect of ototopic triethanolamine polypeptide oleate condensate 10% (Cerumenex) on hearing.Study Design: Prospective, randomized, controlled trial in a chinchilla animal model.Methods: Tympanostomy tubes were inserted in five chinchillas, and hearing was assessed with distortion product otoacoustic emissions (DPOAE) between 1 and 9 kHz prior to application and at days 1, 4, 30, and 100 postototopic application of Cerumenex. One ear received Cerumenex; the other ear served as control. Postmortem scanning electron microscopy was performed to assess the cochlear hair cells.Results: A reduction in the mean DPOAE signal was shown in the ears treated with Cerumenex from the first day after treatment and throughout the study. Almost all tested frequencies were affected. Swelling, crusting, and fluid were observed in four of the five experimental ears. One animal also developed facial paralysis in the experimental side. Electron microscopy showed damage of the outer and inner hair cells in the Cerumenex‐treated ears.Conclusions: In the chinchilla, when a tympanic perforation is present, Cerumenex causes a reduction in DPOAE signal and damage to the cochlear hair cells. Caution should be observed when prescribing this agent if the status of the tympanic membrane is unknown. Furthermore, its use without medical prescription should be discouraged because of the risk of ototoxicity and severe inflammatory reaction.
History of Voice Rehabilitation Following Laryngectomy
Authors: Bień Stanisław , Rinaldo Alessandra , Silver Carl E. , Fagan Johannes J. , Pratt Loring W. , Tarnowska Czesława , Towpik Edward , Weir Neil , Folz Benedikt J. , Ferlito Alfio 
Published: February 2009

AbstractIntroduction: The history of voice rehabilitation following laryngectomy is as long as the history of laryngectomy itself. The multitude of methods which have been employed to reduce the disability associated with the loss of the larynx, illustrate the difficulty of finding an optimal method of reestablishing verbal communication while preserving the ability to breathe and swallow.Material and Methods: The world literature was reviewed using various Internet and medical search engines and library facilities. Landmark articles were identified and summarized.Results: A coherent history of voice rehabilitation following laryngectomy was constructed.Discussion: The methods employed to reestablish voice after extirpation of the larynx may be grouped into the categories of: esophageal speech, surgical methods of creating competent tracheo‐pharyngeal shunts to create lung powered voice with and without the use of prosthetic devices to prevent aspiration, “near‐total” resection of the larynx with dynamic phonatory shunt, and the use of external pneumatic or electrical devices to create sound which is then transmitted through the oral cavity and pharynx.Conclusion: For the past two decades, simple shunt devices inserted either primarily, at the time of laryngectomy, or later as a secondary procedure, have mainly supplanted the other methods of voice rehabilitation, with the exception of an occasional patient who has acquired good esophageal speech, or for whom external devices may be the only practical method of voice production.