bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retroauricular Hairline Incision for Removal of Upper Neck Masses
Authors: Roh Jong‐Lyel 
Published: December 2005

AbstractBackground/Objectives: The general population has been increasingly concerned about cosmesis and hopeless about prominent or invisible postoperative scars of the face and neck. The purpose of this study was to evaluate the benefit of a retroauricular hairline incision (RAHI) by comparing it with conventional cervical incision for removal of upper neck masses.Study Design: Prospective clinical study.Methods: Thirty‐four patients with upper neck masses were divided into two surgical groups of RAHI (17) and conventional cervical incision (17) matched by age, sex, marital status and size, location, pathology of lesions. The operation time, complications, length of hospital stay, and subjective satisfaction with incision scar checked by visual analogue scale were compared between groups.Results: The lesions of each group were congenital cysts (6), abscesses (2), inflammatory masses (2), and benign (6) or malignant (1) tumors and located in the upper neck. Mean operation time was 51 ± 17 minute in the RAHI group and 41 ± 13 minutes in the controls (P = .064). Mean hospital stay and complication rates were comparable between groups. Mean score of patient's satisfaction was 8.9 ± 0.7 in the RAHI group and 4.5 ± 2.7 in the controls (P < .001). The degree of incision scarring did not differ between groups, but the scars were less visible in the RAHI group because of hiding by the auricle and hair.Conclusions: The postauricular approach leading to a potentially invisible area of operation has a clear cosmetic benefit compared with conventional cervical incision. This will be helpful for patients with surgically indicated upper neck masses who hope for invisible incision scars.
The Jaundiced Gunn Rat Model of Auditory Neuropathy/Dyssynchrony
Authors: Shaia Wayne T. , Shapiro Steven M. , Spencer Robert F. 
Published: December 2005

AbstractObjective: High levels of bilirubin are neurotoxic and may result in deafness or auditory neuropathy/auditory dyssynchrony (AN/AD). The jaundiced (jj) Gunn rat animal model of kernicterus has electrophysiologic and neuroanatomic abnormalities of brainstem auditory nuclei with normal cochlear microphonic recordings. We examined morphologic changes in the cochlea, spiral ganglion, and auditory nerve and relate these findings to current understanding of AN/AD.Methods: At 15 days of age, jj and nonjaundiced (Nj) littermates were injected with sulfadimethoxine (sulfa) and killed 3 days later by transcardial perfusion. Sections were cut through decalcified temporal bones, cochlear nerves, and auditory brainstem and processed for light and electron microscopy and immunohistochemical localization of calbindin‐D and parvalbumin.Results: Spiral ganglion neurons were severely degenerated with a paucity of myelinated axons in jj animals. Electron microscopy of the intramodilar auditory nerve revealed a lack of large caliber axons in jj‐sulfa versus Nj‐sulfa controls. Large diameter degenerating axons were characterized by an electron‐dense atrophied axis cylinder resembling an axonopathy.Conclusions: Our findings of abnormal spiral ganglion cells and selective loss of large, myelinated auditory nerve fibers with no abnormalities in cochlear hair cells, support the sulfa‐treated jj Gunn rat as a model for bilirubin induced AN/AD. The paucity of large caliber neurons undermines temporal coding of auditory information and neural synchrony and demonstrates that in addition to brainstem auditory nuclei, spiral ganglion neurons are selectively vulnerable to bilirubin toxicity.
Confocal microscopy of the Peripheral Gustatory System: Comparison between Healthy Subjects and Patients Suffering from Taste Disorders during Radiochemotherapy
Authors: Just Tino , Pau Hans Wilhelm , Bombor Ingmar , Guthoff Rudolf F. , Fietkau Rainer , Hummel Thomas 
Published: December 2005

AbstractObjectives: Laser‐scanning microscopy (LSM) was used to compare taste buds and epithelia of fungiform papillae of healthy subjects with those of patients suffering from taste disorders during/after radiochemotherapy (RCT). Aim of the study was to investigate effects responsible for taste loss at a microscopic level.Study Design: Prospective study.Methods: Data from 12 healthy subjects (mean age 52.4, SD 9.5 years) were compared with those of 12 patients (mean age 54.7, SD 8.5 years) with head and neck cancer suffering from taste disorders during RCT. Four parameters from LSM were selected for analysis: 1) distance between the pore of the taste buds of fungiform papillae and the crest of the papillary vessels; 2) epithelial cells of each taste bud at 34 μm; 3), cell density, and 4) area of the taste pore at 4 μm. These data were correlated to measures of gustatory sensitivity obtained with both the validated “taste strips” test kit and electrogustometry.Results: Patients complaining from taste disorders during RCT exhibited a significant decrease of taste function assessed with both natural and electric stimuli. In these patients, we found thicker epithelia and smaller areas of the taste pores compared with healthy subjects. In 30% of those patients, no taste pores were detectable; in deeper sections, however, normal taste buds were present.Conclusions: In conclusion, in RCT patients with taste disorders, LSM indicates changes of epithelia of fungiform papilla but no changes of the taste bud structure. Damage of the chorda tympani nerve by scattered rays, direct or indirect mucotoxic effects of chemotherapeutic agents, and covering of taste pores by epithelial cells are likely reasons for taste loss during RCT.
Does Severity of Obstructive Sleep Apnea/Hypopnea Syndrome Predict Uvulopalatopharyngoplasty Outcome?
Authors: Friedman Michael , Vidyasagar Ramakrishnan , Bliznikas Darius , Joseph Ninos 
Published: December 2005

AbstractObjectives:Uvulopalatopharyngoplasty (UP3) is the single most commonly performed surgical procedure for the treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS), but its success is limited. Our objective was to determine whether severity of disease of OSAHS based on polysomnography (PSG) data (apnea/hypopnea index [AHI]) is a significant factor in predicting successful treatment by UP3. In addition, we compared anatomic staging with severity of disease to determine which is the better predictor of success.Study Design:A retrospective chart review of 134 patients who underwent UP3 as an isolated procedure for the treatment of OSAHS in a tertiary university‐affiliated medical center.Results:Forty‐five patients had mild disease with an AHI less than 20. The surgical success rate (defined as a 50% reduction in AHI and a postoperative AHI of < 20) was 26.7%. There were 40 patients with moderate disease (AHI 20–40) who had a surgical success rate of 42.5%. There were 49 patients with severe disease (AHI < 40) with a surgical success rate of 26.5%. The same patients were analyzed by the Friedman Staging System using anatomic findings without incorporating the severity of disease. Results indicated the following. Stage I had a success rate of 80.6%, stage II patients had a success rate of 37.9%, and stage III had a success rate of 8.1%. Assessment of severity within each stage did not affect outcome.Conclusions:Patients with mild disease based on PSG data do not have a better chance of successful treatment than patients with severe disease. Severity of disease should not be incorporated in the staging system. The Friedman Staging System based on anatomic factors is superior to severity of disease as a predictor of successful UP3.
Quality of Life and Head and Neck Cancer: A 5 Year Prospective Study
Authors: Abendstein Helmut , Nordgren Mats , Boysen Morten , Jannert Magnus , Silander Ewa , Ahlner‐Elmqvist Marianne , Hammerlid Eva , Bjordal Kristin 
Published: December 2005

AbstractObjectives: Assessment of health‐related quality of life (HRQL) in head and neck cancer patients from diagnosis to 5 years after start of treatment.Study Design: A prospective, descriptive studyMethods: three hundred fifty‐seven patients from Norway and Sweden filled in HRQL questionnaires, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ–C30 and the EORTC QLQ‐H&N35, six times during the first year and then after 5 years. At 5 years, 167 (87%) of the 192 living patients filled in questionnaires.Results: Group data: clinical significant improvements in HRQL were not found between 1 and 5 years. Problems with teeth, opening of the mouth, dryness in the mouth, and sticky saliva were persistent or worsening. Similar findings were found regardless of sex, age, stage, or site when clinical significant changes are considered. Patients who died between 1 and 5 years reported reduced HRQL on 15 of 28 scales at 1 year compared with the survivors. Individual data: 40% of patients reported improved global HRQL from diagnosis to 5 years after start of treatment. In addition, 11% had “top scores” at both assessment points. The pattern in global HRQL scores also applies for most of the other function and symptom scales.Conclusion: After the first year after treatment, recovery of the persisting side effects of treatment cannot be expected for the group as a whole. Patients must be prepared for this. Some individual patients experience improvement in global HRQL. HRQL assessments in daily clinical practice can identify patients who are in need of additional support and symptom relief.
Spontaneous Temporomandibular Joint Herniation into the External Auditory Canal: A Case Report and Review of the Literature
Authors: Moriyama Masaomi , Kodama Satoru , Suzuki Masashi 
Published: December 2005

AbstractObjectives: Case report of a man presenting with spontaneous temporomandibular joint (TMJ) herniation into the external auditory canal (EAC).Study Design: Case report and literature review.Methods: A case report of a patient with spontaneous TMJ herniation into the EAC is presented.Results: The patient was a 41‐year‐old man complaining of tinnitus in his right ear. Examination revealed that the anterior wall of the bony EAC moved backward when the patient's mouth was closed and forward when opened, causing the resultant discomfort. In this case, surgery was performed, resulting in a good outcome with no complications. Thirteen other cases of spontaneous TMJ herniation into the EAC were found in the literature.Conclusion: Few cases of spontaneous TMJ herniation into the EAC have been reported; however, if surgical treatment is desired, we should comply with the patient's request.
Comparison of Open Dilatational Tracheostomy with Conventional Pediatric Tracheostomy in a Growing Animal Model
Authors: Baek Chung‐Hwan , Chung Young‐Jun , Jeong Han‐Sin , Kim Sang‐Woo 
Published: December 2005

AbstractObjectives: To compare the tracheal changes after applying a new open dilatational tracheostomy (ODT) technique with those from a conventional open tracheostomy (COT) with vertical cartilage incision in a growing animal model.Study Design: Prospective, experimental investigation in a rabbit model.Materials and Methods: Thirteen New Zealand white rabbits as a pediatric model were divided into three groups: six rabbits had COT (n = 6), another six underwent an ODT (n = 6), and one rabbit acted as a control. Each rabbit underwent tracheostomy by assigned procedures on the first day. On day 8, they were decannulated. On day 15, their tracheas were harvested. We examined the gross findings and histologic changes of each tracheal segment at the stomal level. In addition, we analyzed three parameters: the quotient of the stomal and nonstomal segment in sagittal diameter, coronal diameter, and cross‐sectional area.Results: The framework of cartilages at the stomal level were more distorted in the COT group. Histologic examination also showed buckling of the anterior tracheal wall, loss of cartilage, infiltration by many polymorphonuclear neutrophils, and the marked ingrowth of fibrous tissue in the COT group. Sagittal and coronal diameters and cross‐sectional areas were significantly affected more severely after a COT than after an ODT.Conclusion: Our new modification of percutaneous dilatational tracheostomy, named “open dilatational tracheostomy,” was successfully applied to a small, growing animal model and showed more favorable and consistent healing of trachea compared with COT. Therefore, the authors' new tracheostomy procedure could be applied to children who require short‐term tracheostomy at any age in clinical settings.
Predictive Factors for Posterior Triangle Metastasis in HNSCC
Authors: McDuffie Chad M. , Amirghahari Nazanin , Caldito Gloria , Lian Timothy S. , Thompson Luke , Nathan Cherie‐Ann O. 
Published: December 2005

AbstractObjective: Surgical modifications sparing uninvolved structures such as the spinal accessory nerve have been implemented since the advent of the radical neck dissection in 1906. The increased morbidity to the spinal accessory nerve involved with the dissection of level V lymph nodes has led to much controversy. In this study, we examine the incidence of nodal metastasis to all nodal levels involved with upper aerodigestive squamous cell carcinoma and attempt to determine when level V dissection is indicated.Study Design: Retrospective chart review.Methods: A study of all radical and modified radical neck dissections was performed at Louisiana State University ‐ Shreveport Health Sciences Center and Overton Brooks Veterans Administration Hospital between 1996 and 2003 for upper aerodigestive squamous cell carcinoma. Univariate and multivariate analyses were performed to determine which neck and patient factors were significantly associated with level V metastasis.Results: Seventy–nine patients with a total of 94 neck dissections were analyzed. The prevalence of level V metastasis was 7.4% of the total neck dissections. Multivariate analysis found that positive lymph nodes involving levels II, III, and IV was the only independent significant factor for level V metastasis (P = .0003).Conclusion: Our study is in concordance with other studies in the literature, revealing a low prevalence of level V metastasis in upper aerodigestive squamous cell carcinoma. Unlike other studies, we have found if levels II, III, and IV lymph nodes are found to be positive, dissection of level V is warranted.
Objective Computerized versus Subjective Analysis of Facial Synkinesis
Authors: Wu Zhenqing B. , Silverman Carol A. , Linstrom Christopher J. , Tessema Belachew , Cosetti Maura K. 
Published: December 2005

AbstractObjectives/Hypothesis: To compare the sensitivity of an objective, computerized approach to measurement of facial synkinesis with that for a subjective approach and to examine the test‐retest reliability of these approaches.Study Design: Prospective, nonrandomized, and blinded.Methods: Remote facial motion at the upper eyelids and oral commissures during a closed‐lip smile and eyelid closure were measured using a commercially available computerized motion analysis system. Thirty healthy adults with normal facial nerve function were enrolled to establish normative data and a threshold value for synkinesis. Thirty consecutive patients were analyzed based on the synkinesis threshold value. Blinded subjective evaluations by two observers were also performed independently on the same patients.Results: Facial synkinesis was detected significantly more frequently with objective than subjective analysis for eyelid closure; no significant differences between approaches were shown for the closed‐lip smile. Interestingly, five (17%) patients developed early synkinesis within 3 months from the onset of the facial nerve injury. The test‐retest reliability of all objective measures was excellent for both expressions. Close agreement in percent of patients with synkinesis between test and retest subjective evaluations was obtained for both observers for both expressions.Conclusions: The objective, computerized approach to detection of facial synkinesis has excellent reliability and is more sensitive than the subjective approach to assessment to the presence of facial synkinesis associated with eyelid closure. The finding of early synkinesis suggests that central nervous reorganization plays a role in regeneration of the facial nerve.
Predictive Factors and Outcomes in Endoscopic Sinus Surgery for Chronic Rhinosinusitis
Authors: Smith Timothy L. , Mendolia‐Loffredo Sabrina , Loehrl Todd A. , Sparapani Rodney , Laud Purushottam W. , Nattinger Ann B. 
Published: December 2005

AbstractPurpose:To assess objective and quality of life (QOL) outcomes before and after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS) and to determine preoperative factors that predict surgical outcome in these patients.Methods:One hundred nineteen adult patients with CRS and a mean follow‐up of 1.4 ± 0.35 years were evaluated prospectively including the following patient factors: prior sinus surgery, polyps, asthma, acetylsalicylic acid intolerance (ASA), smoking, allergy, depression, and sex. Computed tomography (CT), endoscopy, and QOL assessment was performed. Predictive value of patient factors was determined based on change in endoscopy and QOL scores after ESS.Results:Objective outcomes: preoperative CT scores were significantly worse in patients with polyps, asthma, and ASA, whereas CT score was unaffected by prior sinus surgery, smoking, allergy, depression, and sex. Patients with CRS demonstrated significant improvement on nasal endoscopy after ESS, but preoperative, postoperative, and change in scores were affected by certain patient factors. Endoscopy scores were significantly worse in patients with prior sinus surgery, polyps, asthma, and ASA, but these patients also experienced the greatest improvement in endoscopy scores. Smokers and patients with depression had the least change in endoscopy scores. QOL outcomes: patients with CRS experienced improvement in QOL after ESS. Pre‐ and postoperative QOL was positively affected by polyps and adversely affected by ASA, depression, and female sex, but these groups still experienced significant improvement in QOL scores. Pre‐ and postoperative QOL was unaffected by prior sinus surgery, asthma, smoking, and allergies, and all of these groups experienced significant improvement in QOL scores. Factors predictive of outcome: ASA and depression were predictive of worse outcome. Preoperative CT scores approached significance as being predictive of outcome.Conclusion:Surgical management of CRS was associated with significant improvement on objective and QOL measures; however, specific patient factors, in particular ASA and depression, predict poorer outcome. Preoperative CT may be a predictor of endoscopic and QOL outcome and deserves further study.
Utility of a Three‐Item Smell Identification Test in Detecting Olfactory Dysfunction
Authors: Jackman Alexis H. , Doty Richard L. 
Published: December 2005

AbstractObjective: Physicians rarely assess smell function, largely because of time considerations. Therefore, there is clinical need for very brief cranial nerve I screening tests. Although a few such tests exist, none have been adequately validated. The goal of this study was to empirically assess the utility of a three‐item microencapsulated odor identification test in detecting olfactory dysfunction.Setting: Smell and taste center at a university medical center.Methods: The test was administered to 224 consecutive patients (98 men and 126 women ranging in age from 15–88 years). As part of their overall assessment, the well‐validated 40‐item University of Pennsylvania Smell Identification Test (UPSIT) was also administered. Sensitivity, specificity, and both negative and positive predictive values of the three‐item test were established relative to UPSIT dysfunction categories. Test‐retest reliability was determined in a subset of 39 patients.Results: The three‐item test was abnormal in 99% (67/68) of patients with anosmia, 85% (35/41) of those with severe microsmia, 76% (31/41) of those with moderate microsmia, and 50% (17/34) of those with mild microsmia. Of the 40 normosmic patients, 62.5% (25/40) correctly identified all odors, 25% (10/40) two odors, and 12.5% (5/40) one odor. None of the normosmic patients missed all three items. Using a cut‐off score of 2, the test's sensitivity and specificity were 99% and 40%, respectively, for detecting total anosmia. The corresponding negative and positive predictive values were 98% and 43%. For detecting anosmia and severe microsmia, these values were 93%, 45%, 88%, and 63%. For detecting any olfactory pathology, they were 82%, 63%, 42%, and 91%. The test‐retest reliability was 0.87.Conclusion: The brief three‐item test used in this study was found to be highly sensitive in identifying olfactory loss in patients with chemosensory complaints, particularly those with severe dysfunction. Although only moderately specific, its high reliability and negative predictive value suggests it may be an appropriate screening test for olfactory loss.
Linking of Bone Morphogenetic Protein‐2 To Resorbable Fracture Plates for Enhancing Bone Healing
Authors: Shibuya Terry Y. , Wadhwa Ashish , Nguyen Kevin H. , Panossian Abraham M. , Kim Sanghun , Wong Hausin , Feinberg Steven , Damisah Eyiyemisi C. , Camilon P Ryan , Bang Hoang 
Published: December 2005

AbstractObjective: To test whether bone morphogenetic protein (BMP)‐2 may be covalently linked to resorbable fracture repair plates using an ester‐hydrolysis reaction and determining whether the linked compound can facilitate bone growth.Study Design: Laboratory in vitro experiments.Method: Resorbable fracture repair plates were partially hydrolyzed using varying concentrations of acid or base. This intermediate was then reacted with EDAC (1‐ethyl‐3[‐3‐dimethylamino propyl carbodiimide) to form an EDAC intermediate, which was then reacted with either horseradish peroxidase (HRP), interleukin (IL)‐2, or BMP‐2. Compound binding to the plate was confirmed by immunofluorescent staining. Confirmation of protein function was determined by the following assays: HRP's ability to cleave peroxide, IL‐2's ability to stimulate lymphocytes, and BMP‐2's ability to stimulate C3H10T1/2 cells to generate alkaline phosphatase.Results: Three compounds (HRP, IL‐2, and BMP‐2) were successfully linked to plates as confirmed by immunofluorescence staining or functional testing. Compounds demonstrated better covalent linking to plates under basic conditions. HRP, IL‐2, and BMP‐2 retained function after binding as measured by cleaved peroxide levels, lymphocytes proliferation, and alkaline phosphatase production.Conclusions: Covalent linking of compounds such as HRP, IL‐2, and BMP‐2 to resorbable plates is possible and represents a novel protein delivery technique. BMP‐2 covalently linked to resorbable plates may be used to facilitate bone healing. Covalent linking of compounds to plates represents a novel method for delivering concentrated levels of growth factors to a specific site and potentially extending their half‐life. Further investigation into this application for bone healing may lead to quicker healing.