bluuebunny/crossref_metadata_2025_split huggingface dataset:
S111 – Monitoring Frequency: A Determinant in Free Tissue Transfer
Authors: Hornig Joshua D 
Published: August 2008

Objectives1) To compare the success rates of free tissue transfer (FTT) between a cohort of patients who underwent frequent scheduled checks to a cohort who received checks on an as‐needed basis. 2) To compare the overall flap survival, ICU stay, in‐hospital stay, complications, and cost.MethodsPatients meeting the criteria for free tissue transfer were divided into 2 cohorts: minimal FTT monitoring and frequent scheduled FTT monitoring. In August 2005, frequent scheduled flap monitoring was instituted. The study was set up to identify if this method impacted overall patient outcomes. The 2 groups were compared over several dimensions: overall flap outcome, total vs. partial flap loss, length of stay in hospital, revision procedures, and complications.ResultsA total of 212 patients were identified. 107 of the patients were in the frequent, scheduled group and 105 were in the minimal group. The overall FTT success rates were significantly higher in the frequently scheduled group versus the minimal group (100% vs 89%). The rates of partial flap loss and total flap loss were higher in the minimal group (11% vs 4%). The overall length of stay in the hospital, length of stay in the ICU, and complication rates were nonsignificant between the 2 groups. However, the number of revision procedures were significantly lower in the frequently scheduled FTT group.ConclusionsThe implementation of frequent scheduled flap monitoring significantly improves free tissue transfer survival in head and neck patients and decreases the number of revision procedures that need to be performed.
S116 – Microbiology of PTA in the Age of Antibiotic Resistance
Authors: Burkhead Steven K , Curry Martin P , Miller Lee A. 
Published: August 2008

ObjectivesNumerous publications have demonstrated Group A Streptococcus pyogenes is the most common pathogen isolated from peritonsillar abscesses (PTAs). We have noted multiple patients presenting with PTAs despite being recently treated with penicillin for tonsillitis. The objective of this study was to assess the bacterial content of PTAs in our practice to determine proper antibiotic therapy.MethodsA retrospective chart review was conducted at 2 tertiary care hospitals. Charts of patients diagnosed with PTA from 2001 through 2005 were reviewed for microbiology studies. If cultures were drawn, the microbiology content and any available sensitivities were assessed.Results205 patients were given the diagnosis of PTA, with an average age of 26. Of these, 64 patients (31.2%) had culture results available for study. Most cultures demonstrated mixed organisms. At least 35.9% demonstrated anaerobic organisms, most commonly Fusobacterium species (20.3%). The 3 most common aerobic organisms isolated were Group A Streptococcus pyogenes (18.8%), Group C Streptococcus (15.6%), and Streptococcus viridans (14.1%). Interestingly, 1 culture (1.6%), grew Escherichia coli as a single pathogen and 2 cultures (3.1%) grew Group D Streptococcus resistant to clindamycin.ConclusionsMost prior studies of PTAs have found Streptococcus pyogenes to be the most common isolate. Our review of 64 cultures found the most frequent pathogen to be anaerobic species, particularly those from genus Fusobacte‐rium. Interestingly, at least 8 cultures (12.5%) isolated pathogens not sensitive to the antibiotic most commonly used in our practice after incision and drainage. These results support the use of broader spectrum antibiotics in the treatment of periton‐sillar abscess.
S126 – Missed Diagnoses in Otolaryngology
Authors: Gorman Mary E. , Gould Herbert , Giel Dana W. , Thompson Jerome W 
Published: August 2008

Objectives1) Increase awareness of common missed diagnoses in the practice of otolaryngology. 2) Identify opportunities for improvement in the quality of patient care.MethodsWorking with the State Volunteer Mutual Insurance Company of Tennessee State, we evaluated malpractice claims in otolaryngology that were closed with indemnity payment between 1981 and 2005. We identified all such claims resulting from alleged missed or delayed diagnoses by otolaryngologists. Claims were divided into two main categories based on whether the missed diagnosis was primarily otolaryngologic or non‐otolaryngologic.ResultsA total of 9 missed diagnosis claims were identified, representing 9% of claims overall. 6 of the 9 were otolaryngologic missed diagnoses, with the remaining 3 non‐otolaryngologic diagnoses. The total indemnity payment for missed diagnosis claims was $4,072,100, representing 32% of all indemnity payments for the study period.ConclusionsMissed diagnoses represent a danger to patients and a disproportionately high percent of total indemnity payments (32%). Increased awareness of missed diagnoses is necessary to improve patient care and maintain a level of excellence within the field of otolaryngology‐head and neck surgery.
S163 – Laser Endoscopic Microsurgery for Supraglottic Cancer
Authors: Pinto Jose A , Godoy Luciana , Marquis Valéria , Brunoro Michelle , Bellotto Silvana , Gasques Cris 
Published: August 2008

ObjectivesReport our experience in the endoscopic treatment of supraglottic cancer with CO2 laser. Show the outcome reached with laser microsurgery in the treatment of supraglottic cancer.MethodsFrom 1990 to 2007, 19 patients with supraglottic cancer underwent CO2 laser microsurgery.ResultsThere were 7 (36.8%) T1, 5 (26.4%) T2, and 7 (36.8%) T3. T1 and T2 supraglottic tumors underwent endoscopic surgery with CO2 laser. T2 stage patients also were submitted to unilateral neck dissection. 2 patients (10.5%) with early supraglottic cancers had recurrence (one local and cervical and another cervical metastasis submitted to external surgery). Supraglottectomy with CO2 laser was performed to analize the preepiglottic space and to allow tumor stage. All T3 supraglottic tumors had pre‐epiglottic invasion and underwent external supraglottic laryngectomy with neck dissection.ConclusionsEndoscopic treatment for laryngeal cancer is an efficient therapy for early supraglottic cancers and is the best method to evaluate the preepiglottic invasion. This therapy makes local function possible without prejudice to oncological results.
S165 – Locally Advanced Head and Neck Cancer Treatment Patterns
Authors: Farwell Wildon R , Lawler Elizabeth , Chittamooru Subha , Botteman Marc F 
Published: August 2008

ObjectivesWe assessed the extent of chemoradiation therapy (CRT) or high‐dose platinum‐based chemotherapy plus radiation (P‐CRT) initiation for patients with stage III/IV, locally advanced head and neck cancer (LAHNC) treated in the VA New England Healthcare System (VA‐NEHS), and identified the factors associated with such initiation.MethodsNewly diagnosed LAHNC patients treated in the VA‐NEHS (from 1996 to 2006) were identified from electronic records. Patients’ tumor staging (TNM), demographics, performance score, comorbidities, alcohol and tobacco use or dependence, and diagnosis year were abstracted via chart review. The primary outcome was the initial treatment strategy, grouped as CRT ± surgery (including P‐CRT), chemotherapy (CT) ± surgery, radiation therapy (RT) ± surgery, surgery alone, or no treatment. Multiple logistic regressions compared odds of failure to initiate CRT or P‐CRT across the aforementioned patient characteristics.ResultsOf 496 patients identified, 34.5%, 34.7%, 6.7%, and 5.4% initiated CRT, RT, CT, and surgery alone, respectively, whereas 18.8% were untreated. Most patients initiating CRT (59.7%) or CT (51.5%) received platinum‐based chemotherapy. Predictors of failure to initiate CRT included diagnosis year 2002 (OR=3.57, 95% CI: 2.32, 5.55), age >65 years old (OR=2.47, 95% CI: 1.55, 3.92), performance score <90 (OR=2.27, 95% CI: 1.43, 3.59), and past/present alcohol use (OR=1.95, 95% CI: 1.08, 3.52). Similar factors predicted failure to initiate P‐CRT.ConclusionsAlthough CRT/P‐CRT initiation increased over time, older patients, patients with poorer performance status, and those using alcohol were less likely to initiate CRT. Research is needed to describe treatment outcomes in LAHNC patients not initiating CRT/P‐CRT.
S177 – Treatment Efficacy of Locally Advanced Skin Cancers
Authors: Ardeshirpour Farhad , Apisarnthanarax Smith J , Park Richard Chan Woo , David Hayes , Rosenman Julian , Shores Carol G. 
Published: August 2008

ObjectivesTo evaluate the treatment outcomes of our patients with locally advanced head and neck non‐melatomatous skin cancers (HNNMSC). In this study we determined the 1‐and 2‐year disease‐free survival and the 5‐year overall survival of our patients treated with surgery, radiation, and chemotherapy, as a single modality or in combination.MethodsBetween 1994 and 2006, 197 patients with locally advanced HNNMSC were identified from our institution's Head and Neck Clinical Cancer Database. These patients had their medical records reviewed and of those, 66 met inclusion criteria. We included patients with pathological documentation of locally advanced HNNMSC.ResultsThe majority of these patients were Caucasian and males with an average age of 69 years. 52 patients (79%) had squamous cell carcinoma and 14 (21%) had basal cell carcinoma. 23 patients (35%) received surgery alone, of which 20 (87%) showed no evidence of disease (NED). 5 patients (7%) received radiation alone, all of which showed NED except 1 who is alive with disease. 29 patients (44%) received surgery and radiation, of which 15 (51%) showed NED and the others recurred. 4 patients (6%) had chemotherapy plus radiation, of which 2 recurred. 5 patients (7%) had surgery plus chemotherapy and radiation, of which 2 showed NED, with the others recurred.ConclusionsWe cannot show statistical differences between different treatment modalities; however, there were more patients with NED in the surgery group compared to surgery and radiation. It is difficult to make conclusions about the chemoradiation because of the small number of patients.
S179 – Voice Self‐evaluation after Treatment for T1 Glottic Cancer
Authors: Nunez Faustino , Caminero Maria Jesus , Llorente‐Pendas Jose‐Luis , Suarez‐Nieto Carlos 
Published: August 2008

Objectives1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self‐evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy.MethodsWe performed an objective voice evaluation, as well as a physical, emotional, and functional well‐being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi‐squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05.ResultsVoice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p < 0,005). Patients Self‐Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p < 0,005). No significant differences were found in the physical scales.ConclusionsThere is a reduced impact in patient's perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy.
S197 – Detection of HPV and Adenovirus in Laryngeal Lesions
Authors: Gallo Andrea , Degener Anna Marta , Pagliuca Giulio , Pierangeli Alessandra , Bizzoni Federica , Greco Antonio , De Vincentiis Marco 
Published: August 2008

ObjectivesTo investigate the role of Human Papillomavirus (HPV) and Adenovirus (AdV) infections in the oncogenesis of squamous cell carcinomas of the larynx and of laryngeal dysplasia.MethodsBetween April 2002 and November 2003, biopsy samples were taken from 40 patients with squamous cell carcinomas of the larynx, 1 with verrucous carcinoma, 5 with laryngeal papillomas, 4 with dysplastic lesions, and 18 control cases. The control biopsies were taken in microlaryngoscopy from patients with vocal disorders caused by nodules and polyps, or by inflammatory or traumatic conditions of the larynx. All the frozen tissue samples, which were previously taken from fresh tissue and then stored at −70°C, were analyzed using the Polymerase Chain Reaction (PCR) with 2 groups of primers for HPV and with a pair of primers for AdV. In the positive cases, the viral type was established by using the automated DNA sequence analysis.ResultsAll the cases of squamous cell carcinomas, laryngeal verrucous carcinomas, dysplasia, and all the control cases were negative for both viruses. 4 of the 5 cases of laryngeal papillomas (80%) were only positive for HPV (2 HPV6 and 2 HPV11), confirming the role of these viral types in the origin of papillomas.ConclusionsThe absence of viral genomes in laryngeal carcinomas as in the other cases studied suggests the existence of other factors playing a more important role than viral infection in the carcinogenesis of these lesions.
S199 – Subglottic Stenosis: Clinical Outcomes in 131 Patients
Authors: Kasperbauer Jan L , Hinkley Lucinda , Alon Eran E. , Moore Eric J , Bungum Aaron , Edell Eric 
Published: August 2008

ObjectivesEvaluate outcomes of patients treated for dyspnea secondary to subglottic stenosis.MethodsRetrospective medical record review of patients from February 2000‐January 2008 that underwent intervention for subglottic airway stenosis.Results131 patients ages 16 to 88 years (mean 46.68 years) (17 male and 114 female) were treated for subglottic airway obstruction. The stenosis was idiopathic in 73 (56%), traumatic in 4 (3%), Wegner's Granulomatosis in 13 (10%), and other in 41 (31%). In the idiopathic group, 73 (100%) were female. 88 (67%) of the patients had pretreatment maximum voluntary ventilation (MVV) recorded with a mean value of 52.16 (47.33 % Predicted). 16 patients with idiopathic stenosis were managed by nd‐YAG laser therapy and rigid bronchoscopic dilation. 131 patients were treated with CO2 laser division of scar or dilation with Kenalog injection and Mitomycin C application. A select group underwent laryngotracheal res‐construction or resection. Retreatment in the idiopathic group varied widely. The average number of treatments per patient were 2.8 with symptom control from 1 month to 4 years.ConclusionsSublglottic stenosis is a challenging clinical entity. Pulmonary function testing using the MVV can be helpful in predicting those patients that will benefit from treatment. Idiopathic subglottic stenosis is primarily a female disorder. Endoscopic management of idiopathic subglottic stenosis with CO2 laser, Kenalog, and Mitomycin C treatment improves length of symptom control compared to nd‐YAG laser therapy with rigid dilation alone.
S229 – One‐Stage Tympanoplasty with or without Mastoid Obliteration
Authors: Hayashi Ken , Shinkawa Atsushi 
Published: August 2008

ObjectivesTo confirm the efficacy of one‐stage tympanoplasty with mastoid obliteration and a tymapanoplasty by transcanal approach using ceramic prosthesis.MethodsOur surgical procedure was performed on 163 patients with cholesteatoma and 545 patients with chronic otitis media in Shinkawa Clinic. The operative method was classified into 2 groups. We use one‐stage tympanoplasty with mastoid obliteration, a canal wall down procedure for chronic otitis media with cholesteatoma and chronic otomastoiditis. On the other hand, we use a tympanoplasty by an endaural approach for chronic otitis media without chronic otomastoiditis. The ossicular chain was reconstructed using the ceramic ossicular prosthesis (P‐type and T‐type). We performed modified Type III tympanoplasty using the P‐type ceramic when the superstructure of the stapes could be utilized, while we performed modified Type IV tympanoplasty using the T‐type ceramic when the superstructure of the stapes could not be used.ResultsIn chronic otitis media with cholesteatoma or chronic otomastoiditis, the success rate of modified Type III tympanoplasty using ceramic P type was 77.8%; on the contrary, that of modified Type IV tympanoplasty using ceramic T type was 70.6%. In chronic otitis media without chronic otomastoiditis, the success rate of modified Type III tympanoplasty using ceramic P‐Type was 69.8%, while that of modified Type IV tympanoplasty using ceramic T was 69.1%.ConclusionsOur results show that there are no significant differences of success rate between these 2 procedures. We confirmed that the use of ceramic implant was satisfactory for both one‐stage tympanoplasty with mastoid obliteration and a tympanoplasty by an endaural approach.
S236 – Novel Biomarker Use in the Evaluation of Facial Nerve Palsy
Authors: Flanagan Carrie , Gerry Shaw , Odland Rick 
Published: August 2008

Objectives1) To determine whether a novel biomarker (hyperphosphorlyated neurofilament‐heavy subunit) is able to be quantitated in patients with idiopathic facial nerve paralysis. 2) To determine whether correlation exists between biomarker quantitation and clinical parameters in patients with idiopathic facial nerve paralysis.MethodsThis is a prospective pilot study that assesses the utility of the serum biomarker hyperphosphorylated neurofilament‐heavy subunit protein(NF‐H) in evaluating patients with idiopathic facial nerve paralysis. From May 2006 to August 2007, 12 patients that presented to the Emergency, Neurology, and Otolaryngology departments at a county hospital with acute onset unilateral facial paralysis were enrolled into the study. Serum samples at the time of presentation were obtained, and the following additional data was recorded and analyzed: age, sex, severity of paralysis at presentation, duration between time of onset of paralysis and presentation, side of paresis, associated comorbidities, time to recovery, and ancillary testing results. Data analysis was performed using Student's T‐test and analysis of variance; linear regression models and correlation coefficients were calculated using Microsoft Excel computer software.ResultsThere was no significant relationship between patient age (r2=0.20), sex (p=0.19), and side of paralysis (p=0.49) and biomarker level. The biomarker level increased with increasing facial paresis severity (p=0.002, r2=0.17), and had a more pronounced correlation when patients presented within the first 24 to 48 hours of paralysis (p=0.006, r2=0.59). There was no correlation between biomarker and prognosis or ancillary testing results.ConclusionsHyperphosphorylated neurofilament‐heavy subunit levels correlated with initial severity of facial paralysis, but were time‐dependent.
S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients
Authors: Cordes Brett M , Madduri Nurupama , Friedman Ellen M 
Published: August 2008

ObjectivesThe purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy tube (PET) insertion in children with Down syndrome.MethodsRetrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy tube insertion for middle ear disease are analyzed.ResultsThe mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third tube insertions, respectively, for persistent pathology and failed tube function. The mean age at first tube insertion was 3.3 years, while the mean age at second and third tube insertion was 6.9 and 6.0 years. Outcome measures included a documented conductive hearing loss on audiological assessment and/or persistent middle ear effusion on physical exam. Speech and language skills were also assessed.ConclusionsChildren with Down syndrome have an increased incidence and persistence of middle ear disease. Additionally, affected children may require multiple surgical interventions for persistent disease and failed tube function. The multiple medical problems often associated with Down syndrome result in an increased anesthetic risk for these patients. Therefore, we propose the utility of a durable tympanostomy tube for more efficient treatment and the avoidance of multiple interventions.
S254 – Bone Conduction Noise Exposure via Ventilators in the NICU
Authors: Black Angela P , Sidman James D 
Published: August 2008

ObjectivesTo demonstrate that neonatal ventilators produce high noise levels through bone conduction (BC) via endotracheal tubes, as well as air conduction (AC) from ambient noise.MethodsA sound level meter was used to measure the noise levels 4 feet from the ventilator and in direct contact at the end of a balloon attached to the ETT to simulate the noise presented to the infant. 3 commonly used neonatal ventilators (Sensormedics 3100A, VIP Bird and Bunnell Jet) were examined.ResultsNoise levels were significantly higher (6 – 14 dB) at the end of the ETT than 4 ft from the ventilator for all ventilators studied.ConclusionsPrevious studies have shown high ambient noise levels in NICUs, but have failed to address the actual noise presented to the infant. ETT transmission of noise as a direct bone stimulus through the skull has been overlooked. This study has shown that high noise intensities are being presented not only as AC, but as BC to the infants though the ETT. This study demonstrates, therefore, that ear protection alone will not save these at‐risk infants from hearing damage. More must be done to decrease noise exposure and develop quieter machines.
S255 – Treatment of Complicated and Uncomplicated Preauricular Pits
Authors: Vivero Richard J. , Roy Soham 
Published: August 2008

Objectives1) To review our experience with complicated and uncomplicated preauricular pits requiring surgical excision. 2) To review relevant embryology, anatomy, and surgical technique.MethodsA retrospective chart review from 2002 to 2007 was conducted at a tertiary care university hospital to identify patients less than 18 years old undergoing surgical excision of a preauricular pit. Charts were reviewed for patient age, presentation, complications, treatment algorithm, and outcome.Results13 patients underwent surgical excision of a preauricular pit. The indication for excision was either recurrent infection or recurrent drainage in all cases. 3 of 13 patients had a pre‐surgical complication of the infection, including localized cellulitis of the preauricular skin or infection of the helical cartilage. These patients were treated with a prolonged course of antibiotics prior to surgical excision. All 13 patients were treated with wide surgical excision; in the 3 patients with pre‐excision complications, careful attention was paid to meticulous surgical excision of all involved tissue. There were no postoperative complications. No recurrences were noted at up to 3‐year follow‐up. Parents were satisfied with the cosmetic outcome in all cases.ConclusionsPreauricular pits are an important entity due to their potential for significant infectious morbidity. Appropriate diagnosis and management with wide local excision, especially in the context of a complicated presentation, can result in excellent cosmesis with minimal risk of recurrence. Relevant embryology, anatomy, and surgical technique will be reviewed.