bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 23,000-yr Pollen Record from Lake Euramoo, Wet Tropics of NE Queensland, Australia
Authors: Haberle Simon G. 
Published: November 2005

AbstractA new extended pollen and charcoal record is presented from Lake Euramoo, Wet Tropics World Heritage rainforest of northeast Queensland, Australia. The 8.4-m sediment core taken from the center of Lake Euramoo incorporates a complete record of vegetation change and fire history spanning the period from 23,000 cal yr B.P. to present. The pollen record is divided into five significant zones; 23,000–16,800 cal yr B.P., dry sclerophyll woodland; 16,800–8600 cal yr B.P., wet sclerophyll woodland with marginal rainforest in protected pockets; 8600–5000 cal yr B.P., warm temperate rainforest; 5000–70 cal yr B.P., dry subtropical rainforest; 70 cal yr B.P.–AD 1999, degraded dry subtropical rainforest with increasing influence of invasive species and fire.The process of rainforest development appears to be at least partly controlled by orbital forcing (precession), though more local environmental variables and human activity are also significant factors. This new record provides the opportunity to explore the relationship between fire, drought and rainforest dynamics in a significant World Heritage rainforest region.
Unrecognized Benign Paroxysmal Positional Vertigo in Elderly Patients
Authors: Oghalai John S. , Manolidis Spiros , Barth Justine L. , Stewart Michael G. , Jenkins Herman A. 
Published: November 2005

Balance disorders in elderly patients are associated with an increased risk of falls but are often difficult to diagnose because of comorbid chronic medical problems. We performed a cross‐sectional study to determine the prevalence of unrecognized benign paroxysmal positional vertigo (BPPV) and associated lifestyle sequelae in a public, inner‐city geriatric population. Dizziness was found in 61% of patients, whereas balance disorders were found in 77% of patients. Nine percent were found to have unrecognized BPPV. Multivariate analysis demonstrated that the presence of a spinning sensation and the absence of a lightheadedness sensation predicted the presence of unrecognized BPPV. Patients with unrecognized BPPV were more likely to have reduced activities of daily living scores, to have sustained a fall in the previous 3 months, and to have depression. These data indicate that unrecognized BPPV is common within the elderly population and has associated morbidity. Further prospective studies are warranted.
Long‐term Results with Hydroxylapatite Middle Ear Implants
Authors: Goldenberg Robert A. , Driver Mark 
Published: November 2005

PURPOSEThis study evaluated long‐term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant.METHODSA total of 233 patients underwent implantation; of these, 77 had 5‐year or longer follow‐up and are the subjects of this study of long‐term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea.RESULTSThe hearing success rate at long‐term follow‐up was 56.8%; the mean air‐bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympa‐nomastoidectomy.CONCLUSIONHydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.
Prevalence of Unsuspected Acoustic Neuroma Found by Magnetic Resonance Imaging
Authors: Anderson Timothy D. , Loevner Laurie A. , Bigelow Douglas C. , Mirza Natasha 
Published: November 2005

OBJECTIVESAcoustic neuromas (ANs) comprise 6% of intracranial tumors. Population and autopsy studies have widely divergent estimates of AN incidence. With widespread use of MRI, asymptomatic ANs will be identified, which should improve estimates of the prevalence of this tumor.METHODSThe reports of all brain MRI scans during a 5‐year period were retrospectively searched for the diagnosis of AN. MRIs obtained because of a suspicion of AN were discarded, leaving only the unsuspected ANs.RESULTSA total of 24,246 MRI studies were performed during this time period. Seventeen patients had unsuspected ANs. Eight tumors were smaller than 1 cm, 6 were between 1 and 2 cm, and 3 were 2 cm or larger. For all MRI scans, we found 7.0 unsuspected ANs per 10,000 brain MRI studies (0.07%).CONCLUSIONThe true prevalence of AN is likely greater than the 10 per million per year previously reported. This implies that there may be a larger number of asymptomatic ANs than previously suspected.
Malignant Peripheral Nerve Sheath Tumors of the Head and Neck: Analysis of Prognostic Factors
Authors: Loree Thom R. , North James H. , Werness Bruce A. , Nangia Rina , Mullins Alan P. , Hicks Wesley L. 
Published: November 2005

Malignant peripheral nerve sheath tumors of the head and neck region are uncommon and may be associated with neurofibromatosis or occur in a sporadic manner. This is a retrospective review of 17 patients with these tumors who were treated at a single institution. Analysis of clinical and pathologic factors that influenced outcome was performed. There were 9 men and 8 women. Seven patients had a history of neurofibromatosis. Radiotherapy was implicated as a possible etiologic factor in 4 patients. The neck was the most frequently involved site. Overall survival at 5 years was 52%. Survival was improved for women and for patients with low‐grade tumors. Age, tumor site, and size had no impact on survival. Survival was worse for patients with neurofibromatosis than for those with the sporadic form of the disease (P= 0.02). Survival was calculated by the method of Kaplan and Meier. The significance of such results was based on results of the log rank test. Local recurrence correlated with tumor size and resection margin status. No local recurrences occurred in those patients who had negative margins of resection and received adjuvant radiotherapy. Tumor grade was predictive of the development of distant metastases. Negative margins of resection are essential for obtaining local control, and the addition of adjuvant radiotherapy may be beneficial in this group. Salvage surgery for local recurrence is possible in some patients.
Comparison of Open, Percutaneous, and Translaryngeal Tracheostomies
Authors: Maccallum Patricia L. , Parnes Lorne S. , Sharpe Michael D. , Harris Chris 
Published: November 2005

INTRODUCTIONWith 3 tracheostomy techniques currently available, controversy exists regarding which is safest and most economical. Percutaneous (PDT) and the new translaryngeal (TLT) tracheostomies are cited as more cost‐effective than the traditional open surgical procedure because they are bedside techniques. Our objective was to compare the perioperative and postoperative complications of the 3 techniques.STUDY DESIGNThis was a prospective trial involving 100 consecutive patients who underwent tracheostomy between April and December of 1997 at the London Health Sciences Centre and St Joseph's Health Centre in London, Canada.RESULTSFifty open tracheostomies were performed. Indications included prolonged ventilation (n = 42), airway protection (n = 5), pulmonary hygiene (n = 2), and sleep apnea (n = 1). A tension pneumothorax was the one significant intraoperative complication. Fifteen postoperative complications occurred, most notable of which was a 2‐L hemorrhage at 24 hours. Thirty‐seven TLTs were performed, 20 in patients with coagulopathy. Indications were prolonged intubation (n = 27), airway protection (n = 9), and pulmonary hygiene (n = 1). One intraoperative complication of accidental decannulation occurred. One postoperative complication, a pretracheal abscess, occurred in a decannulated transplant patient 2 weeks after the procedure. Thirteen PDTs were performed. Indications were prolonged intubation (n = 6), airway protection (n = 6), and tracheal toilet (n = 1). No significant complications occurred.CONCLUSIONSTLT and PDT have fewer complications than the traditional open technique. TLT appears to have the greatest utility in the coagulopathic patient.
Botulinum Toxin Injection of the Cricopharyngeus Muscle for the Treatment of Dysphagia
Authors: Ahsan Syed F. , Meleca Robert J. , Dworkin James Paul 
Published: November 2005

OBJECTIVEThis study was conducted to evaluate, subjectively and objectively, the diagnostic and therapeutic effects of botulinum toxin (Botox) in patients with dysphagia caused by cricopharyngeus (CP) muscle spasm and/or hypertonicity.METHODSA retrospective chart review was done of 5 patients with normally functioning larynges treated with CP Botox injection for dysphagia caused by perceived spasm. Subjective measures of swallowing function after injection were obtained with a patient questionnaire. Objective data were obtained both before and after surgery by one or more of the following tests: modified barium swallow study, manometry, videostroboscopy, and fiberoptic endoscopic evaluation of swallowing. Quality‐of‐life measures were obtained with a swallowing rating scale.RESULTSOverall, all patients had initial improvement in swallowing after Botox injection. The duration of benefit was from 2 to 14 months. There were no complications. Four of 5 patients had long‐term benefits, as evidenced by decreased or eliminated aspiration symptoms, removal of tracheotomy, ability to eat solid foods, and weight gain. One patient continues to have poor swallowing function.CONCLUSIONBotox injection of the CP muscle to treat dysphagia is effective in patients with underlying muscle spasm or hypertonicity. A positive response to Botox can also help confirm the diagnosis of CP muscle spasm.
Nitric Oxide is a Mediator of the Late‐Phase Response in an Animal Model of Nasal Allergy
Authors: Durland William F. , Lane Andrew P. , Durland Kimberly W. , Smith Timothy L. , Johnson Kenneth L. , Prazma Jiri , Pillsbury Harold C. 
Published: November 2005

The presence of nitric oxide (NO) in the nose is well documented; however, the role of this molecule in nasal physiology is still poorly understood. Our laboratory has previously demonstrated that NO is a mediator of the immediate secretory response to an intranasal histamine challenge in a rat model of nasal allergy. Histamine challenge, however, does not elicit a late‐phase response (LPR). To study the role of NO in the LPR, we developed a model of nasal allergy in which brown Norway rats are actively sensitized to the allergen ovalbumin and later challenged intranasally with either phosphate‐buffered saline solution (vehicle), ovalbumin in vehicle, or ovalbumin and the NO synthase inhibitor N‐nitro‐L‐arginine methyl ester. In each experiment, nasal lavage samples were collected 30, 120, 240, and 360 minutes after challenge. Lavage samples were analyzed for albumin content by ELISA, inflammatory cell concentration with a hemocytometer, and evidence of inflammation by light microscopy. Blocking NO synthesis with N‐nitro‐L‐arginine methyl ester significantly inhibited both albumin exudation and inflammatory cell influx into the nasal cavity during the LPR. These data suggest that NO plays a role in the LPR of nasal allergy.
Surgical Treatment of Labyrinthine Fistula Caused by Cholesteatoma
Authors: Soda‐Merhy Antonio , Betancourt‐Suárez Miguel Angel 
Published: November 2005

In a 144‐month period, 27 cases of labyrinthine fistula (LF) were seen, and 360 mastoid operations were performed; the LF prevalence was 7.5%. Primary symptoms were hypoacusis, otorrhea, vertigo, tinnitus, and otalgia. All patients underwent preoperative CT scans and preoperative audiometry. LF diagnosis was made before surgery for 93% of patients on the basis of symptoms, signs, and imaging studies. With respect to surgical technique, the canal‐wall‐down procedure was performed in 92%, and the canal‐wall‐up procedure was performed in 8%. In 88% of patients the fistula was located in the horizontal semicircular canal. In 96% of patients the cholesteatoma matrix was removed, and the fistula was sealed; in 4% of patients the matrix was left. With a follow‐up of 13 years, vertigo disappeared in 96% of patients, and hearing remained unchanged in 70% of patients. Further complications of chronic otitis media existed in approximately half of the patients with LF. Open surgery with removal of the cholesteatoma matrix and sealing of the fistula with temporalis fascia in a canal‐wall‐down manner is a safe procedure that can make vertigo disappear and helps to preserve cochlear function.
Acoustic Analysis of the Voice in Phonatory Fistuloplasty after Total Laryngectomy
Authors: Arias Mariano Rosique , Ramón José Luis , Campos Matilde , Cervantes Juan Jiménez 
Published: November 2005

A comparative study of the voice with sustained phonation of the vowel /a/ was made in 3 groups of male patients: (1) 20 patients receiving total laryngectomy for epidermoid carcinoma of the larynx who had acquired good voice quality after a phonatory fistuloplasty with a Herrmann voice prosthesis; (2) 20 patients undergoing total laryngectomy for epidermoid carcinoma of the larynx who had learned esophageal speech; and (3) 20 subjects with normal voices. Statistical analysis yielded significant differences in fundamental voice frequency between the 3 groups, with the patients with phonatory prostheses revealing the closest to a normal voice. For other parameters used, such as jitter, shimmer, and harmonics/noise ratio, voice quality with a phonatory prosthesis was similar to that obtained with esophageal speech.
Hearing Results in the Second Stage of Open Mastoidectomy: A Comparison of the Different Techniques
Authors: Cristóbal Fernando , Gómez‐Ullate Rafael , Cristóbal Isabel , Arcocha Alfredo , Arroyo Ramón 
Published: November 2005

OBJECTIVEThe goal of this study was to compare the hearing results obtained through different hearing‐restoration techniques in open‐cavity mastoidectomy.METHODS AND MATERIALA total of 116 ears operated on during the second stage of open mastoidectomy were studied. The hearing gain was registered as the difference between preoperative and 1‐year postoperative conversational frequency means (500, 1000, 2000 Hz). High‐pitched frequencies (4000 Hz) were used equally. Two groups of studies were carried out: in one study the stapes was intact, and in the other the stapes arch was absent. The columella techniques we examined, from a hearing point of view, are total and partial ossicular replacement prostheses, ossiculoplasty, cartilage with or without perichondrium, and the myringostapediopexy.RESULTS AND CONCLUSIONSIn the group of patients in whom the stapes was intact, the differences in high‐pitched frequencies found between the different techniques were negligible, but the differences were quite significant in conversational frequencies, where the partial ossicular replacement prosthesis turned out to be the technique with the worst results. In ears in which only the footplate was present, the total ossicular replacement prosthesis gave better results than any other technique, both in conversational frequencies and in 4000‐Hz frequency.
Complications of Postoperative Radiation Therapy after Partial Laryngectomy in Supraglottic Cancer: A Long‐Term Evaluation
Authors: Laccourreye Ollivier , Hans Stéphane , Borzog‐Grayeli Ali , Maulard‐Durdux Catherine , Brasnu Daniel , Housset Martin 
Published: November 2005

This retrospective study, based on a series of 90 patients with invasive squamous cell carcinoma of the supraglottis, was designed to document the functional outcome and complications after postoperative radiation therapy following partial laryngeal surgery. The surgical procedure was a standard supraglottic laryngectomy in 62 patients and a supracricoid partial laryngectomy in 28 patients. All of the patients had an unremarkable postoperative course and achieved locoregional control. The average dose delivered to the remaining larynx was 51.2 Gy (range 25‐71 Gy). The average dose delivered to the neck was 50.6 Gy (range 2270 Gy). The patients were treated at 180‐cGy per fractions in a continuous course technique with a cobalt 60 beam. In 5 patients (5.5%) complications led to cessation of postoperative radiation therapy, and the total dose delivered to the remaining larynx and neck was less than 40 Gy. All patients were followed up for a minimum of 10 years or until death. The 5‐, 10‐, and 15‐year actuarial survival estimates were 71.5%, 44.3%, and 36.3%, respectively. The 5‐, 10‐, and 15‐year actuarial severe complication estimates were all 11.2%. Overall, severe complications occurred in 15 patients. Severe complications led to death in 3 patients (3.3%), permanent gastrostomy in 3 (3.3%), and permanent tracheostomy in 1 (1.1%). A severe complication never resulted in completion of total laryngectomy. In univariate analysis, the mean dose delivered to the larynx was the only variable statistically related to the incidence of a severe complication. The mean dose delivered to the larynx was statistically higher(P= 0.014) in patients who had severe complications (60 Gy) than in patients who did not (50 Gy).
Skin Prick Test Reactivity to Foods in Adult Malaysians with Rhinitis
Authors: Gendeh Balwant Singh , Murad Shahnaz , Razi Azizah Mohd , Abdullah Nasaruddin , Mohamed Abdullah Sani , Kadir Khalid Abdul 
Published: November 2005

The aim of the study was to determine the incidence of food and house dust mite (HDM) allergy in patients with nasal congestion and rhinorrhea attending the Otorhinolaryngology Clinic, National University of Malaysia, Kuala Lumpur. This was a prospective matched, controlled study of patients skin prick tested with commercial food and common aeroallergens. The participants were 148 Malaysian adults with symptoms of nasal congestion and rhinorrhea and 113 adult Malaysian control subjects without rhinitis symptoms. The skin prick test (SPT) was used to evaluate 11 foods common to the Malaysian diet and 3 HDM inhalants. Forty‐eight percent of the patients with rhinitis had positive SPT results to foods, compared with 4.4% of control subjects (P > 0.05). The most commonly implicated foods were shrimp (48%) and rice (30%), which are common in the Malaysian diet. Seventy‐two percent of rhinitis patients had positive SPT results to HDM, compared with 22.2% of control subjects (P > 0.05). Patients with rhinitis also had significantly more gastrointestinal problems than control subjects (P > 0.05). The incidences of HDM and food allergy are significantly greater in Malaysian adults with rhinitis symptoms than in control subjects without rhinitis. The effect of avoidance or immunotherapy awaits further study.
Voice quality after narrow‐margin laser cordectomy compared with laryngeal irradiation
Authors: Delsupehe Kathelijne G. , Zink Inge , Lejaegere Maryline , Bastian Robert W. 
Published: November 2005

Voice quality remains the issue often used to support preference for radiotherapy in treatment of early glottic cancer. We therefore conducted a perceptual voice study in 2 groups, one treated with radiotherapy for malignant disease and the other with narrow‐margin laser cordectomy for either malignant or extensive benign lesions. Sequential patients, 12 treated with radiotherapy and 30 with CO2 laser excision, were included. Voice samples were recorded before and at intervals after surgery. Ratings of validated judges were used for statistical analysis of various voice characteristics at each time point. Voice deteriorated temporarily after surgery as compared with the radiated group; however, at 6 and 24 months no significant differences were found between the groups. Preferential use of narrow‐margin laser cordectomy for appropriate early glottic tumors can be supported not only for oncologic reasons but also on the basis of voice results, cost, and efficiency considerations. (Otolaryngol Head Neck Surg 1999;121:528–33.)
Predictive markers for response to chemotherapy, organ preservation, and survival in patients with advanced laryngeal carcinoma
Authors: Bradford Carol R. , Wolf Gregory T. , Carey Thomas E. , Zhu Shaobo , Beals Theodore F. , Truelson John M. , Mcclatchey Kenneth D. , Fisher Susan G. 
Published: November 2005

OBJECTIVEA systematic retrospective study of the largest randomized trial of induction chemotherapy and radiation for advanced laryngeal cancer was undertaken to determine whether specific tumor or biologic factors were predictive of chemotherapy response, organ preservation, or survival.METHODSThe variables analyzed included clinical and histologic factors, immunohistochemical expression of proliferating cell nuclear antigen and p53, and adjusted DNA index measurements. Variables were evaluated for correlation with outcomes of tumor response, organ preservation, and survival.RESULTSMultivariate analysis revealed that the best predictor of complete response to induction chemotherapy was low T class. The full multivariate model for predicting larynx preservation in patients treated with induction chemotherapy plus radiation shows that T class, p53 overexpression, and elevated proliferating cell nuclear antigen index were independent predictors of successful organ preservation.CONCLUSIONSThese predictive markers should be included in future clinical trials of advanced laryngeal cancer to determine their usefulness prospectively.
Central neck dissection for the treatment of recurrent thyroglossal duct cysts in childhood
Authors: Kim Michael K. , Pawel Bruce R. , Isaacson Glenn 
Published: November 2005

OBJECTIVEThe recurrence rate of thyroglossal duct cysts removed by the classic Sistrunk procedure exceeds 4%, even in skilled hands. Simple reexcision fails in 33% of these patients. Recent pathology literature suggests that the tracts of thyroglossal duct cysts may arborize, arguing for a wide‐field approach to recurrent lesions. We describe the anatomic rationale and technique of an en bloc central neck dissection in children, on the basis of cadaver dissections and histopathologic review of recurrent thyroglossal duct cyst specimens.METHODSWe reviewed the medical records of all the children undergoing surgery for thyroglossal duct cysts and fistulas during the years 1990 to 1998 by the senior author. En bloc central neck dissections were performed on several cadaver specimens to further delineate the anatomic rationale for this procedure.RESULTSWe have performed an en bloc central neck dissection in 7 children, 5 with recurrent or multiply recurrent thyroglossal duct cysts. None has had a recurrence after follow‐up of 9 months to 6 years. All have acceptable functional and cosmetic results.CONCLUSIONAn en bloc central neck dissection is a logical and effective surgical technique for the removal of recurrent or multiply recurrent thyroglossal duct cysts.
Safety of home‐based and office allergy immunotherapy: A multicenter prospective study
Authors: Hurst David S. , Gordon Bruce R. , Fornadley John A. , Hunsaker Darrell H. 
Published: November 2005

During a 1‐year period, 27 otolaryngic allergy practices recorded all systemic reactions to immunotherapy resulting from 635,600 patient visits and 1,144,000 injections. Sixty percent of injections were given at home. Major systemic reactions were observed after 0.005% of injections. There were no hospitalizations or deaths. Eighty‐seven percent of major reactions began within 20 minutes of injection. Frequently observed risk factors for major reactions were buildup phase of immunotherapy, active asthma, and first injection from a treatment vial. Home and office injections had similar rates of total systemic reactions, but home‐based immunotherapy had far fewer major reactions. Home‐based immunotherapy was found to be safe. The methods and precautions used to treat patients with this degree of safety are specified and discussed.