bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advantages of a Targeted Approach in Minimally Invasive Radioguided Parathyroidectomy Surgery for Primary Hyperparathyroidism
Authors: Grady Jennifer A. , Bumpous Jeffrey M. , Fleming Muffin M. , Flynn Michael B. , Turbiner Elliott , Lentsch Eric J. , Ziegler Craig H. 
Published: March 2006

AbstractObjective: In a large series of patients, we associated the need for preoperative parathyroid hormone (PTH) and calcium levels as a vital component in our approach to the radioguided minimally invasive parathyroidectomy (MIRP) procedure. Our objective was to determine whether these preoperative levels indeed complemented the procedure. Our study also included a postoperative assessment of excised gland volume and length of operation.Study Design: This was a prospective cohort study.Methods: One hundred seventy‐three patients with primary hyperparathyroidism enrolled in our radioguided MIRP protocol. Patients were divided into groups based on the results of sestamibi scans. Comparisons were made between these results and the assessed preoperative PTH and calcium levels and the postoperative excised gland volume and length of operation.Results: PTH and calcium levels did not statistically relate with the likelihood of having a “positive,” “equivocal,” or “negative” sestamibi scan, but the volume of excised gland was significantly different among the three groups (P < .01). There was no significant difference between positive and equivocal scans (P = .40). Operative time was significantly different between positive and equivocal scans (P < .01), positive and negative scans (P < .01), and equivocal and negative scans (P < .01).Conclusions: Routine preoperative PTH and calcium levels are necessary for the biologic diagnosis of hyperparathyroidism, but they do not appear to relate to the outcome of a sestamibi scan and therefore do not complement the radioguided MIRP procedure. Because the size of the affected gland, however, did correlate with a positive sestamibi scan, we conclude that as the volume of the gland increases, so does the likelihood of a successfully chosen minimally invasive surgical approach.
Olfactory Function and Olfactory Bulb Volume in Patients with Postinfectious Olfactory Loss
Authors: Rombaux Philippe , Mouraux André , Bertrand Bernard , Nicolas Georges , Duprez Thierry , Hummel Thomas 
Published: March 2006

AbstractObjective: The study aimed to investigate whether the degree of postinfectious olfactory loss is reflected in volume of the olfactory bulb (OB).Study Design: Retrospective study of 26 patients with postinfectious olfactory loss.Materials and Methods: Olfactory function was assessed with the “Sniffin Sticks” test kit, and the magnetic resonance imaging study focused on OB volume and the olfactory sulcus.Results: The study revealed that 1) OB volume varies with regard to olfactory function, 2) OB volume decreases with duration of olfactory loss, and 3) patients with parosmia had smaller OB volumes than patients who did not report such smell distortions, although their overall olfactory function was not significantly different from each other.Conclusion: The study emphasizes that OB volume is a gauge of olfactory function.
Pediatric Epistaxis
Authors: Damrose John F. , Maddalozzo John 
Published: March 2006

AbstractObjectives/Hypothesis: Otolaryngologists are frequently consulted for the evaluation and treatment of pediatric epistaxis. There is a lack of consensus as to the optimal approach to this problem. This study evaluated an approach used to evaluate and treat patients referred on an outpatient basis.Study Design: Retrospective study.Methods: Charts from 90 patients referred for the treatment of epistaxis were reviewed.Results: Anemia was identified in 22% of patients. An abnormal coagulation study was identified in 7.8% of patients. Computed tomography (CT) imaging of the sinuses was obtained in nearly 90% of patients and revealed no suspicious masses. Opacification of the sinuses consistent with sinusitis was commonly seen. The majority of cases were resolved by the first follow‐up visit with a topical nasal emollient.Conclusions: The outpatient evaluation of epistaxis should include a screen for anemia and coagulopathy. Routine CT imaging of the sinuses is unhelpful and is not recommended. The majority of cases are easily treated with rehydration of the nasal mucosa. Consideration should be given to rhinosinusitis as a co‐existing factor in patients with epistaxis.
Can Mitomycin C Really Prevent Airway Stenosis?
Authors: Roh Jong‐Lyel , Lee Yong‐Won , Park Chan Il 
Published: March 2006

AbstractBackground/Objectives: Mitomycin C (MMC) is used in the prevention of upper airway stenosis. However, the efficacy of MMC is still debatable, and the potential complications of MMC use have been scarcely reported. We evaluated the efficacy and early complications of MMC in a wound model of the subglottis.Study Design: A randomized animal study.Methods: Sixty rabbits underwent a full‐thickness injury to the posterior subglottis by diode laser. The animals were randomly assigned to three groups according to the different topical treatments of MMC 0.4 or 10 mg/mL or saline alone for 5 minutes. Animals were killed at 4 weeks, and gross and histologic findings were compared among different groups and 10 age‐matched, nonwound, normal controls.Results: Thirty‐two of the 60 (53%) animals died mainly of acute airway obstruction by necrotic debris, sloughs on, or cartilage collapse of the unhealed posterior subglottis during early weeks after wounding, higher in the MMC‐treated animals (67%) than in the wound controls (25%) (P = .007). This resulted from the significant delay of wound healing in the MMC‐treated groups compared with the wound controls (P = .012). The degree of subglottic stenosis was comparable among different groups (P > .8), although collagen deposition was significantly lower in the MMC‐treated groups compared with the untreated controls (P = .036).Conclusions: There was a significant risk of acute airway obstruction from delayed wound healing in rabbits that received subglottic laser wounding and MMC treatment. This risk should be considered in the use of MMC in clinical practice.
Salvage Conservation Laryngeal Surgery after Irradiation Failure for Early Laryngeal Cancer
Authors: Motamed Mehdi , Laccourreye Ollivier , Bradley Patrick J. 
Published: March 2006

AbstractObjectives: One third of recurrences after radiotherapy for early laryngeal cancer remain localized. Salvage conservation laryngeal surgery, with total laryngectomy held as reserve, is a surgical management option that is arguably underused. The aim of this review is to report the oncologic and functional results of salvage conservation laryngeal surgery, using the external or the endolaryngeal laser approach.Study Design: Review article.Methods: A computerized literature search of the Medline database from 1985 to 2005 was performed using the following search strategy: laryngeal neoplasm/AND salvage therapy/. Studies with a sample size less than 10 and an average follow‐up of less than 24 months were excluded from analysis. The oncologic outcome, functional outcome, length of hospitalization, and the frequency of complications were recorded.Results: The average reported local control rate for recurrent early glottic cancer after radiotherapy salvaged by using the external or the endolaryngeal laser approach is 77% and 65%, respectively. The average reported overall local control rate, including cases that subsequently required total laryngectomy, is 90% and 83%, respectively. The endolaryngeal approach when compared with the extralaryngeal approach does have the advantage of reduced complications, lesser requirement for tracheostomy and nasogastric feeding, and shortened hospitalization time.Conclusions: Conservation laryngeal surgery is a safe and effective treatment for recurrent localized disease after radiotherapy for early stage glottic cancer. Local control may be achieved without the sacrifice of laryngeal function, and total laryngectomy may be held in reserve as the ultimate option for salvage without compromising ultimate survival significantly.
Altered Expression Profile of Superoxide Dismutase Isoforms in Nasal Polyps from Nonallergic Patients
Authors: Cheng Yuan‐Kai , Hwang Guang‐Yuh , Lin Chia‐Der , Tsai Ming‐Hsui , Tsai Shih‐We , Chang Weng‐Cheng 
Published: March 2006

AbstractObjective/Hypothesis: Nasal polyposis (NP) is a chronic inflammatory disease of the upper respiratory tract. The pathophysiology is unknown but has been shown to be multifactorial. Free radical‐mediated damage has been implicated in the pathogenesis of NP. Superoxide dismutases (SODs) are the first and the most important line of antioxidant enzyme defense against reactive oxygen species. Moreover, isozymes of the SOD family are critical for modulating the activity of nitric oxide, a gaseous free radical that is believed to play roles in the physiology and pathology of respiratory tracts. However, the expression profile of SOD isoforms in NP remains unclear. We aimed to investigate the expression profile of the SOD isoforms in nasal polyps from nonallergic patients.Study Design: Prospective study.Methods: Nasal polyp tissues were obtained from eight nonallergic patients who underwent elective polypectomy; mucosal specimens from the middle turbinates were acquired from eight subjects without NP as control tissues. The expression profile of SOD isoenzymes, SOD1, SOD2, and SOD3, in the nasal tissues was determined by reverse transcription‐polymerase chain reaction (RT‐PCR), enzyme‐linked immunosorbent assay (ELISA), and Western blotting (WB).Results: NP in all eight of the NP patients manifested as severe or recurrent sinonasal polyposis clinically. The expression pattern of SOD isoenzymes evaluated by RT‐PCR analysis indicated that the mean levels of SOD1 mRNA and, to a greater extent, SOD3 mRNA were higher in polyp tissues than in control tissues. There was no significant difference in the expression levels of SOD2 mRNA between the two groups. The data from ELISA and WB analysis showed that there were increased expressions of SOD1 and SOD3 protein in polyp tissues compared with the control tissues, but there was no difference in the expression of SOD2 protein between the two groups. The results from RT‐PCR, ELISA, and WB were paralleled and revealed that the expressions of SOD1 and, to a greater extent, SOD3 were higher in polyp tissues than in the control group.Conclusions: The expressions of SOD3 and SOD1 were higher in polyp tissues. These results are consistent with previously reported data and support the hypothesis that there is increased oxidative stress in NP. Our data also suggest that the SODs might be important in the pathogenesis of NP; however, the roles these SOD isoforms, especially SOD3, play in both normal nasal mucosa and NP require further clarification.
Nasal Vaccination With CpG Oligodeoxynucleotide Induces Protective Immunity Against Nontypeable Haemophilus influenzae in the Nasopharynx
Authors: Abe Nobuyuki , Kodama Satoru , Hirano Takashi , Eto Mayumi , Suzuki Masashi 
Published: March 2006

AbstractObjectives: Nasal vaccination is an effective therapeutic regimen for preventing otitis media. Since cholera toxin (CT) is toxic, an alternative adjuvant is required for the development of a nasal vaccine. The efficacy of CpG oligodeoxynucleotide (ODN) as a mucosal adjuvant was examined.Methods: Mice were immunized intranasally with P6 protein of nontypeable Haemophilus influenzae (NTHi) and adjuvant, CT, or CpG ODN, and P6‐specific antibody responses were examined. The expression of P6‐specific cytokine mRNA in splenic CD4+ T cells was also determined. In addition, NTHi challenges were performed and the NTHi was quantified in nasal washes.Results: P6‐specific IgA in nasal wash and serum IgG titers were elevated significantly after nasal immunization. The IgG1/IgG2a ratio in serum from P6+CpG‐immunized mice was less than that of P6+CT‐immunized mice. Although IL‐6 was expression similarly in both groups, IFN‐γ expression was greater in P6+CpG‐immunized mice than in P6+CT‐immunized mice. Enhanced clearance of NTHi from the nasopharynx was also shown equally in both groups.Conclusion: These results indicate that CpG ODN might be an effective mucosal adjuvant, acting by mechanisms that are different from CT. These findings suggest that nasal vaccination with P6 and CpG ODN might be an effective regimen for the induction of NTHi‐specific protective immunity.
Diagnosis of Unilateral Recurrent Laryngeal Nerve Paralysis: Laryngeal Electromyography, Subjective Rating Scales, Acoustic and Aerodynamic Measures
Authors: Bielamowicz Steven , Stager Sheila V. 
Published: March 2006

AbstractObjective/Hypothesis: To determine whether specific laryngeal electromyography (LEMG) patterns in patients with unilateral vocal fold paralysis/paresis (UVFP) are related to etiology of injury, time from onset of injury, patient perception of symptom severity, acoustic measures, and laryngeal aerodynamic measures.Study Design: This is a retrospective review of 75 patients.Methods: Each patient received LEMG, acoustic and aerodynamic testing, and a subjective rating scale assessment (the Glottal Closure Index). Statistical analysis by groups were performed using both ξ2 and single‐factor analysis of variance testing.Results: An iatrogenic etiology was associated with poor tone on LEMG (P = .05). Those individuals evaluated after 3 months after onset demonstrated more nascent units, a sign of reinnervation, compared with individuals evaluated before 3 months (P < .02). Individuals with fewer normal motor units on LEMG had significantly higher mean translaryngeal air flows (P = .044). Individuals with poor recruitment had significantly shorter maximum phonation times (P = .034) and higher mean flows (P = .044). Individuals with better laryngeal tone as noted on LEMG had significantly lower mean flows (P = .06).Conclusions: Specific LEMG patterns are related to the etiology of the UVFP and time course since recurrent laryngeal nerve injury. LEMG appears to reflect vocal fold muscle tone as seen on laryngeal function studies. In combination, these studies provide a cohesive assessment of laryngeal function in patients with UVFP.
In Vitro Model for Intraoperative Adjustments in an Implantable Hearing Aid (MET)
Authors: Jorge Jesus Rodriguez , Pfister Markus , Zenner Hans P. , Zalaman Ilse M. , Maassen Marcus M. 
Published: March 2006

AbstractObjective: Assessment of the optimal static preloading of Otologics Middle Ear Transducer (MET) Ossicular Stimulator, when coupled to the incus.Background: The MET Ossicular Stimulator is a partially implantable electromagnetic middle ear hearing device that transmits vibrations to the ossicular chain. The vibration patterns were measured with laser‐Doppler vibrometry.Study Design: Experimental.Material: We used three human cadaveric temporal bones (TB) and one MET ossicular stimulator.Methods: Laser‐Doppler vibrometry was used for the selection of TBs. The cochlea was subsequently extirpated from the posterior side to measure the vibrational patterns (VP) of the footplate. Three TBs with different VP were selected based on data obtained from volunteers with normal hearing (n = 110): one TB with a VP larger than +1 SD, one TB with a VP in the range of ±1 SD, and 1 TB with a VP smaller than −1 SD. Transfer functions were calculated between VP of the measurement points at the coupling rod, umbo, incus, and footplate. The TBs were subsequently defrosted. The MET was implanted and coupled to the ossicular chain. Different coupling loads were measured at the incus, the umbo, and the footplate.Results: Optimal transfer function between the MET transducer and the oval window was achieved during contact when the coupling rod advanced 0.0625 mm (90° rotation). Additional advances of 0.0625 mm (180° turn = 0.125 mm) resulted in a decreased vibrational amplitude, ranging between 20 and 40 dB below 3 kHz. The lowest linear distortion occurred up to 10 kHz during direct contact without advancing the coupling rod.
Effects of Time of Contact and Concentration of Caustic Agent on Generation of Injuries
Authors: Mattos Gustavo M. , Lopes Daniel Dias , Mamede Rui Celso Martins , Ricz Hilton , Mello‐Filho Francisco V. , Neto José Barbieri 
Published: March 2006

AbstractObjectives: Solid caustic soda (CS) ingestion levels continue high in Brazil. The aggressiveness of a caustic agent depends, among other factors, on its concentration and time of contact with mucosa. However, the interdependence of these factors in the production of caustic lesion in the esophageal mucosa is not known, especially regarding CS as the strongest corrosive agent. We analyze the effects of concentration and time of contact on the aggressiveness of CS to the esophagus of live animals.Study Design/Methods: One milliliter of CS at concentrations between 1.83% and 73.33% was applied to rats. The solution was kept in contact with the mucosa for 10 to 120 minutes. Internal and external organ aspects were analyzed and the epithelium, submucosa, muscle layer, and adventitia were analyzed microscopicallyResults: Epithelial necrosis was observed at all concentrations. Among the necrotic layers, the submucosa was observed starting at the 7.33% concentration, and the muscular layer and adventitia were observed at 14.66% concentration. Damage to the pulmonary parenchyma and trachea occurred at 33.66% after 10 minutes, and perforation of the esophagus was observed only after 120 minutes. After 10 minutes, important corrosive lesions installed in the esophageal layers, expanding in depth and superficial extension. The use of heparin had no effect on the production of lesions.Conclusions: Ten minutes were sufficient to provoke necrosis, and longer contact increased the area of necrosis. Solution concentration levels were more important in damage production: 1.83% was sufficient for epithelial necrosis, 7.33% caused submucosal necrosis, and 14.66% muscle and adventitia necrosis; 33.66% solutions caused lung and trachea damage after 10 minutes and esophageal perforation after 120 minutes.
Endolymphatic Duct Status During Middle Fossa Dissection of the Internal Auditory Canal: A Human Temporal Bone Radiographic Study
Authors: Drew Brian R. , Semaan Maroun T. , Hsu Daniel P. , Megerian Cliff A. 
Published: March 2006

AbstractObjective: Successful hearing preservation after acoustic neuroma resection is sometimes complicated by delayed hearing deterioration. The middle fossa approach appears to offer superior long‐term hearing results when compared to the retrosigmoid surgical approach. The goal of this study is to investigate the hypothesis that internal auditory canal (IAC) drilling during middle fossa acoustic neuroma removal is associated with a lower incidence of endolymphatic duct (ELD) injury, a potential cause of delayed hearing loss (HL) known to accompany retrosigmoid hearing preservation dissection techniques.Study Design: A human temporal bone anatomic and radiographic study complemented with a literature review.Methods: Twenty human temporal bones were analyzed with high‐resolution multislice computed tomography (HRMCT) and subjected to standard extended middle fossa IAC dissection with labyrinthine preservation and follow‐up HRMCT for analyses of the ELD.Results: Zero of 20 (0%) temporal bones were found to have violation of the ELD with preservation of the labyrinthine structures and the endolymphatic sac. Reviews of human and animal studies indicate that injury to the ELD may create endolymphatic hydrops, a known cause of hearing deterioration.Conclusion: The ELD is not vulnerable to injury during IAC dissection using the middle fossa approach. A previous radiographic study has shown that the ELD is violated in 24% of temporal bones during retrosigmoid dissection of the IAC. These findings support and may help explain other outcome studies that show that long‐term hearing results are superior with the use of the middle fossa approach when compared to results following retrosigmoid dissection.
Minimally Invasive Management of the Mediastinal Parathyroid Adenoma
Authors: Sukumar Mithran S. , Komanapalli Christopher B. , Cohen James I. 
Published: March 2006

AbstractIntroduction/Methods: Traditional surgical management of mediastinal parathyroid adenomas has required mediastinal exploration via sternotomy or thoracotomy. By contrast minimal access approaches to the mediastinum via videoscopic transthoracic or transcervical approaches can offer equivalent visualization, patient safety and decreased patient morbidity. The availability of sternal retractor systems, the rapid parathyroid hormone (PTH) assay for intraoperative confirmation of cure, recurrent laryngeal nerve monitoring technique and video‐assisted thoracic surgery (VATS) instrumentation have made this possible. The purpose of this article is to discuss these approaches and the results with their application in five consecutive patients.Results: Five consecutive patients underwent mediastinal exploration of which three were performed transcervically and three transthoracically (one patient underwent both procedures). One patient had a negative thoracic exploration; one patient's course was complicated by transient recurrent laryngeal nerve injury which resolved spontaneously.Conclusion: Transcervical approaches for resection of anterior mediastinal parathyroid adenomas are possible with the use of the Rultract Skyhook™ Retractor without the need for sternotomy. VATS provides excellent visualization of the middle and posterior mediastinum avoiding the morbidity of thoracotomy.
Antimeasles Immunoglobulin G for Serologic Diagnosis of Otosclerotic Hearing Loss
Authors: Karosi Tamás , Kónya József , Petkó Mihály , Szabó László Z. , Pytel József , Jóri József , Sziklai István 
Published: March 2006

AbstractHypothesis: Persistent measles virus infection of the otic capsule is suggested to be an etiologic factor in otosclerosis. Otosclerosis is a disease of complex unknown etiology causing progressive conductive and/or sensorineural hearing loss (HL).Background: Diagnostic methods of otosclerosis are sensitive to ossicular chain fixation with low specificity for otosclerotic stapes ankylosis.Methods: Nucleic acid was extracted from stapes footplates of clinically stapes fixation patients (N = 213). Measles virus nucleoprotein RNA was amplified by reverse‐transcriptase polymerase chain reaction. Amplification results were correlated to histologic findings in 49 cases. Antimeasles IgG levels of all clinically stapes fixation as well as control sera specimens were measured by enzyme‐linked immunosorbent assay.Results: Among clinically stapes fixation patients, 141 stapes footplates contained measles virus RNA. Among 49 histologic specimens, viral RNA was detectable only in histologically otosclerotic stapes footplates (n = 35). Histology for virus‐negative footplates (n = 14) excluded otosclerosis. Antimeasles IgG levels were significantly lower in the sera of patients with virus‐positive stapes than in control sera.Conclusions: Combination of decreased antimeasles IgG serum level and conductive HL has a great specificity and sensitivity as a diagnostic method in the preoperative evaluation of ossicular chain fixations otosclerosis. Low antimeasles IgG level indicates otosclerosis, whereas high level suggests nonotosclerotic ossicular chain fixations. Preoperative elucidation of the cause of a conductive HL may suggest optional medical treatment in preference to surgical methods.