bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Anatomy of Anterolateral Thigh Flap
Authors: Malhotra Kavita , Lian Timothy S. , Chakradeo Vinaya 
Published: February 2009

AbstractObjectives: To understand the vascular anatomy of the anterolateral thigh (ALT) free flap. To anatomically determine whether including a 2‐cm cuff of vastus lateralis muscle (VLM) incorporates musculocutaneous perforators in the harvest of the ALT free flap.Study Design: Anatomic study on human cadavers.Methods: Twenty‐seven cadaver thighs were dissected. Musculocutaneous perforators from the vascular pedicle of the ALT free flap were identified. The distance from the anterior border of the VLM to the point where perforators entered the muscle was measured.Results: An average of four musculocutaneous perforators to the ALT free flap were identified per thigh. The distance from the anterior border of the VLM to the point where perforators entered the muscle ranged from 0.1 to 7 cm, with the mean distance being 1.80 cm. Sixty‐four percent of perforators entered the VLM within 2 cm of the muscle's anterior border. At least one perforator entered the VLM within 2 cm of the muscle's anterior border per thigh.Conclusions: Most musculocutaneous perforators to the ALT free flap enter the VLM within 2 cm of the muscle's anterior border, thus providing for an anatomic basis for including a 2 cm cuff of VLM when harvesting the ALT free flap. By including a 2 cm cuff of VLM, tedious dissection of individual musculocutaneous perforators is unnecessary, thereby increasing the ease of dissection and expediting the harvest of the ALT free flap.
Pediatric Myringoplasty: Factors That Affect Success—A Retrospective Study
Authors: Sckolnick Joshua S. , Mantle Belinda , Li Jia , Chi David H. 
Published: February 2009

AbstractObjective: To evaluate the impact of patient and graft variables on the successful closure of tympanic membrane perforations treated with myringoplasty at the Children's Hospital of Pittsburgh from 2000 to 2005.Study Design: Retrospective chart review at an academic tertiary‐care children's hospital.Methods: Charts were reviewed for 604 children, ages 1 to 18 years old, with complete records who underwent myringoplasty by the pediatric otolaryngology practice at Children's Hospital of Pittsburgh of UPMC from 2000 to 2005, totaling 777 procedures.Results: Significant variables include patient age, number of prior tubes, perforation etiology (P < .000), presence of a retained tube (P < .000) as well as tube type (P = .016), graft material (P = .001), and history of Down syndrome (P = .035). Nonsignificant variables include season of procedure (P = .599), status of adenoid tissue (P = .910), prior otorrhea (P = .175), as well as perforation location (P = .318) and duration (P = .150).Conclusions: Proper patient and graft material selection can affect the outcome of myringoplasty procedures. Practical implications from these data suggest that Gelfoam myringoplasty is more successful than either paper patch or fat graft closures, with a 90.8% success rate (P = .001). Myringoplasty should not be deferred during the winter months as the season of procedure does appear to not affect the success of closure (P = .60). Similarly, the presence or absence of adenoid tissue did not affect the success of closure (P = .91).
Thoracic Duct Embolization: A New Treatment for Massive Leak After Neck Dissection
Authors: Patel Neel , Lewandowski Robert J. , Bove Michiel , Nemcek Albert A. , Salem Riad 
Published: February 2009

AbstractChylothorax results from injury to the thoracic duct or one of its branches. It is an uncommon but possibly serious complication of thoracic or head and neck surgery. We report a case of thoracic duct transection complicating a total laryngectomy with bilateral selective neck dissection for subglottic squamous cell carcinoma. High‐output Jackson Pratt drainage was noted, resulting in patient hypovolemia that was unresponsive to volume resuscitation. Treatment consisted of percutaneous embolization of the thoracic duct proximal to the transection that subsequently normalized chylous output.
A Thin Tracheal Silicone Washer to Solve Periprosthetic Leakage in Laryngectomies: Direct Results and Long‐Term Clinical Effects
Authors: Hilgers Frans J. M. , Soolsma Jessica , Ackerstaff Annemieke H. , Balm Fons J. M. , Tan I Bing , van den Brekel Michiel W. M. 
Published: February 2009

AbstractObjectives: Assessment of the immediate results and long‐term clinical effects of a thin silicone washer placed behind the tracheal flange of voice prostheses to treat periprosthetic leakage.Patients and Methods: Three year retrospective analysis of 32 laryngectomized patients with 107 periprosthetic leakage events (PLEs). Custom‐made silicone washers (outer diameter 18 mm, inner diameter 7.5 mm, thickness 0.5 mm) were placed behind the tracheal flange either in combination with prosthesis replacement or later.Results: There was immediate resolution of periprosthetic leakage in 88 PLEs (median, 38 d; mean, 53 d; range, 8–330 d) and in 6 PLEs with the washer still in situ at the date of analysis (median, 75; mean, 97 d; range, 38–240 d). There was no resolution for periprosthetic leakage in 13 PLEs. Thus, in total, 94 of 107 PLEs (88%) were successfully resolved. In 29 of 32 (91%) patients, the washer resolved the problem at least in one PLE successfully. Twelve of 32 patients, including all 3 with washer failures, also required other interventions to ultimately solve the problem. The vast majority of patients (80%) did not consider placement of the washer to be inconvenient.Conclusions: In consideration of the high success rate and limited inconvenience for patients, this simple thin silicon washer application provides a good first option for the treatment of periprosthetic leakage.
Incidence of Thyroid Cancer in Residents Surrounding the Three Mile Island Nuclear Facility
Authors: Levin Roger J. 
Published: February 2009

AbstractObjectives/Hypothesis: On March 28, 1979, the worst nuclear exposure incident in U.S. history occurred near Harrisburg, PA. Small quantities of xenon and iodine radioisotopes were released into the environment from the Three Mile Island (TMI) nuclear power plant. The Pennsylvania Department of Health (PDoH) implemented a TMI Population Registry, including 32,135 individuals within a 5‐mile radius of TMI, to track possible health effects to the local population. Although no increase in cancer mortality has been noted in this cohort, cancer incidence has not been tracked. Given the long latency period for the development of thyroid cancer after exposure to low‐level radiation exposure, it is plausible that an increase in thyroid cancer incidence might just now be occurring.Study Design: Retrospective analysis of the Pennsylvania Cancer Registry Dataset for Thyroid Cancer using the Epidemiological Query and Mapping System (EpiQMS) search engine. EpiQMS is an interactive health statistics Website that can produce numbers, rates, graphs, charts, maps, and county profiles using various demographic variables (age, sex, race, etc.) from birth, death, cancer, and population datasets for the state and counties or regions of Pennsylvania.Methods: Eighteen years of data (1985–2002) on thyroid cancer incidence were obtained from the PDoH. The three at‐risk counties of Dauphin, York, and Lancaster were analyzed with regard to observed numbers of thyroid cancer cases versus expected incidence. Although the nuclear accident at TMI occurred in 1979, 1985 was chosen as the starting point for data analysis because that is when the PDoH began maintaining cancer incidence records.Results: In the first year available for evaluation (1985), there were 11 new thyroid cancer cases in each of the at‐risk counties (Dauphin, York, Lancaster). By 2002, the incidence had increased to 29 in Dauphin County, 81 in Lancaster County, and 69 in York County. The increase in thyroid cancer in Dauphin County is not above what would be expected for both the local population growth and the increase in thyroid cancer incidence in the U.S. population in general. Thyroid cancer incidence was greater than expected in York County for all but 1 year between 1995 and 2002. Lancaster demonstrated a marked increase in thyroid cancer incidence over expected norms throughout the study period. An increase greater than 50% was noted in certain years.Conclusions: Thyroid cancer incidence has not increased in Dauphin County, the county in which TMI is located. York County demonstrated a trend toward increasing thyroid cancer incidence beginning in 1995, approximately 15 years after the TMI accident. Lancaster County showed a significant increase in thyroid cancer incidence beginning in 1990. These findings, however, do not provide a causal link to the TMI accident.
Predictive Factors for Central Compartment Lymph Node Metastasis in Thyroid Papillary Microcarcinoma
Authors: Lee Sang‐Hyuk , Lee Seung‐Suk , Jin Sung‐Min , Kim Jin‐Hwan , Rho Young‐Soo 
Published: February 2009

AbstractObjective: We examined the incidence of nodal involvement and attempted to determine the predictive factors for central compartment lymph node (LN) metastasis in thyroid papillary microcarcinoma (PMC).Study Design: Retrospective chart review.Methods: We undertook a retrospective study of 52 patients treated between January 2000 and December 2005 for PMC by total thyroidectomy and elective central compartment LN dissection with or without comprehensive lateral neck dissection (n = 9). There were 45 women and 7 men whose mean age was 47.6 ± 11.5 years. The following criteria were used to study the predictive value of central compartment LN metastasis: sex, age, multifocality of the tumor, extracapsular spread (ECS), the involvement of the lateral neck LN, tumor size, and tumor location.Results: In 16 of 52 (31%) patients, central compartment LN metastasis was found. With use of univariate and multivariate analysis, ECS, lateral LN metastasis, and tumor size (>5 mm) were independent correlates of central compartment metastasis. Sex, age, multifocality, and tumor location were not associated with central compartment LN metastasis and did not significantly influence the predictive value of these variables.Conclusions: We found a significant association among ECS, lateral LN metastasis, tumor size (>5 mm), and central compartment LN metastasis in patients with PMC. A prophylactic neck dissection of the central compartment should be considered particularly in patients with ECS of the tumors, metastatic LN in the lateral neck, and a greater than 5 mm tumor size.
Phonovibrogram Visualization of Entire Vocal Fold Dynamics
Authors: Lohscheller Jörg , Eysholdt Ulrich 
Published: February 2009

AbstractObjectives: High‐speed (HS) video recordings are the up‐to‐date method for visualizing irregular vocal fold vibrations. However, perceptive evaluation during offline replay is time consuming and shows high inter‐rater variability.Method: A visualization procedure is presented that extracts vocal fold vibrations from HS videos and transfers the motion information into a set of three phonovibrogram (PVG) images that make visual vocal fold displacements (PVG‐0), velocities (PVG‐1), and accelerations (PVG‐2).Results: The principles of PVG computation as well as their application to three clinical examples (normal voice, laryngeal nerve paralysis, functional voice disorder with vocal nodules) are presented. For normal and dysphonic subjects, the PVG images show the characteristics of vocal fold vibrations as concern the dynamic patterns of displacements, velocities, and accelerations.Conclusion: The PVG approach makes visual the entire range of motion of vibrating vocal fold edges in easy‐to‐read color images for differentiation of normal and pathologic voices. PVG images are printable and can be stored on a hard‐disc drive, enabling the documentation of the course of voice disorders that is essential for evidenced‐based medicine. PVG visualization has the potential to overcome the subjective quality of assessing HS videos, which makes it a valuable tool with broad clinical application.
Ascorbic Acid Reduces Noise‐Induced Nitric Oxide Production in the Guinea Pig Ear
Authors: Heinrich Ulf‐Rüdiger , Fischer Ilka , Brieger Jürgen , Rümelin Andreas , Schmidtmann Irene , Li Huige , Mann Wolf J. , Helling Kai 
Published: February 2009

AbstractObjectives: Noise‐induced hearing loss can be caused, among other causes, by increased nitric oxide (NO) production in the inner ear leading to nitroactive stress and cell destruction. Some studies in the literature suggest that the degree of hearing loss (HL) could be reduced in an animal model through ascorbic acid supplementation. To identify the effect of ascorbic acid on tissue‐dependent NO content in the inner ear of the guinea pig, we determined the local NO production in the organ of Corti and the lateral wall separately 6 hours after noise exposure.Study Design: Prospective animal study in guinea pigs.Methods: Over a period of 7 days, male guinea pigs were supplied with minimum (25 mg/kg body weight/day) and maximum (525 mg/kg body weight/day) ascorbic acid doses, and afterwards exposed to noise (90 dB sound pressure level for 1 hour). The acoustic‐evoked potentials were recorded before and after noise exposure. The organ of Corti and the lateral wall were incubated differently for 6 hours in culture medium, and the degree of NO production was determined by chemiluminescence.Results: Ascorbic acid treatment reduced the hearing threshold shift after noise exposure depending on concentration. When the maximum ascorbic acid dose was substituted, NO production was significantly reduced in the lateral wall after noise exposure and slightly reduced in the organ of Corti.Conclusions: Oral supplementation of the natural radical scavenger ascorbic acid reduces the NO‐production rate in the inner ear in noisy conditions. This finding supports the concept of inner ear protection by ascorbic acid supplementation.
Nasal Pepsin Assay and pH Monitoring in Chronic Rhinosinusitis
Authors: Ozmen Süay , Yücel Omer Taskin , Sinici Incilay , Ozmen Omer Afsin , Süslü Ahmet Emre , Oğretmenoğlu Oğuz , Onerci Metin 
Published: February 2009

AbstractObjectives/Hypothesis: The primary objective of this study was to determine the relationship between chronic rhinosinusitis (CRS) and laryngopharyngeal reflux (LPR). We also investigated the diagnostic value of pepsin in nasal lavage by means of fluorometric assay as compared with 24‐hour dual‐probe pH monitoring.Study Design and Methods: This is a controlled, prospective study from a retrospective dataset of 33 patients recruited for endoscopic sinus surgery between 2005 and 2006 in a tertiary care referral center (Hacettepe University Medical Center). All patients underwent 24‐hour dual‐probe pH monitoring and nasal lavage fluid investigation for pepsin. A fluorometric pepsin assay using casein‐fluorescein isothiocyanate in nasal lavage fluid was used to detect LPR. The control group included 20 patients who were proven not to have sinusitis.Results: A higher incidence of pharyngeal acid reflux events was found in patients with CRS (29 of 33, 88%) compared with the control patients (11 of 20, 55%). The difference was statistically significant (P = .01). The fluorometric pepsin assay was correlated to the results of 24‐hour dual‐probe monitoring for LPR diagnosis with a 100% sensitivity and 92.5% specificity. These data suggest that an association between CRS and LPR is present and that the detection of pepsin in nasal lavage fluid may provide a noninvasive and feasible method of LPR screening.
Spiral Ganglion Degeneration Patterns in Endolymphatic Hydrops
Authors: Bixenstine Paul J. , Maniglia Mauricio P. , Vasanji Amit , Alagramam Kumar N. , Megerian Cliff A. 
Published: February 2009

AbstractObjectives: The mechanistic association between endolymphatic hydrops (ELH) and hearing loss (HL) is unclear. Although ELH severity has been shown to correlate in some studies with HL, injury of vital structures, including hair cells and the cochlear nerve, have failed to demonstrate correlation with ELH severity. The goal of this study is to evaluate the hypothesis that spiral ganglion cell degeneration is the principle pathologic site of ELH‐related cochlear injury, correlates with ELH severity, and is most profound in the apical region.Study Design: Surgical induction of ELH in the guinea pig model was followed by histologic confirmation of ELH and subsequent correlation with segmental spiral ganglion cell densities.Methods: Guinea pigs (N = 14) were subjected to unilateral ELH induction and killed after 4 to 6 months. ELH severity and spiral ganglion densities were obtained using computer‐aided morphometric analysis. Densities were normalized by calculating a spiral ganglion degeneration index (DI) for each animal.Results: The apical spiral ganglion demonstrated significantly greater degeneration than that noted in the basal spiral ganglion (DI: 1.93 vs. 1.13; P = .004). The degree of spiral ganglion degeneration in the apex correlates well with a total hydrops index (P = .006) and an apical hydrops index (P = .003). Basal spiral ganglion degeneration however, does not correlate well with hydrops severity (total hydrops index: P > .05; basilar hydrops index: P > .05).Conclusions: ELH‐related pathology appears to focus initially on the apical spiral ganglion and the degree of deterioration correlates well with the severity of ELH. These findings mirror some reports in the human condition, and imply that the mechanism of cochlear injury in ELH and secondary dysfunction appears to be a neural toxicity that begins in the apex of the cochlea.
Modified Nasal Specula and Flexible Holder for Endoscopic Nasal Surgery
Authors: Ushio Munetaka , Nakaya Muneo , Kondo Kenji , Suzuki Mitsuya , Yamasoba Tatsuya 
Published: February 2009

AbstractThe use of an endoscope in nasal surgery has now extended to surgery on the nasal septum as well as to sinus surgery. We devised the use of the modified nasal specula with Yasargil's flexible holder to resolve the technical problems in using an endoscope for septal surgery. One nasal speculum has two plates for connecting to the Yasargil's flexible holder. This speculum allows the surgeon to use both hands freely and also functions as a guide for stabilizing an endoscope. Another nasal speculum has two long adjustable wings. This speculum can widen the working space between the cartilage or bone of the nasal septum and detached mucosa. Our modified nasal specula are readily applicable to resolve the problems such as unstable endoscope and narrow working space in septal surgery under endoscopic view.
Desirudin Reduces the Rate of Microvenous Thrombosis in a Rat Model
Authors: Lewis Carol M. , Deschler Daniel G. 
Published: February 2009

AbstractObjectives: In an effort to evaluate pharmacologic agents for optimal anticoagulant prophylaxis in patients undergoing free tissue transfer, we evaluated the efficacy of desirudin (Canyon Pharmaceuticals, Hunt Valley, MD), a recombinant hirudin that acts as a direct thrombin inhibitor, using a rat model of microvenous thrombosis.Study Design: Randomized, blinded study using an in vivo rat model of microvenous failure.Methods: Thirty‐two rats received either desirudin or saline in a randomized, blinded fashion 30 minutes prior to performance of a standardized thrombogenic procedure on rat femoral veins. Bleeding time, vessel patency, and presence of clot within the anastomosis were subsequently assessed. Appropriate statistical analyses were then performed.Results: There was a significant increase in vessel patency in rats treated preoperatively with desirudin compared to controls receiving saline (96.9% vs. 53.1%, P < .001). In evaluating patent vessels for non‐occluding clot, 41.2% of control rats had non‐obstructive clot at the site of anastomosis, versus 3.2% of rats treated with desirudin (P = .002). Bleeding times were longer in desirudin‐treated rats than those that received saline (7.17 ± 3 minutes vs. 5.15 ± 1.2 minutes, P = .027).Conclusions: The use of preoperative desirudin increases the rate of microvascular anastomotic patency, decreases the occurrence of non‐occluding clot, and increases bleeding time in an in vivo rat model, indicating potential efficacy in patients undergoing microvascular free tissue transfer.
Long‐Term Efficacy of Microdebrider‐Assisted Inferior Turbinoplasty With Lateralization for Hypertrophic Inferior Turbinates in Patients With Perennial Allergic Rhinitis
Authors: Chen Yu‐Lin , Tan Ching‐Ting , Huang Hung‐Meng 
Published: February 2009

AbstractObjectives: The aim of the study was to evaluate the long‐term efficacy of microdebrider‐assisted inferior turbinoplasty with lateralization (MAITL) compared to submucosal resection for hypertrophic inferior turbinates.Study Design: Surgical outcomes were evaluated with respect to visual analogue scale, anterior rhinomanometry, and saccharin test results.Methods: From January 2002 to December 2006 inclusively, 160 patients with perennial allergic rhinitis and hypertrophic inferior turbinates were enrolled into this study. The patients, all suffering from chronic nasal obstruction, were randomly classified into two groups, MAITL group or SR group, each comprised of 80 patients. Ten patients who did not display any nasal discomfort served as normal controls. For the submucosal resection group, patients underwent submucosal resection of the inferior turbinate, whereas patients in the MAITL group underwent microdebrider‐assisted inferior turbinoplasty with lateralization. Assessments (visual analogue scale, anterior rhinomanometry, and saccharin test) were conducted prior to the surgery and 1, 2, and 3 years after completion of surgery.Results: Compared to preoperative values, subjective complaints including nasal obstruction, sneezing, rhinorrhea, and snoring improved significantly in both groups at 1, 2, and 3 years after surgery in both groups (P < .05 for all). Rhinomanometric assessment also showed significant improvement at 1, 2, and 3 years postoperatively in both groups (P < .05 for all). Saccharin transit time was significantly decreased (P < .05 for all) compared to preoperative values 1, 2, and 3 years after surgery in both groups.Conclusion: Microdebrider‐assisted inferior turbinoplasty with lateralization appears to be as effective as submucosal resection at relieving nasal symptoms and decreasing total nasal resistance and saccharin transit times for more than 3 years in patients with perennial allergic rhinitis who have had substantial nasal obstruction.