bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Single‐Stage Multilevel Treatment for Obstructive Sleep Apnea/Hypopnea Syndrome
Authors: Friedman Michael , Lin Hsin‐Ching , Gurpinar Berk , Joseph Ninos J. 
Published: February 2009

AbstractObjectives: To assess subjective and objective improvement after single‐stage multilevel minimally invasive treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS).Study Design: A retrospective review of a prospective dataset of patients treated in a tertiary care referral center.Methods: Charts of 145 patients with mild/moderate OSAHS treated with a single‐stage multilevel minimally invasive technique were reviewed to abstract pre‐ and posttreatment symptoms and polysomnographic data. One hundred twenty‐two patients had minimum follow‐up of 6 (range, 6–23) months and complete data available for analysis. All patients studied had three‐level treatment that included nasal surgery, palatal stiffening by Pillar implant technique, and radiofrequency volume reduction of the tongue base. Primary outcomes included change from baseline in apnea/hypopnea index (AHI). Secondary outcomes included change in Epworth Sleepiness Scale (ESS) and bed‐partner assessed snoring visual analogue scale (VAS, 0–10), pain levels, narcotic use, and complications.Results: Mean AHI decreased from 23.2 ± 7.6 preoperatively to 14.5 ± 10.2 postoperatively (P < .0001). Classical “cure” was achieved in 54 (47.5%) patients. Mean ESS decreased from 9.7 ± 3.9 preoperatively to 6.9 ± 3.3 postoperatively (P < .0001). Mean snoring VAS decreased from 9.4 ± 0.9 preoperatively to 3.2 ± 2.4 postoperatively (P <. 0001).Conclusion: Polysomnographic respiratory parameters, ESS, and snoring VAS significantly improved in patients with mild/moderate OSAHS treated with single‐stage multilevel minimally invasive surgery. Multilevel minimally invasive single‐stage surgery is a valid option for selected patients with mild/moderate OSAHS with the understanding that they may require secondary treatment.
Caveolin‐1 Inhibits the Growth of Human Laryngeal Squamous Cell Carcinoma and Down Regulates EGFR‐MAPKs Signaling Pathway
Authors: Gu Donghua , Li Hua , Wang Zhen , Chen Qi , Jiang Jack , Zhu Hongguang 
Published: February 2009

AbstractObjective: To investigate the effects of caveolin‐1 on the growth of laryngeal squamous cell cancer HEp2 cell line in vitro and in vivo.Methods: The caveolin‐1 gene was introduced into HEp2 cells and stable over‐expressing caveolin‐1 clones were obtained. In vitro and anchorage‐independent growth rates were measured by methyl thiazolyl tetrazolium (MTT) and colony formation in soft agar assay, respectively. Flow cytometry was used to analyze the cell cycle and apoptosis. Activities of extracellular signal‐regulated kinase 1/2 (Erk1/2) and epidermal growth factor receptor (EGFR) were determined by Western blot analysis, and the interaction between EGFR and caveolin‐1 was determined by coimmunoprecipitation assay. The effect of caveolin‐1 on the tumor growth in vivo was tested by tumorigenicity assay in nude mice.Results: Stable over‐expressing caveolin‐1 clones, namely HEp2‐CAV1‐2 and HEp2‐CAV1‐3, exhibited a slower rate of growth in vitro and reduced capacity of anchorage‐independent growth. In addition, over‐expression of caveolin‐1 resulted in a cell cycle arrest in the G0/G1 phase and increased the apoptotic cell fraction by 3.86‐fold and 3.71‐fold in HEp2‐CAV1‐2 and HEp2‐CAV1‐3 cells. Compared with the parental HEp2 cells, the phosphorylation of EGFR and Erk1/2 was reduced by 66% and 83% in HEp2‐CAV1‐2 cells and by 58% and 78% in HEp2‐CAV1‐3 cells, respectively; an interaction between EGFR and caveolin‐1 was observed. Moreover, over‐expression of caveolin‐1 in HEp2 cells significantly reduced the probability of tumor formation in vivo.Conclusion: Caveolin‐1 inhibits the growth of human laryngeal squamous cell carcinoma HEp2 cell line in vitro and in vivo. Downregulation of EGFR‐mitogen‐activated protein kinase signaling pathway may be critical for understanding its mechanism of tumor suppression.
Assessing Penetration and Aspiration: How Do Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing Compare?
Authors: Kelly Annette M. , Drinnan Michael J. , Leslie Paula 
Published: February 2009

AbstractObjectives/Hypothesis: We aimed to investigate whether the type of dysphagia examination (fiberoptic endoscopic evaluation of swallowing [FEES] or videofluoroscopy) influences the scoring of penetration and aspiration.Study Design: Prospective, single‐blind study.Methods: Fifteen dysphagic participants were recruited and underwent one FEES and one videofluoroscopy examination, performed and recorded simultaneously. Fifteen independent raters from 12 centers scored penetration and aspiration from recordings using the Penetration Aspiration Scale. Raters were blind to participant details, the pairing of the FEES and videofluoroscopy recordings, and the other raters' scores. Interrater and intrarater reliability were analyzed using weighted kappa.Results: The Penetration Aspiration Scale scores were significantly higher for the FEES recordings than for the videofluoroscopy recordings (ANOVA P < .001). The mean difference between the FEES and videofluoroscopy penetration aspiration scores for the same swallows was 1.15 points. Interrater and intrarater reliability ranged from 0.64 to 0.79 (weighted kappa).Conclusions: Penetration aspiration is perceived to be greater (more severe) from FEES than videofluoroscopy images. The clinical implications are discussed.
The Supraglottic Nerve Supply: An Anatomic Study With Clinical Implications
Authors: Olthoff Arno , Schiel Rolf , Kruse Eberhard 
Published: February 2009

AbstractObjectives: To describe the course of the superior laryngeal nerve (SLN) and its branches, in particular, with regard to supraglottic motor and sensory functions.Methods: In 30 normal human hemilarynges, the SLN with its internal (intSLN) and external branch (extSLN) were dissected under microsurgical conditions and marked with acrylic dye. All anatomic structures of the larynges (muscles, cartilages, and ligaments) were dissected in detail.Results: The intSLN subdivides into three branches. The superior branch (I) runs to the lingual (extralaryngeal) part of the epiglottis and sends small fibers through the epiglottic foramina to the laryngeal surface. The middle branch (II) runs through the aryepiglottic fold into the ventricular fold, and the inferior branch (III) to the piriform sinus and to the postcricoid region, forming various anastomoses (e.g., ansa galeni) with the recurrent laryngeal nerve (RLN). The extSLN runs to the cricothyroid muscle (CT) and sends a branch through the CT along the lower rim of the thyroid cartilage into the larynx and up to the ventricular fold. This ventricular branch is a potential candidate for the innervation of the ventricular muscle (VM).Conclusions: Our results may contribute to a better understanding of supraglottic actions that provide primary functions of the larynx (such as swallowing, coughing, and breathing). An enhanced knowledge of neurolaryngology also provides a basis for interpreting disorders or paralyzes following surgical treatments (e.g., thyroid surgery, partial laryngectomy) and helps to lower the risks.
Visual‐Motor Integration Skills of Prelingually Deaf Children: Implications for Pediatric Cochlear Implantation
Authors: Horn David L. , Fagan Mary K. , Dillon Caitlin M. , Pisoni David B. , Miyamoto Richard T. 
Published: February 2009

AbstractObjective: To investigate visual‐motor integration (VI) skills of prelingually deaf (PLD) children before and after cochlear implantation (CI) and investigate correlations with spoken‐language and related processing measures.Design: Study 1 was a longitudinal study in which VI was tested preimplant. Study 2 was a cross sectional study of school‐age children who used a CI for >2 years.Method: In study 1, a standardized design‐copying task was administered preimplant, and spoken‐language data were obtained at intervals up to 4 years postimplantation. Analyses were conducted to determine if preimplant VI scores were predictive of various spoken‐language measures. In study 2, standardized design copying and speeded maze tracing tasks were administered along with speech perception, vocabulary, and related processing measures.Results: Whereas preimplant VI scores for children in study 1 fell within the typical range based on age‐equivalent norms, postimplant VI standard scores in study 2 were low compared to the normative sample. Postimplant VI scores were inversely related to age at implantation. Preimplant VI scores were robustly predictive of most, but not all, spoken‐language outcome scores. Postimplant design copying scores were also correlated with spoken‐language and related processing measures whereas maze‐tracing scores were less robustly related to these measures.Conclusions: Early auditory and linguistic experience may impact the development of VI skills. VI is a preimplant predictor of later spoken language outcomes. Design copying and speeded maze tracing tasks appear to tap different sets of cognitive resources in PLD children with CIs.
Restoration of Eyelid Closure in Facial Paralysis Using Artificial Muscle: Preliminary Cadaveric Analysis
Authors: Tollefson Travis T. , Senders Craig W. 
Published: February 2009

AbstractObjectives:Electroactive polymer artificial muscle is an emerging technology that has the potential to be used in rehabilitating facial movement in patients with paralysis. These electroactive polymers act like human muscles by expanding and contracting based on variable voltage input levels. The authors seek to establish a reproducible eyelid blink with artificial muscle. The aim of this proof of concept study is to determine whether eyelid closure can be created with a novel eyelid sling model.Study Design:A human cadaver study was performed.Methods:With use of four cadaver heads, an extended upper and lower blepharoplasty incision was used to secure an upper and lower expanded polytetrafluoroethylene implant in the medial orbital wall and tarsal plates. The slings were passed through a hole drilled in the lateral orbital wall or around a titanium screw. Lateral pull on the sling created eyelid closure, and the necessary distance of pull was measured.Results:The eyelid sling mechanism functioned to achieve complete eyelid closure. Less tension was required for eyelid closure when the sling was placed in both eyelids (3 mm of pull instead of 6 mm).Conclusions:The application of artificial muscle to a range of problems that affect both patient morbidity and quality of life is promising. Eyelid closure was created in a cadaver model using a novel sling, but future studies will need to address the feasibility of a prototype artificial muscle eyelid device in humans.
Comparison of Pullout Strength of Resorbable Screws and Titanium Screws in Human Cadaveric Laryngeal Cartilage
Authors: Windham B Pearson , Jordan J Randall , Parsell Doug E. 
Published: February 2009

AbstractObjectives: To compare the pullout strength of titanium screws and resorbable screws from human fresh‐frozen cadaveric laryngeal cartilage. The importance of drill hole diameter, screw diameter, and whether the drill hole was tapped (resorbable screws only) was also determined.Study Design: Prospective.Methods: Sixteen cartilage specimens were tested after debridement of connective tissue and perichondrium. Linear pullout strength of screws was measured using a load cell. Titanium and resorbable screw sizes of 1.5 and 2.0 mm were tested using drill hole diameters of 1.1 and 1.5 mm. For the resorbable‐tapped group, screw diameters of 1.5 and 2.0 mm were tapped with 1.5 and 2.0 mm taps, respectively. All tested screws were 6 mm in length.Results: We found a uniformly constant difference between the three screw types (P < .001). Post hoc analysis indicated a significant difference between the resorbable‐untapped screw and both the resorbable‐tapped screw and the titanium screw. We failed to find a significant difference, however, between the resorbable‐tapped screw and the titanium screw. We also found a significant effect in regard to screw size (P = .0133), with post hoc analysis demonstrating the 1.1/1.5 mm combination to be inferior to the 1.1/2.0 and 1.5/2.0 mm combinations. There was no significant difference between the 1.1/2.0‐ and 1.5/2.0‐mm combinations.Conclusions: Resorbable screws with untapped drill holes result in higher resistance to linear loads than both titanium screws and resorbable screws with tapped drill holes. The 1.1/2.0‐ and 1.5/2.0‐mm drill/screw combinations are superior to the 1.1/1.5‐mm combination when considering untapped resorbable screws.
AM‐111 Reduces Hearing Loss in a Guinea Pig Model of Acute Labyrinthitis
Authors: Barkdull Gregory C. , Hondarrague Yannick , Meyer Thomas , Harris Jeffrey P. , Keithley Elizabeth M. 
Published: February 2009

AbstractObjectives/Hypothesis: This study investigated the otoprotective properties of AM‐111, an inhibitor of c‐Jun N‐terminal kinase‐mediated apoptosis and inflammation.Study Design: A controlled, prospective animal study using a guinea pig model of acute labyrinthitis.Methods: Acute labyrinthitis was generated by injection of antigen into the scala tympani of sensitized guinea pigs. Treatment groups received 100 μL of AM‐111 at concentrations of 100 μmol/L, 10 μmol/L, and 1 μmol/L in a hyaluronic acid gel formulation delivered over the round window niche within 1 hour of antigen challenge. Cochlear function was monitored over 21 days with serial auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) measurements followed by histologic analysis.Results: The ABR results on day 21 demonstrated that untreated control ears for acute labyrinthitis had a mean hearing loss (HL) of 68 ± 12 dB. In contrast, ears treated with AM‐111 (100 μmol/L) had a mean HL of 39 ± 31 dB. These two groups were statistically different (one‐way analysis of variance, P = .03). Secondary outcomes, including DPOAE shift, inner hair cell survival, inflammatory cell counts, and spiral ganglion density, were also statistically significant in favor of an otoprotective effect of AM‐111. Lower doses of AM‐111 did not produce a statistically significant reduction in HL over controls.Conclusion: AM‐111 delivered over the round window membrane in a 100 μL hyaluronic acid formulation at a 100 μmol/L concentration immediately after induction of acute labyrinthitis in the guinea pig cochlea protects hearing, reduces hair cell loss, and reduces the number of inflammatory cells at 21 days after treatment.
Utility of History and Physical Updates for Ambulatory Otolaryngic Surgery
Authors: Lee Scott L. , Taliercio Salvatore , Ata Ashar , Clayton Jessica , Parnes Steven M. 
Published: February 2009

AbstractObjectives/Hypothesis: Preoperative assessment is intended to identify anesthetic risk and a patient's appropriateness to undergo a proposed surgery. The timing of these assessments varies among institutions. In our ambulatory surgery center, preoperative reassessments were initially performed within 30 days of surgery (group A). Recently, this changed to require reassessments within 7 days of surgery (group B). Now, the policy mandates a preoperative reassessment within 24 hours (group C). We evaluate whether there are differences in surgical cancellations based on these new reassessment intervals.Study Design: Retrospective operative log and chart review.Methods: We identified 1,108 cases representative of group A. The rate of surgical cancellations for this group was compared with that of the 3,705 cases in group B and the 1,060 cases in group C. Differences were evaluated with a χ2 test.Results: Total cancellation rates for groups A, B, and C were 3.0%, 3.3%, and 3.9%, respectively (P = .51). Cancellations secondary to a history and physical examination findings during these preoperative reassessment periods were 0.81%, 0.38%, and 0.66% for groups A, B, and C, respectively (P = .15).Conclusions: Cancellation rates for patients undergoing ambulatory otolaryngic surgery based on preoperative reassessment intervals of 30 days, 7 days, and 24 hours were similar.
Collagen Fiber and Versican Distribution Within the Lamina Propria of Fetal Vocal Folds
Authors: Buhler Rogerio Borghi , Sennes Luiz U. , Mauad Thais , Melo Erich Christiano M. , Silva Luiz Fernando F. , Saldiva Paulo Hilário N. 
Published: February 2009

AbstractObjectives: To analyze the presence and distribution of collagen fibers and versican in human vocal fold lamina propria of fetal larynges.Study Design: Cross sectional analysis of cadaveric vocal folds of human fetuses.Methods: Seven fetal larynges obtained from 28‐ to 36‐week‐old fetuses were analyzed with the Picrosirius‐polarization method, immunohistochemistry, and image analysis.Results: Collagen fibers within the lamina propria exhibited a monolaminar distribution pattern and spatial arrangement in “wicker basket.” Versican distribution was larger in the superficial and intermediate layers when compared to the deep layer.Conclusion: Our findings suggest that collagen and versican distribution and arrangement within the lamina propria in the developing fetus are important for vocalization at birth.
A Rational Approach to the Use of Tracheotomy in Surgery of the Anterior Skull Base
Authors: Ducic Yadranko , Zuzukin Vladimir 
Published: February 2009

AbstractObjective: To offer an algorithm for airway management in anterior skull base surgery.Methods: This is a retrospective review of 109 patients undergoing major anterior skull base surgery from a single senior surgeon's experience from September 1997 to May 2006.Results: We report only one (1%) postoperative mortality in this series and only seven major complications in six patients, including two cases of stroke, one case of cerebrospinal fluid (CSF) leak, and four cases of delayed osteoradionecrosis. No patients in this series developed tension pneumocephalus. The total major complication rate is 6%. Fifty‐one (47%) patients received prophylactic tracheotomy, and 58 (53%) patients did not receive prophylactic tracheotomy. Eighty‐eight (81%) patients received anterior skull base reconstruction with local flaps. Six (5.5%) patients required primary reconstruction with a free flap.Conclusion: We attribute the very low rate of major complications in this series and, in particular, no cases of tension pneumocephalus and rarity of CSF leaks primarily to prophylactic tracheotomy in selected patients and to a reconstructive strategy that emphasizes use of local vascularized tissue to reconstruct the anterior skull base.
Polydimethylsiloxane in the Human Vocal Fold: Description of Partial Explantation
Authors: Echternach Matthias , Delb Wolfgang , Wagner Mathias , Sittel Christian , Verse Thomas , Richter Bernhard 
Published: February 2009

AbstractWe describe here for the first time a partial explantation of polydimethylsiloxane in a patient 7 years after implantation caused by faulty positioning of the implant. The histopathologic examination demonstrated that the material that displayed green autofluorescence in hematoxylin‐eosin staining was biologically inert and stable. Major inflammatory reaction could not be ascertained.
Patient Compliance to Radiation for Advanced Head and Neck Cancer at a Tertiary Care County Hospital
Authors: Patel Urjeet A. , Thakkar Kunal H. , Holloway Nathaniel 
Published: February 2009

AbstractBackground: Combined chemotherapy and radiotherapy are routinely used to treat advanced‐stage head and neck squamous cell carcinoma (HNSCC). Patient compliance is often difficult given increased toxicities. Medically underserved or uninsured patients may lack the necessary support to complete such treatment.Objective: To evaluate compliance to radiation therapy for patients with advanced stage HNSCC at an urban tertiary‐care county hospital.Study Design: Retrospective review.Methods: Data were extracted from the charts of 136 consecutive patients who had been advised to undergo chemoradiotherapy for newly diagnosed HNSCC from 2004 to 2006. Demographic and tumor‐related information was collected, as was patient compliance with radiation treatment. Total dose, length of treatment, and theoretical “loss of loco‐regional control” was calculated. Benchmark compliance data were obtained from select publications.Results: Of 136 patients, 55 did not begin treatment or transferred care elsewhere, leaving 81 study patients. Twenty‐eight patients (35%) had unacceptable overall treatment courses. Forty‐eight patients (59%) received less than the effective dose of 65 Gy after accounting for missed treatment days. Fifty‐one patients (63%) had a greater than 10% calculated loss in loco‐regional control. Univariate and multivariate analysis yielded no predictive value for gender, ethnicity, node status, stage, or primary site on compliance.Conclusion: Compared with other institutions, HNSCC patients in this setting are less likely to complete a prescribed therapeutic regimen. Patient and tumor characteristics measured in this study do not predict compliance. Organ preservation protocols require further evaluation in populations where compliance is suspect. Future research must examine interventions to improve compliance and assessment of its impact on survival.
Effects of Depression on Quality of Life Improvement After Endoscopic Sinus Surgery
Authors: Mace Jess , Michael Yvonne L. , Carlson Nichole E. , Litvack Jamie R. , Smith Timothy L. 
Published: February 2009

AbstractObjectives/Hypothesis: To determine whether self‐ reported depression predicts lesser postoperative improvement in health‐related quality of life (HRQoL) after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).Study Design: Prospective open cohort.Methods: An adult (≥18 yr) cohort of 23 patients with depression and 79 patients without depression undergoing ESS were followed for 12 ± 2 months. Patient characteristics and computed tomography scores were examined preoperatively. Endoscopy scores and two HRQoL measures, the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey, were analyzed pre‐ and postoperatively. Univariate and multivariate analyses were used to evaluate outcome differences for patients with depression.Results: There was a significantly higher prevalence of women (P = .002) and longer duration of follow‐up (P = .004) for the depressed subgroup. Depressed patients reported significantly lower pre‐ and postoperative HRQoL scores on all RSDI subscales (P < .05). Without baseline adjustment, depression was not associated with significant differences in postoperative change for disease‐specific HRQoL scores (P > .10) in multivariate analysis.Conclusions: Depressed patients with CRS present similarly but have worse pre‐ and postoperative HRQoL scores and experience similar disease‐specific QoL improvements from sinus surgery compared with other CRS patients. Sinus surgery is not effective in alleviating the effect of depression on disease‐specific HRQoL, and it is likely that comorbid depression and CRS are operating on independent disease pathways. Additional research and hypothesis testing using continuous, objective measures is warranted.