bluuebunny/crossref_metadata_2025_split huggingface dataset:
S218 – Treatment Failures in Acute Otitis Externa
Authors: Roland Peter S , Wall G. Michael , McLean Celeste , Stroman David 
Published: August 2008

ObjectivesUnderstand treatment failure rates of cipro‐floxacin/steroid‐ vs. Neomycin/Polymyxin B/Hydrocortisone (NPH)‐containing ear drops against the two major pathogens in acute otitis externa (AOE), Pseudomonas aeruginosa and Staphylococcus aureus.MethodsRetrospective analysis of clinical studies involving NPH versus either 0.3% ciprofloxacin/0.1% dexamethasone (CDX)(2 trials, 1998–1999) or 0.2% ciprofloxacin/1% hydrocortisone (CHC) (3 trials, 1994–1996) in the treatment of patients diagnosed with AOE. Patients were randomized to treatment with either CHC, CDX (both bid) or NPH (tid), 3–4 drops per ear for 7 days. Microbiology specimens were collected from infected ears prior to the initiation of therapy, and at exit visit if there were any clinical signs of infection.ResultsThe therapy failure rate of P. aeruginosa for CDX and CHC was 6.7% (20/300) versus NPH at 12.8% (39/306), p = 0.017. The failure rate of S. aureus for CDX and CHC was 9.2% (6/65) vs. NPH at 8.3% (4/48), p = 0.87. In no instance of treatment failure was the pre‐therapy pathogen resistant in vitro to the antibiotics used to treat the infection. All of the persisting P. aeruginosa and S. aureus isolates were susceptible to fluoroquinolones and neomycin/polymyxin B.ConclusionsBased on data from 5 separate AOE clinical trials, ciprofloxacin‐containing ear drops, CDX and CHC, provided significantly greater eradication (93.3%) of P. aeruginosa compared to NPH ear drops (87.2%). There was no significant difference in the rate of eradication of S. aureus between the two groups of ear drops.
S237 – Computerized Tomography in the Prediction of CSF Gusher
Authors: Rothholtz Vanessa S , Mafee Mahmood F , Young Nancy M 
Published: August 2008

Objectives1) Identify anatomic variations of the temporal bone in children with and without cochlear malformations who experienced an intra‐operative cerebrospinal fluid (CSF) gusher at the time of cochlear implantation. 2) Compare the anatomic findings in the current study to those described in prior studies.MethodsA retrospective case‐controlled chart review was performed on patients undergoing cochlear implant surgery. Computerized tomography images were analyzed in a single‐blind fashion for characteristics and measurements of both the right and left cochlea, internal auditory canal, cochlear aperture, facial nerve canal, vestibular aqueduct, cochlear aqueduct, oval window, round window, vestibule, mastoid, tegmen tympani and semi‐circular canals. After verifying equal variances, data was statistically evaluated utilizing the paired 2‐tailed t test with criterion for statistical significance set at p < 0.05.ResultsThe average age at implantation for this series of children was 4 years old. 70% of patients had cochlear malformations. 25% of patients had an abnormal internal auditory canal (IAC) and 30% had a widened cochlear aperture. Most patients with an abnormal IAC had an abnormal cochlear aperture; however, some patients with a normal IAC also had an abnormal cochlear aperture. Correlations between the temporal bone anatomy and the incidence of CSF gushers will be discussed.ConclusionsSpecific characteristics of the temporal bone anatomy may lead to an increased incidence of CSF gusher in cochlear implant surgery. Computerized tomography of the temporal bone can assist in the surgeon in evaluation and planning for cochlear implantation.
S243 – An Interactive 3D Game of the Pterygopalatine Fossa
Authors: Javan Ramin , Bryan Jeun , Payne Spencer C 
Published: August 2008

ObjectivesDevelop an interactive computer simulation of complex structures of the head and neck that would assist the teaching of relevant anatomy.MethodsAreas of the head and neck with complex spatial relationships were selected and their anatomical relationships were confirmed. Graphical representations of these areas were created, performed, and integrated into a virtual gaming environment through various software components. A variety of adjunctive teaching materials were also developed and laid over this virtual environment to reinforce the complex relationships.ResultsA 3D simulation was successfully created which allows users to freely move throughout a virtual environment framed by key and complex anatomy of the head and neck. Both this movement and visualization of the environment in all directions is provided through simultaneous use of the mouse and keyboard. Navigation through the game‐space is assisted by a dynamically updated ‘anatomical’ compass. A combination of accurate structural depictions and conceptual representations of cavities and spaces with rooms, hallways, doors and/or windows was employed. Structures can be identified and educational information through adjunctive media can be displayed with simple point‐and‐click techniques. Gaming features were also employed to provide entertainment value, with the expectation that this would reinforce the anatomical concepts.ConclusionsVirtual simulation of the complex anatomy of the head and neck may be an effective means to offset the cost and limited availability of cadaveric dissection. We describe here the development of such a simulated environment employing an interactive gaming construct which, to our knowledge, has not been previously described elsewhere.
S248 – Supraglottoplasty for Laryngomalacia with Sleep Apnea
Authors: Zafereo Mark E , Taylor Rodney J , Pereira Kevin D 
Published: August 2008

ObjectivesTo determine if supraglottoplasty is effective in reversing abnormal respiratory parameters in children with laryngomalacia and obstructive sleep apnea.Methods10 patients with laryngomalacia and obstructive sleep apnea as documented by polysomnography underwent supraglottoplasty at a tertiary referral children's hospital between 2005 and 2007. Retrospective data collection included age, findings on flexible and rigid endoscopy, type of procedure performed, and postoperative course. The postoperative polysomnographies were reviewed to identify changes in obstructive apnea index (OAI), obstructive apnea/hypopnea index (OAHI), respiratory disturbance index (RDI), and low arterial oxygen saturation (O2 nadir) after supraglottoplasty. Pre‐ and postoperative mean data were calculated, and comparisons were made with a Student's T‐test.ResultsAll 10 patients were successfully extubated following supraglottoplasty. There were no perioperative or postoperative complications, and no patient required a subsequent airway procedure. Each patient had a postoperative nocturnal polysomnography performed following supraglottoplasty at 11 weeks (range 2–29 weeks). Caregivers reported mild improvement (10%), significant improvement (70%), and complete resolution (20%) of stridor and nocturnal snoring at a follow‐up visit 4 weeks after hospital discharge. Marked improvements were observed in OAI, OAHI, RDI and O2 nadir, all of which were statistically significant (p<0.05).ConclusionsPolysomnography should be included in the initial evaluation of infants with laryngomalacia to rule out obstructive sleep apnea. Supraglottoplasty is an effective treatment for infants with laryngomalacia and obstructive sleep apnea. The significant benefits of the procedure outweigh the low morbidity. Improvement after surgery can be reliably confirmed by polysomnography.
S266 – Review of Endoscopic Findings in Children with GERD
Authors: Lemonnier Lori A , Koscica Jovana , Coticchia James M 
Published: August 2008

ObjectivesMany children with gastroesophageal reflux will initially present with respiratory symptoms including cough, stridor, increased work of breathing, apneic events, and recurrent episodes of croup. Despite a growing body of literature that suggests a correlation between airway pathology and GERD, there still remains much controversy. Our objective is to systematically review published literature correlating findings on endoscopic evaluation of the larynx and trachea in the pediatric population with the incidence of gastroesophageal reflux disease.MethodsA systematic review was performed of 19 articles relating the presence of gastroesophageal reflux disease in the pediatric population to findings on endoscopic airway evaluation. These were identified through a structured PubMed search of English language literature using the key terms laryngopharyngeal reflux, extraesophageal reflux, and gastroesophageal reflux. Only those articles studying endoscopic findings in the pediatric population were included.ResultsAll studies evaluated the subjects for the presence of gastroesophageal reflux. The most commonly utilized methods of diagnosis include barium esophagram, video fluoroscopy, gastric scintiscan, 24 hour pH probe, and esophageal biopsy. Arytenoid, postglottic and vocal fold edema and erythema, lingual tonsil hypertrophy, laryngomalacia, and subglottic stenosis are among the endoscopic findings most frequently identified in disease‐positive patients.ConclusionsCertain commonly encountered findings on endoscopic evaluation of the larynx and trachea performed in children presenting with respiratory symptoms do indeed demonstrate a correlation with presence of gastroesophageal reflux and may indicate that antireflux therapy should be considered in the treatment of this population of patients.
S275 – Nasal Morphology and Nasal Patency in Leprosy Patients
Authors: Larrosa Maria Teresa Torres , Peréz Luis Jorge Peréz , Toro Juan‐Jose Artazkoz‐del 
Published: August 2008

Objectives1) To assess the impact of multi‐drug leprosy therapy on the development of nasal deformities and nasal airway patency. 2) Evaluate the nasal morphology and nasal patency in leprosy patients treated with the multidrug therapy in comparison with patients treated with 1 drug therapy and a group of healthy volunteers.MethodsIn an overall group of 84 patients studied, 38 were treated with a therapy based on a single drug, and 22 were treated with multi‐drug therapy, while 24 subjects formed a control group. We used anterior rhinoscopy to analised the morphology of the nose. We meassured the nasal inspiratory and expiratory resistance of the right and left nostrils and total nasal inspiratory and expiratory resistance at a transnasal pressure of 150 Pa. by using active anterior rhinomanometry. The statistical analysis was carried out using the Varianza analisys.ResultsThe nasal structures in the 1‐drug therapy group underwent bone and cartilaginous resorption with an increase in nasal resistances. We found significant statistical differences between the resistance values obtained in this group and the control group (p<0,05). In the multidrug therapy group, the morphology of the nose remains as in healthy patients. No significant statistical differences were found between the resistance values obtained in the multidrug therapy patients and the control group (P>0,05).ConclusionsThe multidrug therapy prevents developing nasal deformities and maintains a normal nasal airflow.
S276 – Nasal Sinus Diseases Demonstrating Ophthalmologic Symptoms
Authors: Tsuzuki Kenzo , Takebayashi Hironori , Nishimura Masashi , Fukazawa Keijiro , Sakagami Masafumi 
Published: August 2008

ObjectivesThis study reviewed the clinical features of paranasal sinus diseases demonstrating ophthalmologic manifestations.MethodsBetween April 1995 and December 2007, we performed endoscopic sinus surgery (ESS) in 106 patients with paranasal sinus diseases presenting with ophthalmologic symptoms. There were 57 men and 49 women, aged 56.4 years (10 − 86 years). Diagnosis was based on the pre‐ and intraoperative findings. Patients with symptoms due to tumors were excluded from this study.ResultsOf 106 patients, loss of visual acuity was most frequently observed in 40 patients (37.7%). Other symptoms were eyelid swelling (28.3%), diplopia (18.9%), constriction of the visual field (13.2%), exophthalmos (13.2%), ocular pain (12.3%), external ophthalmoplegia (3.8%), and epiphora (1.9%). The symptoms involved in paranasal sinus cysts were found in 67 patients (63.2%), those in bacterial sinusitis in 36 patients (34.0%), those in fungal sinusitis in 2 patients, and those in Wegener's granulomatosis in 1 patient. The 38 patients (35.8%) were diagnosed as rhinogenic optic neuropathy, and most of them (32/38 patients, 78.9%) initially referred to ophthalmologists. Major lesions were observed in anterior and posterior ethmoid sinus (40 patients, 37.7%). For the treatment, external approaches were required in 11 patients (10.4%). During the postoperative course, reoperation (ESS) was required in 3 patients (2.8%) because of recurrence in the sphenoid sinus, whereas the other 103 patients had an uneventful course.ConclusionsPre‐ and postoperative observation by not only otolaryngologists, but also ophthalmologists, is recommended in order to perform minimally invasive surgery and to avoid recurrence.
S279 – Augmentation Rhinoplasty with Permacol and Cartilage Grafts
Authors: Thinakararajan Thirupathirajan , Srinivasan Venkat R 
Published: August 2008

ObjectivesAssessment of outcome and patient satisfaction following augmentation rhinoplasty with cartilage & Permacol and safety of Permacol.MethodsPermacol is a biomaterial derived from porcine dermis, modified by chemical processing. Patients with Permacol augmentation were compared with a historical cohort of patients who had cartilage augmentation. Patients, who had cartilage grafts, were retrospectively reviewed for a period of 3 years, from 2001 to 2004. Patients in the Permacol group were prospectively studied from 2003 to 2006. The senior author performed all operations. All the patients had supra‐tip depression. The outcome was measured by clinical assessment, evaluation of photographs, and patient satisfaction.ResultsA total 24 patients had augmentation rhinoplasty‐12 with cartilage and 12 with Permacol. Their age ranged from 19 to 54 years (mean 30). The mean follow‐up for cartilage grafts was 33 months and for Permacol 26 months, with a minimum of 12 months for both groups. Cartilage grafts were harvested from the septum in 7 patients and from the pinna in 5 patients. All 12 patients with cartilage augmentation had satisfactory outcome. In the Permacol group, 11 out of 12 were satisfactory with the outcome. In 1 patient, Permacol graft extruded within 2 months.ConclusionsPermacol graft compared very well, in terms of outcome and safety, with cartilage for augmentation of nasal dorsum. Apart from 1 case of extrusion (8%), there were no other complications. Permacol graft is readily available and easy to handle and contour. Long‐term follow‐up is needed for further assessment.
S293 – Does Tobacco Smoking Influence Smell Function?
Authors: Ribeiro João , Paiva Sofia , Cerejeira Rui , Soares Vera , Gapo Carla , Romão José , Paiva António 
Published: August 2008

ObjectivesMany diseases with great prevalence in the population occur with disorders of smell funtction. However, assessment of olfactory function in patients with disorders of smell is frequently neglected in the otolaryngology routine consultation. One of the effects of tobacco consumption is a change in the nasal mucosa. It has been hypothesized that tobacco smoke consumption modifies olfactory levels of these people.MethodsProspective clinical study with 56 consecutive healthy volunteers, submitted to a previously validated protocol of olfactometry composed by a quantitative and a threshold test. Our population was constituted of an equal number of tobacco smokers and controls, between 16 and 78 years old (average 38,3 years), age and sex paired.ResultsThe substance more frequently identified was naphthalene (94%), followed by menthol (88%), while the least times correctly identified had been the cinnamon and talcum (65%). The test of butanol showed a statistically significant difference (3.73±0.50 in smokers vs 4.34±1.00 in nonsmoking, p=0.02). This test presented a significant correlation with the smoking habit (r=‐0.59, p< 0.01). The supraliminary test showed no significant differences between the 2 groups. There was no significant difference between genders.ConclusionsWe observed a significant statistical correlation between the tobacco smoking and the test of butanol, which confirms the subjective sense of former smokers when experiencing again the aromas that have been altered. Our study showed the quantitative difference imposed by tobacco smoking. Smokers presented lower olfaction levels than non‐smokers, keeping, however, a similar discriminative ability.
S295 – Palate Length, Tonsil Size, and Sleep Apnea Severity
Authors: Bhattacharyya Neil 
Published: August 2008

ObjectivesDetermine the relationships between soft tissue oropharyngeal measurements and obstructive sleep apnea severity.MethodsA prospective series of adult patients undergoing surgical theraphy for obstructive sleep apnea (OSA) was studied. Tonsil size (graded 0 to 4+) and median (palatal spineuvula tip) and lateral (posterior hard palate‐free edge soft palate) dimensions of the soft palate were directly measured transorally at the time of surgery. From the preoperative polysomnographic and the medical record, respiratory disturbance index (RDI), lowest oxygen saturation (LSat) and body mass index (BMI) were determined. The relationships between both RDI and LSat and tonsil size and palatal dimensions was determined with multivariate linear regression adjusted for BMI.Results88 patients were enrolled. The mean (±)95% confidence interval values for the median and lateral soft palate lengths were 4.71 (±) 0.14 cm and 3.73 (±) 0.12 cm, respectively; the mean tonsil size was 1.8 (±) 0.3. The mean RDI and LSat were 44.0 (±) 5.6 events/hour and 84.7 (±) 2.4%, respectively. On multivariate regression, only BMI significantly predicted RDI (p=0.003); median (p=0.210) and lateral (p=0.507) palate lengths and tonsil size (p=0.860) did not. For the LSat, both BMI and tonsil size were significant predictors (p<0.001 and p=0.017, respectively); median and lateral lengths were not (p=0.251 and p=.376, respectively).ConclusionsAdjusted for BMI, soft palate length does not consistently predict sleep apnea severity. Adjusted for BMI, tonsil size predicts the LSat but not the RDI. These results highlight difficulties associated with correlating soft tissue anatomy with sleep apnea severity.
S297 – Nasal Surgery for Obstructive Sleep Apnea Syndrome
Authors: Li Hsueh‐Yu , Wang Pa‐Chun 
Published: August 2008

ObjectivesUsing evidence‐based methodology, we report the literature review findings concerning nasal surgery and OSAS.MethodsThe MedLine, EMBRASE, Cochrane databases are searched (1960‐; 2008) using subject headings “nasal surgery,” “sleep apnea,” “snoring,” or “sleep disorder.” Letters to editor, case reports, review articles, and non‐English publications are excluded. Data extracted from these articles are used for critical appraisal and are analyzed using meta‐analysis and data‐synthesis technology.ResultsPatients pooling revealed gender distribution (90% male), with a mean age of 48 years, and respiratory disturbance index (RDI) ranged from 6.2 to 83.6 event/hr. Baseline BMI spanning from 25.9 to 35.7 kg/m2 was recorded in 10 articles. Total nasal resistance from 2.7 to 5.8cm H2O/L/S was measured in 5 articles. In 13 articles, nasal surgery is the only procedure that applied to patients. 5 articles report significant improvement in AHI; 2 of nasal‐surgery only and 3 of nasal with oropharyngeal surgery. The success rate was statistically significant between “nasal surgery‐only” and “nasal with oropharynx surgeries‐together” articles (15.8–57% vs 40–82%, P=0.03). Although significant improvement in nasal obstruction and concomitant quality of life were mentioned in aforementioned articles, there were no universal measures to present a coherent analysis.ConclusionsNasal surgery might be efficacious in treating OSAS‐related symptoms. However, the meta‐analysis does not support the efficacy of exclusive nasal surgery for sleep apnea in regard to the success rate. Heterogeneity in small study population and incoherence of outcomes measures limit the study and warrant further research.
S302 – Prevalence of Depression in Otolaryngology Patients
Authors: Epstein Victoria A. , Fishman Andrew J , Chandra Rakesh K 
Published: August 2008

ObjectivesSeveral chronic intractable medical conditions are associated with depression. We sought to determine and compare the prevalence of depressive diagnoses and antidepressant use in various subsets of otolaryngology patients.MethodsA large tertiary care, university‐based, EMR database was queried. The study group included over 12,000 distinct otolaryngology patients who were analyzed in 3 groups: group 1 (tinnitus, vertigo, peripheral vertigo, positional vertigo), group 2 (chronic sinusitis, allergic rhinitis, deviated septum), and group 3 (sleep apnea related diagnoses). The number of patients with depressive diagnosis and/or taking antidepressive medications was determined.ResultsOverall, 30% of patients either had been diagnosed with a depressive illness or took antidepressants. The prevalence of depression was 13% in Group 1, 10% in Group 2, and 14% in Group 3. The percent of patients on antidepressant medications was 21%, 15%, and 28% respectively. The primary encounter diagnosis with the highest incidence of depression and antidepressive medication use was sleep apnea with insomnia (21%, 46%).ConclusionsOtolaryngology patients exhibited a greater prevalence of depression and antidepressant use than is observed in the general population. Highest prevalence was found in patients with inner ear disease and sleep apnea. Depression may be a cause of significant comorbidity in patients with chronic intractable otolaryngic conditions.
Frontal Sinus Posterior Table Fractures in a Goat
Authors: Maturo Stephen C , Brennan Joseph , Weitzel Erik K 
Published: August 2008

ProblemThe goal of this study was to investigate how patency of the nasofrontal outflow tract would affect the healing of the frontal sinus in the setting of displaced, posterior table fractures in the adult goat (Capra Hircus).MethodsProspective animal study. Posterior table fractures were created in twenty adult goats (Capra Hircus). The nasofrontal outflow tract was obstructed in 10 goats and left patent in 10. Gross, radiologic, and histological evaluation was carried out at six months post operatively.ResultsAll posterior table fractures healed without gross or radiological evidence of mucosal ingrowth. Obstruction of the nasofrontal outflow tract resulted in an increased rate of mucocele formation. Histological analysis did not reveal significant mucosal ingrowth in either group.ConclusionAn occluded nasal frontal outflow tract leads to an increase rate in mucocele formation at 6 months. There is no gross or radiographic evidence that mucosal ingrowth into the posterior table occurs at 6 months. These findings would suggest that not all significantly displaced posterior table fractures need to be surgically addressed if the nasofrontal outflow tract is patent.SignificancePosterior frontal sinus table fracture treatment is based on poorly controlled animal studies from 30 years ago and small case series reports. Our aim in this study was to determine changes in the frontal sinus at 6 months after a displaced, comminuted frontal sinus fracture was created. We hope to provide evidence demonstrating that not all posterior table fractures need to be treated, especially if the nasofrontal outflow tract is intact.