bluuebunny/crossref_metadata_2025_split huggingface dataset:
S212 – Sensitivity of Pseudomonas in Malignant External Otitis
Authors: Felix Felippe , De Oliveira Barros Thiago , Muneroli Emilio Jonatas , Tomita Shiro 
Published: August 2008

Objectives1) To evaluate if there has been an increase in resistance of bacteria from genus Pseudomonas to ciprofloxacin in patients with malignant external otitis (MEO), and 2) if this has increased the morbidity of the disease.MethodsStudy Design: retrospective. Setting: tertiary referral center. Patients: 21 patients with MEO over 15 years. The records of these patients were reviewed. Samples taken from the external auditory meatus using sterile swabs were sent to the laboratory for processing, where sensitivity of the microorganisms was tested using the agar diffusion method for 15 different antibacterial agents.ResultsAs of 2006, no cases of ciprofloxacin resistance had been detected in patients with MEO treated at this institution. 2 cases (9,5%) of ciprofloxacin resistance were identified in 2007, obtaining a good response with the use of cefepime at a dose of 4g/day. None of the cases presented resistance to amikacin, imipenem, meropenem, cefepime, or ceftazidime. All cases of resistance were in elderly coming from the community, diabetics who had already used systemic or topical ciprofloxacin with no improvement in their condition. No increase in morbidity and mortality was observed in this group.ConclusionsCiprofloxacin resistance was found in 9.5% of the samples isolated over the years. No increase in morbidity was observed.
S215 – The Effects of Topical Halofuginon on Myringotomy in Rats
Authors: Cincik Hakan , Ozdemir Taner , Çekin Engin , Dogru Salim , Gungor Atila , Poyrazoglu I. Ethem 
Published: August 2008

Objectives1) To investigate the role of halofuginone hydrobromide on myringotomy incision healing time. 2) To investigate the role of halofuginone hydrobromide on formation of myringosclerosis.Methods40 rats with normal eardrums were involved in this study to determine if topical halofuginone application had an impact on prolonging the time for healing of myringotomy incision and its histopathological consequences. The study group and control group consisted of 30 and 10 rats, respectively. A posterior incision 1 mm in diameter was made on randomly selected healty eardrums of the rats. After making incision in the study group, gelfoam soaked in halofuginone hydrobromide of 30 mg/dl was applied on the perforation, while gelfoam dipped in isotonic saline was introduced to perforation in the control group. On days 1, 3,7,10,14,18,21, 24, 27 and 30, otoendoscopic evaluation of eardrums under general anesthesia was conducted and perforations were screened. On control days, one randomly selected rat from each group was sacrified and temporal bones were dissected in order to evaluate the tympanic membranes histopathologically.ResultsThe average times for patency of perforation in study and control groups were 21.43 and 7.50 days, respectively. The difference was found to be statistically significant (p<0.05).ConclusionsHistopathological evaluation revealed that halofuginone seems to result in low hyalinization and fibrosis on eardrum compared to the control group.
S217 – Neurotologic Features of Temporomandibular Joint Tumors
Authors: Leonetti John P , Marzo Sam , Porter Ryan G 
Published: August 2008

ObjectivesTo present the clinical and radiographic findings in 8 patients with unusual primary tumors of the temporomandibular joint (TMJ).MethodsThis was a retrospective chart review of all patients with neurotologic manifestations caused by primary TMJ tumors seen at our tertiary care, academic medical center between 7/88‐; 7/07.Results8 patients were identified with primary TMJ tumors that caused a variety of neurotologic manifestations, including trismus, otalgia, tinnitus, hearing loss, aural fullness, headache, facial pain, and otorrhea. Tumor histology included chondroma, chondroblastoma, osteoma, giant cell tumor, synovial chondromatosis, and osteosarcoma. Anterior external auditory canal involvement required partial petrosectomy in all 8 patients. Despite aggressive surgical resection and radiotherapy, only 5 of 8 patients are disease‐free, with a mean follow‐up of 7.2 years.ConclusionsPrimary tumors of the TMJ, although rare, can cause a variety of common neurotologic manifestations. A complete physical examination with appropriate radiographic assessment will guide the proper treatment plan. Earlier diagnosis may lead to improved overall control rates.
S220 – Characteristics of Fluid and Tympanometry Profiles in OME
Authors: Lee Seung‐Hwan , Lee Youngseok , Kim Yunjeong , Kim Bum‐Suk , Jeong Seung‐Won , Jeong Jin Hyeok , Park Chul‐Won 
Published: August 2008

ObjectivesThe aim of this study was to compare the characteristics of the type B tympanogram curve (maximum admittance, tympanometric peak pressure) to the volume and viscosity of middle ear fluid.MethodsWe conducted preoperative tympanometry from 175 ears in 94 children with otitis media with effusion. The volume and viscosity of middle ear fluid collected during myringotomy were classified into 3 groups respectively. We analysed the correlations between the characteristcs of middle ear fluid and tympanometric profiles such as maximum admittance, tympanometric peak pressure. Student t test was used for statistical analysis.ResultsNo correlation was found between peak pressure of the tympanogram and the characteristics of middle ear fluid. However, as the volume of middle ear fluid increases, the viscosity and the straight type B tympanogram increased significantly (p<0.001, p=0.002 respectively). And as the volume and the viscosity of the middle ear fluid increased, the Admmax significantly decreased (p<0.001).ConclusionsCharacteristics of type B tympanogram curve were correlated with the volume and viscosity of middle ear fluid. And it can be suggested that tympanometry may be used as an objective measure to estimate the characteristics of the middle ear fluid.
S221 – The Postero‐superior Quadrant of the Tympanic Membrane
Authors: Branco Carla , Paco Joao‐Carlos Lopes Simoes , Carmo Diogo O. , Estibeiro Hugo 
Published: August 2008

ObjectivesThe purpose of this study was to document the anatomic relationship of the postero‐superior segment of the tympanic membrane and its clinical implications.Methods100 temporal bones from adults without history of otologic pathology were studied. The morphological and anatomical details of the tympanic membrane were observed in 70 bones, which implied the use of macroscopic sections of the bones. The histological results were documented in 30 serially sectioned bones, stained previously with hematoxylin‐eosin.ResultsWe established that the postero‐superior quadrant was the largest in size, with a mean dimension of 21.05 mm2, which represents 28.7% of the total area of the tympanic membrane. This feature implies that this quadrant is more exposed to pressure changes. We also verified that the posterosuperior part of the tympanic sulcus, above the chorda tympanic nerve, lost its depth in an unexpected way (60%) or that it gradually diminished from 0.9 to 0.5 mm until it disappeared near the posterior tympanic spine. In association, we established that at this level there was a decrease in the annulus caliber. Additionally, in 25% of cases, given the absence of the circular fibers of lamina propria, the postero‐superior quadrant had only the radial fiber layer.ConclusionsAnatomic and morphologic details in the postero‐superior quadrant were newly described and may explain the greater incidence of retraction pockets and marginal perforations that provide the origin of cholestheatoma.
S222 – Sound Localization in Subjects with Tinnitus
Authors: Shin Il Ho 
Published: August 2008

ObjectivesSound localization in subjects with normal hearing is done by recognition of interaural difference of time, intensity, and phase of sound source. The defect of sound localizing ability may increase the chance of accident, decrease public conversation. Individuals with tinnitus, deprived of the binaural cues, are expected to have difficulty in localizing sound. The purpose of the research is to investigate the sound localizing ability in subjects with tinnitus to localize sound in horizontal plane by comparing with normal control group.Methods3 groups of subjects participated in this study. The first group consisted of 30 subjects with unilateral tinnitus without hearing disturbance, the second group consisted of 30 subjects with unilateral tinntus, hearing disturbance. Control group was 20 normal hearing adults. Sound localization ability was assessed by means of an array of 8 loudspeakers positioned at the azimuth of 45°each in the horizontal plane at a distance of 100 cm from the subject.ResultsThe localization score increased significantly as tinnitus with hearing disturbance as compared with control group(p<0.05). In the tinnitus without hearing disturbance group as compared with the control group, the localization score increased but there is no stastical significance.ConclusionsIn the tinnitus without hearing disturbance group, the sound localization ability was decreased but there is no stastical significance. This means that tinnitus has relatively small effect of interaural intensity difference in usual living. It needs further study with similar tinnitus intensity, pitch.
S223 – Effect of Myopia on the Caloric Test
Authors: Thakar Alok 
Published: August 2008

ObjectivesTo assess the impact of corrected myopia on the caloric test. Correction of myopia with spectacles or contact lenses results in alteration of the size of the retinal image. Previous laboratory experiments have demonstrated that gross changes in the size of the retinal image can result in recalibration or suppression of the vestibulo‐ocular reflex (VOR).MethodsCase‐control study. 17 evaluable healthy volunteers with myopia corrected either by spectacles or contact lenses (case group) compared to 17 volunteers with no refractive error (control group). Complete Electro‐Nystagmography inclusive of bithermal caloric testing undertaken for cases and controls. Assessment of hypoactive caloric responses based on normative laboratory values.Results7 of 17 cases and 1 of 17 controls demonstrated hypoactive caloric responses. In the spectacle users group, 6 of 11 (55%) had hypoactive responses. Spectacle users were significantly more likely than emmetropic controls to have hypoactive caloric responses (p<0.01; relative risk 9.3 {95 % Confidence Interval 1.3 to 66.9}).Conclusions1) A significant proportion of myopes using spectacles have suppression of the vestibulo‐ocular reflex as demonstrated by the caloric test. This has implications for the interpretation of ENG results, and also as a cause of vestibular impairment. 2) Further studies in myopes are warranted for precise and direct evaluation of the VOR by rotation or impulse testing.
S227 – Investigation of the Prion Protein in Subjects with Tinnitus
Authors: Kleinjung Tobias , Langguth Berthold , Veronika Vielsmeier , Landgrebe Michael , Sand Philipp 
Published: August 2008

ObjectivesThe prion protein (PrP) plays a major role in central nervous excitability, cellular adhesion, and neurite outgrowth. We hypothesized that PrP variants may act as a modulator of chronic tinnitus, a condition frequently associated with states of overexcitability in the auditory pathway.Methods139 Caucasian patients who presented with tinnitus lasting more than 6 months were recruited from a tinnitus clinic, underwent detailed neuro‐otological examinations and donated venous blood for the extraction of genomic DNA from lymphocytes. Subjects with a history of vestibular schwannoma, Meniere's disease, or pathological middle ear conditions were excluded. Tinnitus severity was graded using the Tinnitus Questionnaire (TQ). A polymorphism encoding residue 117 of PrP was genotyped by PCR‐based RFLP.ResultsWhen carriers of the minor PrP allele were compared to the remaining subjects, we noted only a moderate difference in mean TQ scores (33.4 ± 4.9 vs. 37.4 ± 1.5, p > 0.05).ConclusionsThe present results thus do not support a significant effect of PrP variant rs8124214 on subjective ratings of tinnitus. However, functional PrP variants may act on additional outcome parameters, e.g., on the response to treatment. Future studies will need to address the interplay of these variants, and their effects on specific subgroups.
S233 – Diagnostic Role of Electrocochleography after Glycerol Test
Authors: Majidi Mohammadreza , Nematollah Mokhtari , Mohammadreza Tale , Aliasghar Rauf , Shakeri Mohammad Taghi 
Published: August 2008

ObjectivesResponse to dehydrating agents such as glycerol in Meniere's disease is evaluated by audiometric shifts after substance administration. Since the major pathogenic event in this disease is endolymphatic hydrops, evidenced by elevated SP/AP ratio, this study was conducted to determine the value of electrochochleography in assessment of response to glycerol administration in patients with definite Meniere's disease.MethodsBetween October 2006 and December 2007, 12 women and 10 men with definite Meniere's disease, based on AAO‐HNS guidelines during acute phase, were included in this study. Pure tone audiometry (before and 1,2,3 hours after glycerol administration) and extratympanic electrocochleography (before and 3 hours after test) were performed; improvement in tinnitus, aural fullness, and vertigo symptoms were recorded after glycerol administration. Chi‐square test was used to compare the sensitivity of electrocochleography and pure tone audiometry for detection of response to glycerol test.Results22 patients, mean age of 40.18±8.8 years, were included in this study. Of 16 patients with tinnitus complaint, 9 patients reported significant improvement after glycerol test. Of 22 patients with vertigo and aural fullness symptoms, 19 reported significant clinical improvement. The SP/AP ratio was significantly reduced and reached to less than 80% of pretest values in 17 of these patients, but improvement in pure tone thresholds was observed in 8 patients. The difference between 2 methods was significant (p<0.05).ConclusionsIt seems that significant reduction in SP/AP ratio in patients with Meniere's disease might be a more sensitive indicator of the response to glycerol test than pure tone threshold shifts.
S235 – Diagnostic Test Validation: CHAMP in Endolymphatic Hydrops
Authors: Rojas Eveling Y , Ordoñez Leonardo , Hernandez Victor , Guzman Jose E , Izquierdo Juan , Lora Jose Gabriel , Prieto Jose 
Published: August 2008

ObjectivesThe Cochlear Hydrops Analysis Masking Procedure (CHAMP) has been reported with a high sensibility and specificity for the diagnosis of endolymphatic hydrops (ELH). Nevertheless, a complete validation of CHAMP with precise methods has not been done. Our objectives: To determine whether CHAMP has a diagnostic value in patients with definite, probable/possible diagnosis of Meniere's disease or endolymphatic hydrops, based on the criteria of the AAO‐HNS.MethodsProspective validation study for a diagnostic test: phase II. Latency of wave V was assessed using CHAMP. We classified subjects in 5 groups: 1‐Definite ELH, 2‐Probable ELH, 3‐Possible ELH, 4‐subjects with other otovestibular symptoms, 5‐normal hearing subjects. We included cases (groups 1–4) with an episode of vertigo with duration equal or longer than 20 minutes, with or without other otovestibular symptoms.ResultsWe included 67 cases (132 ears). 38 cases (76 ears) completed the follow up and their results are presented. In group 1, the sensibility of CHAMP was 43% and its specificity was 100%. In groups 2–3, the sensitivity was 20% and the specificity 100%, with 0% false positive and 80% false negative results. Other indicators of validity for this diagnostic test are presented.ConclusionsCHAMP has a high specificity and low sensibility for the diagnosis of ELH when the delay in wave V latency is used. Future studies may assess the relationship between wave amplitudes to improve the clinical value of CHAMP.
S238 – Clip‐fixation or Crimping? Results of 4 Stapes Prostheses
Authors: A'Wengen Daniel F 
Published: August 2008

ObjectivesLearn about possible differences of results by 4 different stapes prostheses.MethodsIn this retrospective study, all 126 contiguous patients undergoing stapes surgery for otosclerosis are included. All surgeries were performed by 2 surgeons. 4 different types of stapes prostheses were used in separate time intervals. Starting with teflon‐platinum wire prosthesis, to gold piston, to titanium piston, to the self‐retaining titanium Clip‐piston.ResultsPre‐ and postoperative pure tone and speech audiograms are compared. The best results were achieved by the Clip‐Piston. Improvement in PTA over other pistons was 4 dB with p= 0,027 (Mann‐Whitney). Bone conduction levels were better by 2 dB. In speech audiometry intellegibility was better by 3 dB with p=0,024 (Mann‐Whitney).ConclusionsThe tight self‐fixation of the Clip‐Piston to the long process of the incus achieved the best results in pure tone and even more so in speech audiometry. The reason might be due to reduced slippage of the stapes prosthesis at the attachment to the incus. As other studies have shown, tight fixation of a stapes prosthesis provides the best results. The Clip‐Piston achieves this by its spring action and without the danger of heat and strangulation as by other stapes pistons.
S241 – Acoustic Neuroma Surgery: Hydroxyapatite Cement Cranioplasty
Authors: Kruger Emma A. , Arriaga Moises A , Chen Douglas , Hillman Todd 
Published: August 2008

ObjectivesTo review the outcome of hydroxyapatite cement cranioplasy in acoustic neuroma surgery using trans‐labyrinthine and retrosigmoid approaches.MethodsRetrospective chart review of the cases of acoustic neuroma resection performed in our institution from January 1, 2007, until November 1, 2007, using 2 separate types of hydroxyapatite cranioplasty in wound closure. Abdominal fat graft in case of translabyrinthine approach and either abdominal fat graft or duragen were covered using Hydrset (Stryker) or Bonesouce (Stryker) hydroxyapatitie cement bone substitute. Translabyrinthine and Retrosigmoid resections were included in the review. The rate of postoperative cerebrospinal fluid leak, lumbar drain use, and early wound complications were recorded.ResultsThere were 33 cases of acoustic neuroma resection over a period of 10 months using hydroxyapatite cranioplasty. Hydroset bone substitue was used in 16 cases and no CSF leak was observed. Bonesource bone substitute was used in 17 cases and 1 case of CSF leak was observed. The leak was managed with lumbar drain placement and resolved without any additional interventions. In the Hydroset group no drains were used, and in the Bonsource group drains were placed at the completeion of a procedure and removed 12 hours postoperatively. There were no wound complications seen at the completeion of the review. No other adverse outcomes were noted.ConclusionsBoth forms of hydroxyapatite cranioplasty are reliable methods to avoid CSF leak in acoustic neuroma surgery. The handling characteristics and no need for drain with Hydroset may make it preferable as a bone reconstruction technique in acoustic neuroma surgery.
S242 – Comparing the VEMP and ENG Tests in Vestibular Diagnosis
Authors: Bhansali Sanjay 
Published: August 2008

Objectives1) Compare the VEMP to the ENG test in the diagnosis of vestibular disease. 2) Learn clinical usefulness of the VEMP test.MethodsWe prospectively evaluated 166 patients complaining of dizziness with a complete neurotologic examination. VEMP and ENG testing were done on 160 patients. Brain scans were done when indicated. We compared the clinical diagnosis to the VEMP and ENG test results separately for 4 commonly seen vestibular conditions.Results44 patients had no VEMP response and were excluded. Of the 116 patients there were 32 cases of Vestibular Neuronitis, 17 of Meniere's disease, 15 of BPPV, 12 of central vestibular dysfunction, 13 other vestibular diagnoses, and 27 with no vestibular diagnosis. Using a 2×2 contingency table and Fisher Exact Probability Test, there was a statistical difference between the VEMP and ENG tests only in diagnosis of Vestibular Neuronitis (p<0.001) when analyzed individually, and because this difference was so strong, there was a statistical difference with the diagnoses taken all together (p<0.001).ConclusionsThe ENG test remains the gold standard for diagnosis of vestibular disease. The VEMP test is useful in diagnosis of several vestibular disorders, including the 4 considered in this study. There is a strong bias toward the ENG test mainly because the diagnosis of vestibular neuronitis relies heavily on an abnormal caloric response. The VEMP test is administered in a much shorter time than the ENG test and provides valuable information regarding the inferior vestibular nerve and it has a lower false positive rate than the ENG test.
S246 – Chronic Sinusitis in Children: Which Sinuses Are Involved
Authors: Ramadan Hassan H , Douglas Justin 
Published: August 2008

Objectives1) Learn which paranasal sinuses are involved in chronic rhinosinusitis in children. 2) Be able to customize surgical treatment based on those findings.MethodsRetrospective review of children who had sinus surgery over a period of 10 years. 76 children whose age ranged between 3 and 14 years had their CT scans reviewed to determine which sinuses were diseased. All children had a CT scan because of failure of medical management and were considered for surgery. Outcome was to determine which sinuses were developed and of those, which ones were diseased and what was the severity of the disease.ResultsThe maxillary sinuses were the most common sinuses involved in children with chronic rhinosinusits (92%). The ostiomeatal complex was next most common area involved in these children (88%).ConclusionsThe maxillary sinuses, followed by the ostiomeatal complex, were the most common areas involved in children with chronic rhinosinusitis. Initial surgical management of these children should then be based on those findings.
S249 – Grisel's Syndrome in Otolaryngology: A Systematic Review
Authors: Sivaji Nagaraj , Karkos Peter , Samuel Leong 
Published: August 2008

ObjectivesTo assess etiology, treatment, and outcome of Grisel's syndrome.MethodsA Medline search was performed using the terms Grisel's syndrome, spontaneous atlantoaxial subluxation, head, neck, ear, nose and throat. A systematic review of the literature was performed. Case series of both adult and pediatric cases were included. Only papers focusing on true non‐traumatic atlantoaxial subluxation were included.Results71 papers have been published from 1950 to 2006. 48 of these fulfilled our inclusion criteria, totaling 103 patients for review. The main causes of Grisel's syndrome were infection (48%) and post‐adenotonsillectomy (31%). Less common causes included other postoperative cases such as pharyngoplasty and ear operations. Neurosurgical consultation was paramount in all cases. In the majority of cases, conservative management in the form of bed rest, antibiotics, muscle relaxants, traction, and collar was effective; in a few cases, only surgery in the form of arthrodesis was deemed necessary. Morbidity was significant in those cases where diagnosis was delayed, with the most devastating consequence a permanent neurological deficit in one case.ConclusionsGrisel's syndrome is a rare but dangerous complication that can go unnoticed in its early phase and can be a major cause of morbidity and mortality following infection or head and neck procedures/interventions. Early recognition of any cervical complication following routine otolaryngological operations, together with early neurosurgical consultation, is mandatory to prevent devastating consequences.