bluuebunny/crossref_metadata_2025_split huggingface dataset:
S192 – 3D Diagnosis of Vocalizing Larynx Using Cone Beam CT
Authors: Inagaki Koji , Saito Koichiro , Naganishi Hideki , Takuj Takaoka , Suketaka Momoshima , Ogawa Kaoru 
Published: August 2008

ObjectivesCone beam computed tomography (CBCT) was developed for the office‐based quick and precise 3D visualization of maxillofacial region. CBCT requires scanning time of less than 10 seconds and provides isotropic 3D image with high resolution. In this study, we examined the potential role of CBCT as a tool for 3‐dimensional evaluation of the glottal insufficiency.MethodsCBCT was performed in 2 normal controls and in 14 patients with unilateral vocal fold paralysis (13 cases) or paresis (1 case). Laryngeal CBCT images were taken in the resting state and during phonation. Furthermore, preoperative and postoperative images were evaluated to assess the impact of phonosurgeries in 5 cases.ResultsCBCT of the vocalizing vocal fold was successfully performed in all the cases, producing clear coronal images. During phonation, no remarkable differences in levels between the paralyzed and normal vocal folds were observed in 10 cases, proving the 2‐dimensional glottal gap (2D cases). On the other hand, the levels of paralyzed vocal folds stayed higher during phonation compared to the normal side in 4 cases, proving the 3‐dimensional glottal gap (3D cases). 4 of the 2D cases had injection laryngoplasty and 1 of the 3D cases had arytenoid adduction procedure to correct their glottal gaps. Postoperative CBCT images verified the successful correction of these gaps.ConclusionsOur study proved the feasibility of CBCT for 3D evaluation of vocalizing larynx. This quick and easy system may have an informative role to suggest the proper phonosurgical procedure for glottic insufficiency.
S200 – Ventricular Folds in Laryngeal Dystonia Treated with Botox
Authors: Silveira Paula Lorenzon , De Biase Noemi 
Published: August 2008

ObjectivesAnalyze the behavior of Vestibular Folds(VF) in Adductor Laryngeal Dystonia(ALD) after and before the treatment with unilateral botulinum toxin injection(BTX) during different laryngeal tasks, comparing treated side(IPSI) and opposite side (CLT).Methods23 patients with adductor laryngeal dystonia were studied retrospectively. Categorical data were obtained about ventricular fold medial compression from qualitative judgment of the flexible laryngoscopic dynamic examination. It was realized after and before BTX comparing the compression grade of VF in IPSI with CLT. The VF medial compression was graduated in 4 points scale. The tasks were sustained phonation of /e/ and /i/, during inspiration, soft breathing, whispering, emissions with voiceless sounds and voiceful sounds, sniff and whistling. McNemar and Wilcoxon tests were used to statistical analysis.ResultsStatistical significance was noted on improvement of medial compression of CLT and on reduction of medialization of IPSI as follow: soft breathing (IPSI: p=0,031* CLT: p=0,039*), sustained /e/ (IPSI: p<0,001* CLT: p=0,001*), sustained /i/ (IPSI: p=0,012* CLT: p<0,001*), phonation with voiceful souds (IPSI: p<0,001*) and voiceless souds (IPSI: p<0,001*). The whispering (IPSI: p=0,001* CLT: p=0,057) and the whistling (CLT: p=0,125) was significantly improved on IPSI, without significance at CLT. Phonation during inspiration and sniff didn't show significance.ConclusionsSignificant variation occur on VF behavior in ALD after BTX, with reduction of VF medialization in the IPSI in comparison with increased medialization of VF in the CLT, mainly at phonatory tasks and rest. This variation hasn't the same behavior at atypical and non‐phonatory tasks.
S201 – The Progress of Reflux‐Related Symptoms in Healthy Persons
Authors: Möller Riitta Ylitalo , Olle Andersson , Finizia Caterina A , Ruth Magnus 
Published: August 2008

ObjectivesTo evaluate prospectively the progress of pharyngeal and esophageal symptoms in previously healthy subjects.Methods33 healthy persons (mean 57 yrs) earlier included in a normative pH monitoring study were contacted. After a mean follow‐up period of 13 years, the subjects completed 2 symptom questionnaires, Short Form 36, and ambulatory 24‐hour pharyngeal and esophageal pH monitoring.Results24 subjects, 9 males and 15 females (mean age, 57 years), completed the study. All subjects were symptom‐free at baseline. At follow‐up, 11 of the 24 (46%) subjects (p=0.001) reported typical reflux symptoms, e.g. heartburn or regurgitation, of mild to moderate severity. Extraesophageal symptoms occurring at least 1–2 days/week developed across time in 10 of the 24 (42%) subjects. The most common symptoms were throat clearing, excessive phlegm, and daytime cough, in that order. There was no statistically significant correlation between reflux parameters and the occurrence of symptoms (p>0.01). The esophageal, or airway symptoms, or combination of them were similar among persons with and without LPR at baseline and at the follow‐up. The perceived health by 10 subjects who had upper airway symptoms at follow‐up, or those 8 subjects who had pharyngeal reflux at follow‐up, as reflected by the domain specific and summary SF‐36 scores, was not significantly different from the age‐ and gender‐matched randomly selected sample from the Swedish normative database.ConclusionsThe increase in the upper airway as well as esophageal symptoms across time is not correlated to perceived health, or increase in the occurrence of reflux.
S204 – Postoperative Residual Cholesteatoma: Value of MR Imaging
Authors: Fukushima Hisaki , Nishiike Suetaka , Tamada Tsutomu , Yoda Shigetoshi , Harada Tamotsu 
Published: August 2008

ObjectivesThis study was carried out to evaluate the utility of diffusion‐weighted imaging (DWI) and contrast‐enhanced MR imaging (CE‐MRI) for the detection of postoperative residual cholesteatoma in cases where computed tomographic (CT) findings were not conclusive.Methods14 ears from 13 patients, who had undergone canal wall‐up tympanoplasty for cholesteatoma and nonspecific opacity images on postoperative follow‐up CT, underwent MR imaging before revision surgery. T1WI, T2WI DWI (using b‐factors of 0 and 800 sec/mm2) and CE‐MRI were performed using a 1.5‐T MR unit. MR imaging examination was generally completed within 30 min. In all cases, imaging findings were compared with second‐ or third‐look operative findings.ResultsMR imaging depicted 9 out of 10 residual cholesteatomas (sensitivity, 90.0%). In a remaining (false‐negative) case, a 3‐mm cholesteatoma pearl that was encircled by granulation tissue was not depicted. There were no false‐positive cases (specificity, 100%). The positive predictive value and negative predicitive value were 100% and 75%, respectively. DWI showed cholesteatoma high signal intensity in peculiarity. However, the spatial resolution was low and artifacts appeared at the base of skull in DWI. In the case with a small cholesteatoma in the dura mater, CE‐MRI was effective. The minimum size of the cholesteatomas detected by the MR imaging including DWI was 4 mm.ConclusionsWhen postoperative CT is not conclusive, DWI combined with CE‐MRI is a valuable technique for the detection of residual cholesteatoma.
S205 – Neuroradiologic Assessment of Pulsatile Tinnitus
Authors: Kircher Matthew L , Leonetti John P , Marzo Sam J , Standring Bob 
Published: August 2008

ObjectivesTo present a neuroradiographic imaging algorithm for patients presenting with pulsatile tinnitus.MethodsThis was a retrospective review of patients presenting to a tertiary care academic medical center from 1993 to 2007 with a chief complaint of pulsatile tinnitus. Clinical presentation and diagnostic imaging data were analyzed.ResultsOf the 108 patients identified, 93 patients had subjective pulsatile tinnitus and 15 patients presented with objective pulsatile tinnitus. In patients with subjective pulsatile tinnitus, 27/93 (29%) had positive radiologic findings, with 71% of cerebral angiogram studies and 57% of MR studies revealing anatomic abnormalities responsible for the pulsatile tinnitus. In patients with objective pulsatile tinnitus, 9/15 (60%) had positive radiologic findings, with 80% of cerebral angiogram studies and 57% of MR studies revealing anatomic abnormalities responsible for the pulsatile tinnitus. Magnetic resonance sensitivity in subjective and objective pulsatile tinnitus was 67% and 57% respectively.ConclusionsMagnetic resonance is an excellent first‐line diagnostic imaging modality in the assessment of pulsatile tinnitus. However, regardless of the subjective or objective nature of pulsatile tinnitus, cerebral angiography should be considered in patients with a negative MR and disabling pulsatile tinnitus.
S208 – Catabolism of Gycoconjugates in Cholesteatoma Tissue
Authors: Olszewska Ewa , Borzym‐Kluczyk Malgorzata , Olszewski Slawomir , Rogowski Marek 
Published: August 2008

Objectives1) To determine the activity of N‐acetylo‐beta‐D‐hexosaminidase (HEX), alpha‐mannosidase (alpha‐MAN) and beta‐galactosidase (beta‐GAL)in acquired cholesteatoma and normal retroauricular skin specimens. 2) To assess the level of catabolism of glycoconjugates in assays of cholesteatoma extracts, quantifying HEX, alpha‐MAN and beta‐GAL.MethodsCholesteatomas (n=21) and normal adult post‐auricular skin, served as controls(n=21), were collected during surgery in 2006–2007. Exoglycosidases activity was evaluated by determination, the amount of released p‐nitrophenol from p‐nitrophenol derivatives of appropriate sugars (beta‐N‐acetylglucosamine, alpha‐mannose, and beta‐galactose). Statistical analysis was conducted using the Student's t‐test; p<0.05 was regarded as significant.ResultsIn 19 of 21 specimens we observed significantly higher activity of investigated enzymes in cholesteatoma tissue compared with control tissue (p<0.05). Mean activity of HEX, alpha‐MAN and beta‐GAL from the cholesteatoma cells was adequate: 68.55 ±30.77 nkat/g, 1.85 ±1.14 nkat/g and 1.92 ±1.11 nkat/g wet tissue. In the control probes, adequate: HEX: 31.79 ±10.02 nkat/g, alpha‐MAN: 0.69 ±0.24 nkat/g and beta‐GAL: 0.86±0.22 nkat/g wet tissue. The correlation of two variables: enzyme activity in cholesteatoma and enzyme activity in skin specimens was positive. Pearson's coefficient was equal r= 0.3815 (HEX), r= 0.527 (alpha‐MAN) and r= 0.489 (beta‐GAL).ConclusionsCatabolic reactions involving glycoproteins, glycolipids, and proteoglycans may play a role in the pathogenesis of acquired cholesteatoma. The present data indicating that lysosomal exoglycosidases HEX, alpha‐MAN and beta‐GAL are significantly and consistently elevated suggest the need to further assess correlations between levels of HEX, alpha‐MAN and beta‐GAL and cholesteatoma behavior. Further research should also evaluate the relative importance of these particular exoglycosidases in considering the spectrum of identified inflammatory mediators.
S209 – Optimal Electrode Position for ENoG for Facial Palsy
Authors: Haginomori Shin‐Ichi , Takamaki Atsuko , Takenaka Hiroshi 
Published: August 2008

ObjectivesTo develop a more simple procedure for electroneurography (ENoG) of facial palsy for assessing prognosis, we conducted a preliminary study to examine an optimal electrode position for recording evoked compound muscle action potentials (CMAPs) of the perioral muscles.MethodsWe evaluated a new method called the submentall method, in which the electrode connected to the negative input (G1) was placed on the skin over the orbicularis oris muscle, and the other electrode connected to the positive input of the amplifier (G2) was placed on the mental protuberance. We compared the amplitudes and morphology between the CMAPs recorded with this method and those recorded using the standard electrode positions (G1 placed on the skin over the orbicularis oris muscle; G2 placed on the nasolabial fold, closely lateral to the ala nasi). Furthermore, the amplitudes and waveforms of CMAPs were recorded from 4 different G1 positions on the skin over the orbicularis oris muscle, with G2 set on the mental protuberance. The main trunk of the facial nerve was stimulated by percutaneous supramaximal electrical stimulation beneath the auricle.ResultsThe submental method gave greater amplitudes and more obvious biphasic CMAPs than those produced with the standard method. In the submental method, the optimal G1 recording electrode position was on the philtrum.ConclusionsThis recording procedure has the potential to be a simpler and more reliable method for calculating ENoG values than the standard method. However, further studies to establish prognostic criteria of ENoG for facial palsy are needed.
S211 – Staged Tympanoplasty with Tympanic Ventilation Tube
Authors: Murakami Masataka 
Published: August 2008

ObjectivesA technique for providing long‐term ventilation of the middle ear (ME) during staged tympanoplasty is described, and the results using this treatment in patients with chronic Eustachian tube dysfunction (ETD) are reported.MethodsRetrospective, nonrandomized case review. All operations were performed by the same surgeon (author). 26 consecutive patients who underwent staged tympanoplasty with ETD have been followed up and and examined for more than 5 years. Adhesive otitis media, cholesteatoma, and cholesterol granuloma were included in this study. All patients had a T‐tube placed at the first stage tympanoplasty for long‐term ventilation of the middle space. The 3 main outcome measures were inflammation control, hearing improvement, and recurrence of the disease.Results6 had adhesive otitis media, 16 had cholesteatoma, and 4 had cholesterol granuloma. All patients underwent planned first stage tympanoplasty with simultaneous ventilation tube placement; 12 underwent concomitant ossiculoplasty, and 22 underwent mastoidectomy. 2 patients (1 cholesteatoma and 1 cholesterol granuloma) had recurrence. 2 patients with adhesive otitis media had intermittent otorrhea (with maintained ventilation tube). In patients who underwent planned staged tympanoplasty with tube placement, the success rate both in inflammation control and in hearing improvement was higher.ConclusionsThe simultaneous placement of the long‐term ME ventilation tube during planned staged tympanoplasty is a simple, safe, and effective alternative for longer‐term ME ventilation in patients with severe ETD. Staged tympanoplasty technique with ventilation tube is effective and available for the treatment of adhesive otitis media, cholesteatoma, and cholesterol granuloma.
S213 – Gustatory Alterations in Patients with Chronic Otitis Media
Authors: Felix Felippe , Jamerson Reis , Cabral Gustavo A. Porto Sereno , Guilherme Carleti , De Barros Fernando Souza , Tomita Shiro 
Published: August 2008

Objectives1) To identify gustatory alterations due to chorda tympani nerve involvement in patients with chronic otitis media (COM) without prior surgery, and 2) To see if the presence of cholesteatoma worsened gustatory sensitivity in these patients.MethodsStudy Design: prospective study. The test was performed in patients with unilateral cholesteatomatous or suppurated COM not previously submitted to otological surgery. The test was based on “taste strips” with different concentrations of salt, sweet, bitter, and sour, using the otological disease‐free side as the control. The score could be between 0 (worst) and 16 (best). All the other data were collected by interview and physical exam and analysed by Poisson Regression.ResultsA total of 45 patients with COM were evaluated, including 25 with cholesteatoma and 20 with non‐cholesteatomatous COM, with a mean age of 38 years. 8 cases of unilateral ageusia were found on the affected side. The mean score was 6.65 for the affected side and 9.91 for the half of the tongue on the side of the healthy ear (p<0,05). No patients had complained of gustatory alterations before the examination. There was an association between presence of cholesteatoma and worse gustatory sensitivity (p<0.05).ConclusionsPatients with cholesteatomatous or suppurated COM can present gustatory alterations, even in the absence of complaints. The presence of cholesteatoma worsened gustatory sensitivity.
S214 – Temporal Fascial and Periosteal Flap in Tympanoplasty
Authors: Yabe Takao 
Published: August 2008

ObjectivesIt is very important to maintain a stable reconstructed posterior canal wall with bone plate and cartilage in the posterior canal wall reconstructed tympanoplasty. We treat reconstructed posterior canal wall with the temporal fascial flap (TFF) and the temporal periosteal flap (TPF) to have a stable posterior canal wall and a tympanic membrane graft. We investigated the blood supplies of TFF and TPF to know the effectiveness of those flaps.MethodsRetrospecyive analysis of a prospective patient data set. Tertiary care referral center. 25 patients with chronic otitis media underwent canal wall reconstructed tympanoplasty between December 2005 and December 2007. We employed Laser Doppler blood flowmeters to measure the blood supplies of TFF(F1: the tip and F2: the root) and TPF(P) during surgeries. The data were analyzed by Welch's t‐test (p<0.05).ResultsThe mean ± SD were F1:23.3±8.6 Flux?F2: 25.3±8.3 Flux and P:17.1±5.1 Flux in controls, and F1:21.1±4.2 Flux?F2:21.9±3.1 Flux and P:17.1±2.4 Flux in pedicled flaps, respectively. There were no significant statistical differences between controls and pedicled flaps, but were significant differences between TFF (F1 and F2) and TPF (P) (p<0.05).ConclusionsThese findings suggested that the TFF and TPF were reliable sources of local well‐vascularized tissue to be extremely pliable and facilitate to create the stable posterior canal wall. Furthermore, it seems that it was linked to prompt postoperative healing, the avoidance of postoperative infection, the postoperative hearing improvement, the shorter hospitalization stay, and early discharge from the hospital.
S216 – Is Oculomotor Testing Useful in the Modern Era?
Authors: Dewji Zameel , Blakley Brian W 
Published: August 2008

ObjectivesTo understand the role of oculomotor testing in the era of advanced imaging with MRI.MethodsFirst, the literature was evaluated systematically to determine the level of evidence that oculomotor testing is sensitive in central nervous system lesions. Next, the sensitivity and specificity of saccade, pursuit, and gaze testing in detection of brain abnormalities were assessed using a database of 561 patients who underwent ENG using magnetic resonance imaging (MRI) as the “gold standard.” Among the abnormal MRI scans, oculomotor testing was abnormal in 1 and normal in 37. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (PLR and NLR), and the diagnostic odds ratio (OR) with 95% confidence interval (± CI) were calculated.ResultsFor oculomotor testing, our data which concur with the literature indicate: Sensitivity 2.6%, (± 0.005–1.1); Specificity 96%, ± (0.89–0.98); Diagnostic OR 0.71 ± (0.065–5.6); PPV 20% ± (0.043, −0.64); NPV 71% ±(0.62, 0.78).ConclusionsOur data suggest that oculomotor testing adds little diagnostic information. The cost and benefit of oculomotor testing are low.
S219 – Japanese Otosclerosis Patient with Otospongiotic Lesions
Authors: Hashimoto Shigehisa , Yamamoto Yutaka , Takahashi Sugata 
Published: August 2008

ObjectivesAlthough it has been reported that the incidence of otosclerosis is much lower among Japanese patients and clinically the disease shows a reduced activity level, otosclerotic foci are sometimes detected in recent years. However, about the clinical significance, it is not still unclear. This study investigated the incidence of otosclerosis in Japanese patients with otosclerotic foci around the otic capsule, their audiometric correlation and surgical outcome.MethodsWe evaluated 59 patients (86 ears) with confirmed otosclerosis (at least one ear underwent surgery) in our hospital between 2001 and 2006. All patients underwent hearing and CT examination on the same day and hearing examination were repeated every 6 months regardless of whether the patient underwent surgery or observation only.ResultsOtosclerotic foci around the otic capsule were observed in 30.2% of the all ears in the Japanese otosclerosis. There was a correlation between the presence of otosclerotic foci and air‐bone gap (p<0.05). In the surgical group, there was no significant difference between the patients with and without the presence of otosclerotic foci for the hearing improvements after stapes surgery. In the no‐surgical groups, there was significant worsening of the hearing level in patients with otosclerotic foci in comparison to that of those without otosclerotic foci (p<0.01).ConclusionsThis incidence of Japanese otosclerosis patient with otosclerotic foci is not lower than those of Caucasians. Surgical outcome was not affecting by otosclerotic foci. It is concluded that CT examination is important for predicting the hearing level of patients.
S224 – Efficacy of Long Silastic Sheet in COM Surgery
Authors: Cho Hyong‐Ho , Choi Hyun‐Seok , Jang Chul‐Ho , Cho Yong‐Bum 
Published: August 2008

ObjectivesTo determine the effect of long silastic sheet for middle ear aeration in chronic otitis media surgery.MethodsBetween January 2003 and May 2007, 46 patients underwent planned staged canal wall up tympanomastoidetomy, because possibility of residual cholesteatoma and severe swelling middle ear mucosa, especially around the stapes. Long silastic sheet was inserted from mastoid cavity to middle ear via facial recess during operation procedure. To determine the effect of long silastic sheet for recovery of mastoid aeration, various factors such as computed tomography grading, Valsalva maneuver grading for Eustachian function, and hearing result were compared.ResultsDuring the average follow‐up of 31 months, there was 1 recurred chronic otitis media which was revealed tuberculosis otitis media. Intact tympanic membrane was obtained in 45(97.8%) of 46 patients. In CT grading, middle ear aeration was increased significantly (p<0.05). Air‐Bone gap was significantly decreased after staged operation, preoperative average ABG was 29.7dB and last average ABG was 21.0dB (p <0.05). But Eustachian function using Valsalva manerver was not significantly changed (p >0.05).ConclusionsLong silastic sheet insertion from mastoid to middle ear is statistically effective for amelioration of middle ear and mastoid aeration after the first‐stage operation.