bluuebunny/crossref_metadata_2025_split huggingface dataset:
Classification System for Results in Eustachian Tube Surgery
Authors: Yanez Carlos , Mora Nallely 
Published: August 2008

ObjectiveTo present a new classification system for reporting results and severity of disease state preoperatively of Eustachian tube (ET) obstructive (ETOD) and non‐obstructive dysfunction (ETNOD) based in numerical scores, and to report the results obtained in 40 patients intervened by the author following this criteria.MethodsA retrospective review of 25 patients was carried out. 20 patients presented obstructive and 5 patients presented non‐obstructive (patulous) Eustachian tube dysfunction. These patients were diagnosed and treated between May 2002 and Dec 2007. Patients with ETNOD received laser endoscopic tuboplasty (LEPT) and in patients with ETOD, a cartilage grafting reconstruction of the antero‐lateral wall of the ET (ETR) was carried out endonasally.ResultsScores from patients were tabulated accordingly. 18 patients (90%) were symptom free, 1 patient (5%) had partial recurrence of symptoms and 1 patient (5%) had a full recurrence of symptoms at the end of the study in the obstructive dysfunction patients. 3 patients (60%) were symptom free, 2 patients (40%) had partial recurrence of symptoms after Eustachian tube reconstruction. Endoscopy, computed tomography, and audiologic results revealed the efficacy or failure of the interventions.Conclusions1) This suggested system could serve as a starting point for Eustachian tube surgeons to develop criteria. It could be adopted if eventually accepted in the field. 2) Results obtained indicate that LEPT is effective in relieving symptoms in selected patients. 3) EPTR for patulous disease may be not effective in some cases. New experiences are further needed.
Nasal Eosinophilia in Septal and Turbinate Surgery Outcomes
Authors: Melkane Antoine E , Abou Hamad Walid M , Akar Ramzi Abi , Moutran Homere , Haddad Amine C 
Published: August 2008

Objective1) Determine the clinical outcome of septal and turbinate surgery. 2)Evaluate the potential predictive value of the nasal mucosal eosinophilia in this outcome.MethodsA retrospective review of all patients who had undergone septoplasty with inferior turbinate reduction for symptomatic nasal obstruction was conducted in our department between September 2004 and September 2005. The Nasal Obstruction and Septoplasty Effectiveness (NOSE) score was used to assess the preoperative status and the postoperative outcome at one year. Nasal congestion, nasal blockage, trouble breathing through the nose, trouble sleeping, and inability to get enough air through the nose during exertion were evaluated. A histological study was undertaken on paraffin embedded surgical specimens, and a mean chorionic eosinophil count per microscopic field (40x) was performed. Patients were classified into 4 categories according to their mean eosinophilic count (<1cell, 1–3cells, 3–5cells, >5cells).Results54 patients were included in the study (35 males and 19 females). The mean age was 31 years. A significant reduction of the NOSE score was noted a year after the intervention (22 vs. 61.7, p<0.0001), with a mean improvement rate of 67.5%. Better outcomes were observed in patients who had lower preoperative NOSE scores (p<0.0001), and lower eosinophil counts (p<0.0001).ConclusionsBoth preoperative NOSE score and histological eosinophilia seem to be major predictive factors of septal and turbinate surgery outcomes.
Novel Approach to the Sphenoid Sinus
Authors: Nogueira Joao‐Flavio , Kalish Larry Hilton , Hermann Diego Rodrigo , Silva Maria , Harvey Richard J , De Arnaldo Silva Vellutini Eduardo , Cassol Stamm Aldo Eden 
Published: August 2008

ObjectiveTransnasal approaches to the pituitary and beyond are increasingly being utilized. Surgical access to the sphenoid sinus is the first step in any of these approaches. In order to allow a binostril approach, the posterior septum is removed, resulting in a large posterior septal perforation. Another consideration in many cases is harvesting material for repair of any cerebrospinal fluid (CSF) leak. We describe a novel endoscopic transseptal approach using a posterior nasal septal mucosal flap that allows a binostril approach for the surgeons, can cover skull base defects, and avoids posterior nasal septal perforations.MethodsRetrospective chart review of endoscopic pituitary surgery patients, in a tertiary referral center between 2006 and 2008, was performed. Relevant post‐operative complications of CSF leak, epistaxis, crusting, synechiae and septal perforation were documented.Results20 consecutive patients undergoing pituitary surgery were reviewed: 12 males and 8 females aged 24 to 76 years old. No early perioperative complications were encountered. Surgical time was not increased. Two minor postoperative complications: 1 epistaxis and 1 partial flap retraction were noted. There were no CSF leaks and no septal perforations.ConclusionsThe approach has the advantage of allowing two surgeons to manipulate surgical instruments and a more robust pedicled flap is raised to assist the closure of a skull base defect. The nasal septal mucosa from one side is preserved, avoiding a nasal septal perforation. There is minimal additional morbidity.
The Role of Frontal Sinus Obliteration in the Era of FESS
Authors: BuSaba Nicolas , Gray Stacey T. 
Published: August 2008

ObjectiveTo determine the current indications for osteoplastic frontal sinus obliteration (OFSO) for the treatment of inflammatory frontal sinus disease.MethodsRetrospective case series from a single tertiary care facility. The medical records of 35 patients who underwent OFSO for chronic frontal sinusitis (n=26) and frontal sinus mucocele (n=9) between 1995 and 2007 were reviewed. Data regarding age, gender, date and nature of previous frontal sinus operation(s), pre‐operative imaging, pre‐operative diagnosis, and operative complications were culled.ResultsThere were 19 males and 16 females with an age range of 19 to 76 years. All patients had pre‐operative sinus CT, while 6 patients had additional MRI. Among the 9 patients diagnosed with frontal sinus mucocele, OFSO was first‐line treatment in 8 and salvage for 2 failed endoscopic masupialization procedures in 1. Among the 26 patients with chronic frontal sinusitis, OFSO was first‐line in 9 and salvage for failed frontal sinus surgery in 17. The failed surgeries were OFSO (n=7), Lynch procedure (n=2), and endoscopic frontal sinus surgery including drill‐out (n=10). Five patients failed multiple previous operations. The failed operations dated from 1 to 33 years prior to the present illness in the case of OFSO, 1 to 4 years in the case of Lynch procedure, and 1 to 7 years in the case of endoscopic frontal sinus surgery. There was one reported complication (orbital hematoma).ConclusionsOFSO remains a key surgical treatment for frontal sinus mucocele, but is used more commonly as a salvage procedure for chronic frontal sinusitis.
Effectiveness of Pillar Implants in Snoring Management
Authors: Clarke Joseph , Gillespie Marion B , Smith Jacob E 
Published: August 2008

ObjectiveDetermine the effectiveness and complications of Pillar implants for snoring management in the course of routine clinical practice.MethodsRetrospective series of adult patients receiving Pillar implants for snoring management between January 2005 and December 2007. Outcomes include procedure‐related complications and patient satisfaction with snoring control.ResultsA total of 58 males and 12 females with an average age of 56 years (range, 33 to 74 years) underwent placement of Pillar implants for socially disruptive snoring. 21 patients were snorers, whereas 49 had mild to moderate degrees of sleep apnea. 41 patients were treated with 3 implants, and 24 patients received 4 or more implants. The procedure was performed in the outpatient setting in 47 cases and in the operating room in 23 cases. Complications included poor placement requiring removal (5 patients), and implant extrusion (4 patients). Complications were more common with implants placed in the OR, compared to the outpatient office (p=0.004). Of the patients with sufficient 3‐month follow‐up, 35/54 (65%) reported reduction in snoring, however only 28/54 (52%) were completely satisfied with the level of snoring reduction. When the satisfied patients were compared to dissatisfied patients, there were no noted differences in mean age, diagnosis of OSA, the use of adjunctive nasal surgery, or the number of implants placed.ConclusionsPillar implants offer satisfactory snoring reduction in approximately 50% of patients. Additional study is needed to determine factors that increase the probability of success. Implants placed under general anesthesia have a higher risk of poor placement and extrusion.
Evaluation of Somnoplasty using Snoring Symptom Inventory
Authors: Srinivasan Venkat R , Low Christopher , Goodyear Paul W A , Derbyshire Steve , Veetil Aneesh 
Published: August 2008

ObjectiveTo assess whether radiofrequency volumetric tissue reduction of the palate can improve patients’ snoring symptoms and quality of life.MethodsA prospective cross‐sectional study was undertaken. Over an 18‐month period, consecutive habitual snorers without sleep apnoea were asked to complete a validated Snoring Symptoms Inventory (SSI) questionnaire before and 3–6 months after radiofrequency surgical treatment. It contained 25 questions on the impact of snoring symptoms, including social, work, physical and emotional aspects. Most patients underwent 2 operations (Somnoplasty® Somnus device) with a 2‐month interval. A scale of 0 (no snoring) to 10(extremely loud snoring) was used to assess partners’ perception of the snoring intensity. Paired T‐test was used to compare the mean difference in the SSI before and after surgery. Partners’ scores were analysed with Wilcoxon signed ranks test.Results26 patients (19 male, 7 female) aged between 33 and 74 (mean=48) were recruited. Preoperative BMI scores ranged from 19 to 35 (mean=28). Pre‐ and postoperative mean SSI scores were 60.5 (SD 12.3) and 42.8 (SD 17.4). The difference between the 2 means is 17.6 (95% Confidence Interval, 11.0 to 24.2), P<0.0001. The median for pre‐ and postoperative partners’ scores is 10 and 5 respectively. and the difference is statistically significant (P<0.0001).ConclusionsRadiofrequency volumetric tissue reduction can improve habitual snorers’ snoring symptoms, snoring‐related quality of life, and partner's perception of their snoring. Long‐term results of this procedure need to be ascertained with further studies.
S101 – Mometasone Reduces Congestion in Acoustic Rhinometry Study
Authors: Frances Salapatek Anne Marie , Patel Piyush , Deepen Patel , Gopalan Gokul Hiremagalur , Varghese Santosh Thomas 
Published: August 2008

ObjectivesIn a double‐blind placebo‐controlled study of ragweed‐sensitive subjects with seasonal allergic rhinitis (SAR), mometasone furoate nasal spray (MFNS) was evaluated for improvement in nasal congestion, reportedly the most bothersome symptom of SAR.MethodsOn Day 1, 310 subjects were exposed to ragweed pollen in an environmental exposure chamber (EEC) for 2 hours pre‐dose, given MFNS 200 mcg or placebo, and studied for 6 hours post‐dose. Acoustic rhinometry (AcR) was used to measure congestion before and after exposure. Subjects (n=155) who received MFNS or placebo for 7 additional days returned to the EEC on Day 8 for 4 additional hours of pollen exposure at 24, 26, and 28 hours post‐dose.ResultsOn Day 1, after 2 hours of EEC exposure pre‐dose, minimal cross‐sectional areas (MCAs) of each nostril measured with AcR decreased significantly for all subjects. At 6 hours post‐dose, MFNS significantly reduced congestion (increased nasal patency) vs. baseline (P equal to/less than 0.00001) and placebo (P equal to 0.005). On Day 8, MFNS significantly decreased congestion vs. placebo pre‐EEC pollen exposure (P equal to 0.04) and at 2 and 4 hours (P equal to 0.01 and 0.0008, respectively). MFNS protected subjects against nasal congestion throughout EEC pollen exposure on Day 8, while congestion continued to increase in subjects receiving placebo.ConclusionsA single treatment of MFNS demonstrated significantly reduced nasal congestion, as assessed by AcR, a sensitive, objective measure of nasal patency. MFNS effectively reduced allergen‐induced nasal congestion, even at trough levels.
S113 – Facial Suspension & Free Flaps in Composite Parotid Defects
Authors: Skoner Judith M , Buchmann Luke , Hornig Joshua , Lentsch Eric J , Gillespie M. Boyd , Farrar Joshua , Day Terry 
Published: August 2008

Objectives1) Study efficacy of 2 methods of immediate static facial suspension after total composite parotidectomy, facial nerve sacrifice & free flap reconstruction. 2) Compare these regarding outcomes & patient satisfaction.MethodsRetrospective review 2005–08 of all patients at academic tertiary referral center with advanced H&N malignancy necessitating extirpation, including parotidectomy, CN‐VII sacrifice, and microvascular reconstruction. Ipsilateral face addressed simultaneously with either acellular human dermal allograft (AHDA) ‘sling’ or suture suspension (SS). Follow‐up 2–18 months. Outcomes assessed: suspension status (commissure symmetry 1–4 complete ptosis), overall aesthetics (excellent 1–4 unsatisfactory), oral competence (no drooling 1–3 constant drooling) and patient/family satisfaction scores (very satisfied 1–4 very dissatisfied).Results9 patients underwent extirpation, CNVII sacrifice, fasciocutaneous microvascular reconstruction (forearm, ALT or parascapula) and facial suspension. 8 received postoperative radiation; 1 expired. 2 underwent AHDA facial ‘slings.’ 7 underwent SS using polybutilate‐coated braided polyester (Ethibond Excel). Both techniques used 3 distal suspension sites (nasolabial crease, upper/lower commissure) and proximal zygomatic stablization. Suspension grades were 1–3 for AHDA, 1–2 for SS; aesthetic 2–3 for AHDA, 1–3 for SS; competence 2 for AHDA, 1–2 for SS; satisfaction 1–2 for AHDA, 1–2 for SS.ConclusionsFacial nerve rehabilitation in post‐extirpative oncologic setting remains challenging for optimizing function/aesthetics. In our series of patients undergoing extensive resection with facial nerve sacrifice and free flap reconstruction, suture suspension provided slightly better oral symmetry and overall aesthetics compared to AHDA ‘sling’ suspension. Patient satisfaction was high in both groups. Long‐term follow‐up and greater sample size are needed to determine if any observed advantage is real and sustained.
S117 – Gastropharyngeal Reflux and Eustachian Tube Dysfunction
Authors: Georges Eter Elias , Matar Nayla E , Haddad Amine C 
Published: August 2008

ObjectivesDetermine the response of gastropharyngeal reflux (GPR) in the pathogenesis of Eustachian tube dysfunction (ETD) in adults, using a therapeutic trial.Methods18 adult outpatients with symptoms of ETD (associated or not to GPR symptoms) were randomized into two groups: The first group received nasal corticosteroids and Rabeprazole 20mg once daily for 6 weeks. The second group received nasal corticosteroids and placebo for 6 weeks. Symptoms’ severity was evaluated before and after treatment by a tympanometry and a self‐administered questionnaire of 7 items focusing on the severity of ETD. Each of the items was scored on a numeric scale. The local ethics committee approval was obtained and patients signed an informed consent before their participation in the study that was conducted between November 2002 and May 2003.Results8 patients were on Rabeprazole, 10 were on placebo. Patients in the 2 groups were comparable for all the variables except for the severity of symptoms. On enrollment, patients under Rabeprazole had more severe symptoms than those under placebo (SR = 12.4, SP = 7.15 with p = 0.035). At the end of the trial, the improvement of the symptom score under Rabeprazole was significantly higher than that of patients under placebo, using the Mann Whitney test (SR’ = 6.13, SP’ = 11.56 with p = 0.026).ConclusionsBy showing a significant improvement of ETD symptoms in patients under Rabeprazole compared to controls, this study suggests the response of GPR in the pathogenesis of ETD, but larger studies are needed.
S120 – Healthcare‐Associated Infections Can Be Reduced
Authors: Stalfors Joacim 
Published: August 2008

ObjectivesThe WHO states that nosocomial infections occur in 9% of all patients and this mean figure has been confirmed at our hospital. As a result, a project was started, designed to reduce the number of patients with healthcare‐associated infections by means of improved compliance with hygiene guidelines (working clothes and hand hygiene). This prospective study assessed the frequency of healthcare‐associated infections and compliance with hygiene guidelines at an regional ENT ward. At intervention, information was given repeatedly about the current guiding principles, and equipment for hygiene, such as antiseptics, gloves, and aprons, was made more accessible.MethodsHealthcare‐associated infections were assessed by questionnaires sent to a random sample of patients. Compliance with hygiene guidelines was assessed by randomly spot‐checking co‐workers. Assessments were performed before, during, and 6 months after intervention.ResultsHealthcare‐associated infections were registered in 9/67 (13.4%) of the patients before intervention. The rate of correct hand hygiene or clothing was 30% and 50% respectively. After 3 months of intervention, the guidelines for hand hygiene and clothing were followed by 80% and 90% respectively. The healthcare‐associated infections were reduced to 5/66 (7.6%). When repeating the assessment 6 months later, the healthcare‐associated infections were 13/193 (6.7%) and compliance with hand hygiene and clothing was 60% and 75% respectively.ConclusionsBy stressing the guiding principles for hygiene, the frequency of healthcare‐associated infections can be reduced. This reduction was not statistically significant (p=0.15).
S127 – Idiopathic Facial Nerve Paralysis: Analysis of 3T MRI Images
Authors: Mowry Sarah , Kirsch Claudia 
Published: August 2008

Objectives1) To describe the findings on 3 Tesla (T) MRI in patients with idiopathic facial nerve paralysis (IFP). 2) To compare 3T MRI and 1.5 T MRI images of the facial nerve in patients with and without facial paralysis.MethodsA retrospective review of 3T MRI image from 2005–2008 for temporal bone imaging revealed 123 patients; 4 patients underwent imaging for facial paralysis. Images from 3T MRI and 1.5T MRI for these 4 patients were retrospectively assessed by a board‐certified neuroradiologist and otolaryngologist blinded to the affected side and compared to normative controls.ResultsAll patients with facial palsy demonstrated significant enhancement of the affected nerve on post‐gadolinium T1 weighted images. In 3 patients with residual facial weakness (>12 months) demonstrated facial nerve enhancement at the geniculate ganglion and descending portions. In 1 patient, despite resolution of IFP, the nerve continued to enhance at the geniculate ganglion and descending portion of the facial nerve compared to the contralateral nerve. The 3T MRI images demonstrated improved visualization of the entire course of the facial nerve in both normal and IFP patients. Interestingly, in both normal and affected patients, the uninvolved facial nerve also demonstrated slight contrast enhancement throughout its entire course, although not as pronounced as the affected side.Conclusions3T imaging provides significantly improved visualization of the temporal facial nerve in both normal and patients with IFP. Gadolinium enhanced 3T imaging allowed better anatomical delineation of both normal and affected facial nerves when compared to 1.5T MRI.
S129 – Analysis of Fine Needle Biopsy for Malignant Lymphoma
Authors: Ashimori Naoki , Mineta Hiroyuki , Tsurita Minako 
Published: August 2008

ObjectivesTo review fine‐needle aspiration biopsy‐(FNAB) diagnosis of malignant lymphoma retrospectively to determine the diagnostic accuracy and pitfalls.Methods68 cases of malignant lymphoma and 52 cases of non‐malignant lymphoma were identified between 1997 and 2004. All cases were recognized as cervical lymphadenopathy and evaluated by FNAB. Open biopsies were also performed to obtain final diagnoses. Malignant lymphomas were subclassified according to World Health Organization classifications. We compared the FNAB and final diagnostic results to determine the diagnostic accuracy and examine the false negative cases.Results41(60%) cases had a positive diagnosis of malignant lymphoma, 21(31%) had a suspicious diagnosis, and 6(9%) had a false negative diagnosis. On histological examinations, diffuse large B cell lymphomas yielded a high positive diagnosis, whereas follicular lymphoma and Hodgkin's disease had less positive diagnosis and there were also false negative cases. 14(39%) lymphadenitis cases had a suspicious diagnosis and some cases were difficult to differentiate from malignant lymphoma.ConclusionsFNAB is considered a useful and efficient method of estimating malignant lymphoma but diagnostic accuracy varied among lymphoma subtypes. We should remain aware of the existence of false negative cases when using this diagnostic method.
S130 – Otolaryngologic Manifestations in Penphigus Vulgaris
Authors: Fernandez Secundino , España Agustín , San Miguel David Ruba , Marquina Miren 
Published: August 2008

ObjectivesPemphigus vulgaris is an autoimmune disease characterized by mucocutaneous intraepithelial blisters and pathogenic autoantibodies against desmoglein 3. There are 2 clinical forms: mucosal and mucocutaneous. The frequency of ear, nose and throat involvement in pemphigus vulgaris is not clearly defined. Only a few individual cases have been reported. The objective of this study was to determine the incidence of otolaryngologic involvement in patients with pemphigus.MethodsWe have studied prospectively all 18 patients diagnosed with PV and treated by Otolaryngology and Dermatology departments of the University Hospital of Navarra between 2001 and 2007. They were 10 cases of mucosal pemphigus and 8 cases of mucocutaneous pemphigus. All patients were evaluated by endoscopic examination.Results15 patients presented with throat symptoms (83%), 13 pharyngeal (72%), and 8 laryngeal symptoms (44%). 16 patients (88%) had active pemphigus vulgaris lesions localized in pharyngeal and laryngeal mucosa. Laryngeal lesions were most commonly present in mucocutaneous patients. The frequency of nasal symptoms (38%) was lower than active pemphigus vulgaris lesions (63%). Oral symptoms and oral active lesions were the most frequent findings (94%). Only in 3 patients were sown erosions on the external auditory canal.ConclusionsEndoscopic evaluation in patients affected by pemphigus vulgaris allows to study more extensive areas of mucosa. By obtaining more complete information concerning the extent of the disease, a more accurate diagnosis can be made, better choice of drug and dose may be decided, and ultimately, response to treatment may be improved.