bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil‐Derived Metalloproteinase‐9 Predicts Healing Quality after Sinus Surgery
Authors: Watelet J B. , Demetter P , Claeys C , Van Cauwenberge P , Cuvelier C , Bachert C 
Published: February 2009

AbstractBackground: In a recent study, we have shown that gelatinase‐B (metalloproteinase [MMP]‐9) in nasal secretions can have both monitoring and predictive value on the healing outcome after functional endoscopic sinus surgery (FESS) to treat chronic rhinosinusitis (CRS) and nasal polyposis (NP). In this work, we aimed to explore the source of MMP‐9 and the influence of inflammation on MMP‐9 expression and release in nasal tissue and secretions during airway remodelling after surgery.Methods: Biopsies from 23 patients operated by FESS for CRS or NP were collected 1, 3, and 6 months after sinus surgery. MMP‐9 expression in the paranasal mucosa was correlated with healing quality, with MMP‐9 concentrations in nasal fluid, and with histomorphologic findings (edema, fibrosis, αsmooth muscle actin, CD‐68, myeloperoxidase, EG2, and transforming growth factor [TGF]‐β1 stainings).Results: MMP‐9 concentrations in nasal fluid were paralleled by MMP‐9 expression inside the extracellular matrix (ECM) after sinus surgery. MMP‐9 expression in ECM was significantly correlated with healing quality (r = 0.378, P = .0181), and poor healers presented significantly more edema (P < .05). The amounts of MMP‐9 in nasal fluid were significantly and independently predicted by the number of neutrophils (P = .0224) and macrophages (P = .0497) in the tissue. In contrast, MMP‐9 expression was not related to fibrosis, number of myofibroblasts, or TGF‐β1 expression in ECM.Conclusions: MMP‐9 expression is increased in the ECM during wound healing and parallels concentrations of MMP‐9 in nasal fluids. Inflammatory cells represent the major source of increased MMP‐9 expression, which is linked to poor healing quality.
Postoperative Tonsillectomy Bleed: Coblation Versus Noncoblation
Authors: Divi Venu , Benninger Michael 
Published: February 2009

AbstractObjective: To examine the incidence of postoperative bleeding after coblation and noncoblation tonsillectomy and to use postoperative bleeding as an outcome measure to determine the presence of a learning curve with this new surgical technique.Study Design: A retrospective review of records from January 1999 to April 2003 to determine type of tonsillectomy performed and the presence of postoperative bleeding. A chi‐square analysis was used to determine a statistical difference between the postoperative bleed rate of coblation and noncoblation procedures. The examined time period was divided into 3‐month intervals, and the coblation postoperative bleeds were tallied for each interval. The Cochraine‐Armitage test of linear trend was used to assess change in the postoperative bleeds.Results: One thousand seven hundred sixty‐two tonsillectomies were performed. The postoperative bleed rate for noncoblation tonsillectomy was 6.1% (74/1,216). The bleeding rate for coblation tonsillotomy was 5.9% (18/303) and 5.4% (13/239) for coblation tonsillectomy. There was no statistical difference (P = .93) between bleed rates for coblation versus noncoblation techniques. There was no difference in the need for operative intervention to control postoperative bleeding: 16.2% (12/74) for noncoblation technique and 25.85 (8/31) for coblation procedures (P = .25). The postoperative coblation bleed rates for the 3‐month periods did not reveal an increasing or decreasing trend in the postoperative bleed rate (P = .49).Conclusion: Coblation is a safe procedure for performing tonsil surgery with no significant difference in postoperative bleeding from previous techniques and no increased need for operative intervention to control postoperative bleeding. A learning curve could not be identified when using postoperative bleeding as an outcome measure for coblation tonsillectomy.
Combined Microtia and Aural Atresia: Issues in Cochlear Implantation
Authors: Lin Karen , Marrinan Michelle S. , Shapiro William H. , Kenna Margaret A. , Cohen Noel L. 
Published: February 2009

AbstractObjectives: This article presents the first report of cochlear implantation in a patient with congenital aural atresia, microtia, dysplastic cochlea and internal auditory canals, and bilateral profound sensorineural hearing loss (HL). This rare combination requires special management considerations. Preoperative issues include thorough evaluation of computed tomography and magnetic resonance imaging to determine favorable anatomy, cochlear implantation candidacy, and surgical planning. Intraoperative concerns include incision placement, surgical approach to the middle ear, and abnormal facial nerve anatomy. Postoperative use of a special headset combining a microphone and transmitter coil is required.Study Design: Case report and literature review.Methods: The patient's chart was reviewed for diagnostic studies, operative strategy, and postoperative auditory stimulation and testing. A literature review was performed.Results: A 2‐year‐old male presented with bilateral aural atresia, microtia, and profound sensorineural HL. Imaging studies revealed multiple abnormalities of the cochlea, vestibule, and internal auditory canal, all of which were more favorable on the right side. An incision was designed to accommodate future microtia repair. The cochlear implant was placed without difficulty by way of a facial recess approach to the middle ear. Postoperative results include the detection of Ling sounds and voices in the environment as well as the ability to locate sounds.Conclusions: This is the first report of cochlear implantation in a patient with bilateral aural atresia, microtia, and profound sensorineural HL in conjunction with multiple inner ear abnormalities. Close collaboration among the otologist, neuroradiologist, and plastic surgeon is essential to coordinate surgical management and optimize cosmetic and functional outcomes in this unique population.
Development and Maturation of the Pediatric Human Vocal Fold Lamina Propria
Authors: Hartnick Christopher J. , Rehbar Reza , Prasad Vinay 
Published: February 2009

AbstractObjective: To identify characteristic patterns of maturation of the human vocal fold lamina propria as it develops into a mature structure.Methods: Histologic evaluation of sectioned true vocal folds from 34 archived larynges ages 0 to 18 years using hematoxylin‐eosin, trichrome, Alcian blue pH 2.5, Weigert reticular, and Miller's elastin stain.Location: Pathology department at a tertiary care children's hospital.Results: At birth and shortly thereafter, there exists a relative hypercellular monolayer of cells throughout the lamina propria. By 2 months of age, there are the first signs of differentiation into a bilaminar structure of distinct cellular population densities. Between 11 months and 5 years, two distinct patterns are seen: 1) this bilaminar structure and 2) a lamina propria where there exists a third more hypocellular region immediately adjacent to the vocalis muscle (this region is similar to the superficial hypocellular region found just deep to the surface epithelium). By 7 years of age, all of the specimens exhibit this transition between the middle and the deeper layers according to differential density of cell populations. A lamina propria structure defined by differential fiber composition (elastin and collagen fibers) is not present until 13 years of age and then is present throughout adolescence.Conclusions: Using the classic adult model of fiber composition and density to differentiate the layered structure of the lamina propria of the human vocal fold may not adequately allow for a thorough description of the process of maturation and development. Rather, distinct regions of cell density are seen as early as 2 months postpartum, and the model of cellular distribution may serve better to describe the lamina propria as it develops. Cell‐signaling processes that shape the formation of the lamina propria appear to produce layered populations of differential cell density that in turn will later produce differential fiber compositions. Early development therefore can be followed by evaluating the maturation of these differing cell populations. Future studies are needed to quantify these cell distribution patterns, to study the cell signaling processes that trigger this maturation, and to correlate these findings with mechanical modeling.
Circumferential Tracheal Reconstruction for the Functional Treatment of Airway Compromise
Authors: Olias João , Millán Gerardo , da Costa Duro 
Published: February 2009

AbstractObjectives/Hypothesis:The objective was to describe a surgical technique for replacement of long tracheal defects with a totally autologous free prefabricated cutaneous chondromucosal forearm tubular flap, applied to humans.Study Design:Surgical reconstruction of the trachea.Methods:A three‐stage surgery was performed in a 25‐year‐old patient who presented with a long tracheal defect not resolved by previous resection with primary anastomosis and laser surgery.Results:The staged surgery has been well tolerated by the patient, and no problems at all were reported. The postoperative computed tomography scan and the bronchofibroscopy examination of the “neo‐trachea” at 2 and 6 months revealed normal caliber, good healing of the suture lines, absence of crusts or granulation tissue, and a well‐vascularized internal mucosal lining.Conclusion:The modified flap reconstruction technique has the potential to be considered reliable for the definitive circumferential reconstruction of extensive laryngotracheal defects not amenable to being cured by conventional techniques.
Cricopharyngeal Muscle Electromyography in Laryngopharyngeal Reflux
Authors: Celik Münevver , Alkan Zeynep , Ercan Ibrahim , Ertasoglu Hülya , Alkm Canan , Erdem Levent , Turgut Suat , Ertekin Cumhur 
Published: February 2009

AbstractObjectives/Hypothesis: The objective was to determine whether laryngopharyngeal reflux was associated with an electrophysiological abnormality of the main part of the upper esophageal sphincter, namely, the cricopharyngeal muscle, which could be related to laryngopharyngeal reflux symptoms.Study Design: A prospective study of 20 patients with symptoms of laryngopharyngeal reflux.Methods: The diagnosis was based on clinical, laryngoscopic, and ambulatory 24‐hour pH monitoring findings. Double‐probe pH monitoring was performed with placement of the distal and proximal probes 5 cm above the proximal border of the lower esophageal sphincter and 15 cm proximal to the distal probe, in or just beneath the upper esophageal sphincter. Electromyographic recordings were obtained simultaneously on submental and cricopharyngeal muscles during water swallowing. The peak of the submental electromyographic amplitude and its duration was measured using bipolar surface electrodes placed under the chin. The electromyographic features of the cricopharyngeal muscle were investigated by means of concentric needle electrodes inserted percutaneously both in 20 normal subjects and in 20 patients with laryngopharyngeal reflux.Results: All electrophysiological parameters were normal in all of the patients. The durations of foreburst revealed significant correlation with the number of reflux episodes and acid exposure time (P = .026 and P = .044, respectively).Conclusion: The duration of the foreburst correlating with acid exposure time and number of reflux episodes suggested that foreburst duration was extended because of the irritation caused by the acid reflux.
Hush Puppy: A New Mouse Mutant With Pinna, Ossicle, and Inner Ear Defects
Authors: Pau Henry , Fuchs Helmut , de Angelis Martin Hrabé , Steel Karen P. 
Published: February 2009

AbstractObjectives/Hypothesis: Deafness can be associated with abnormalities of the pinna, ossicles, and cochlea. The authors studied a newly generated mouse mutant with pinna defects and asked whether these defects are associated with peripheral auditory or facial skeletal abnormalities, or both. Furthermore, the authors investigated where the mutation responsible for these defects was located in the mouse genome.Methods: The hearing of hush puppy mutants was assessed by Preyer reflex and electrophysiological measurement. The morphological features of their middle and inner ears were investigated by microdissection, paint‐filling of the labyrinth, and scanning electron microscopy. Skeletal staining of skulls was performed to assess the craniofacial dimensions. Genome scanning was performed using microsatellite markers to localize the mutation to a chromosomal region.Results: Some hush puppy mutants showed early onset of hearing impairment. They had small, bat‐like pinnae and normal malleus but abnormal incus and stapes. Some mutants had asymmetrical defects and showed reduced penetrance of the ear abnormalities. Paint‐filling of newborns' inner ears revealed no morphological abnormality, although half of the mice studied were expected to carry the mutation. Reduced numbers of outer hair cells were demonstrated in mutants' cochlea on scanning electron microscopy. Skeletal staining showed that the mutants have significantly shorter snouts and mandibles. Genome scan revealed that the mutation lies on chromosome 8 between markers D8Mit58 and D8Mit289.Conclusion: The study results indicate developmental problems of the first and second branchial arches and otocyst as a result of a single gene mutation. Similar defects are found in humans, and hush puppy provides a mouse model for investigation of such defects.
Overnight Hospital Stay Is Not Always Necessary after Uvulopalatopharyngoplasty
Authors: Spiegel Jeffrey H. , Raval Tejas H. 
Published: February 2009

AbstractObjectives: To determine whether patients with obstructive sleep apnea who undergo uvulopalatopharyngoplasty (UPPP) have a significant incidence of postoperative complications that would justify overnight postoperative observation in the hospital.Study Design: Part 1: review of published medical literature to determine incidence of postoperative complications. Part 2: retrospective review of 117 patients undergoing UPPP with or without additional procedures.Methods: A literature search for existing studies describing the postoperative complications after UPPP for obstructive sleep apnea was conducted. After this, the records of 117 patients who had undergone UPPP at a university‐based medical center during a 5‐year span were reviewed.Results: Respiratory events occur in 2% to 11% of cases. These include airway obstruction (e.g., laryngospasm), postobstructive pulmonary edema (POPE), and desaturation. Airway obstruction occurred in the immediate postoperative setting. POPE was rare and usually occurred within minutes after the conclusion of the surgical procedure. Desaturation could occur at any time, but the severity was usually equivalent to that found on preoperative sleep study. Hemorrhage occurred in 2% to 14% of cases and had a biphasic incidence, occurring either immediately postoperatively or several days after surgery. Depending on definition, hypertension was observed in between 2% and 70% of patients postoperatively. This was most commonly diagnosed and treated in the immediate postoperative setting. In most reports, arrhythmia and angina occurred in less than 1% of cases.Conclusions: The majority of complications after UPPP with or without additional procedures occur within 1 to 2 hours after surgery. Postoperative oxygen desaturation is usually no worse than that that was observed on preoperative polysomnography findings. A 2 to 3 hour observation period may be suitable for patients after UPPP; if a patient experiences no complications and is maintaining adequate oxygenation and analgesia, same‐day discharge from recovery room may be considered.
Telescopic‐Assisted Radiofrequency Adenoidectomy: A Prospective Randomized Controlled Trial
Authors: Shehata Emad M. , Ragab Sameh M. , Behiry Abu Bakr S. , Erfan Fat‐he A. , Gamea Ahmed M. 
Published: February 2009

AbstractObjectives/Hypothesis: The objective was to conduct a prospective randomized controlled trial describing and investigating the efficacy and safety of transoral telescopic‐assisted radiofrequency adenoidectomy in young children.Study Design: Prospective randomized controlled trial.Methods: One hundred twenty patients who were 36 months of age or less and planned to undergo adenoidectomy or adenoidectomy with insertion of tympanostomy tubes were included in the study. Children were prospectively and randomly assigned into two equal treatment groups: the telescopic‐assisted adenoidectomy using radiofrequency curette and the conventional adenoid‐curette adenoidectomy. The main parameters included visual analogue scale score for nasal breathing, amount of blood loss, operating time, completeness of adenoid resection, smoothness of postoperative recovery, and complications.Results: Both groups had a significant improvement in the visual analogue scale score after surgery with no evidence for a significant difference between the conventional adenoid‐curette and radiofrequency groups. The amount of blood lost during radiofrequency adenoidectomy was minimal, with a mean difference of 31 mL and a median difference of 26 mL. There was a tendency for shorter operative time in the radiofrequency group, but this did not reach a statistical significance. No evidence for a significant difference was noticed in the smoothness of postoperative recovery or complication rate.Conclusion: Telescopic‐assisted radiofrequency‐curette adenoidectomy allows removal of huge adenoids completely in a precise, easy, and cost‐effective procedure, with minimal blood loss and short operating time. The use of transoral telescopes provides a clear visualization that helps complete removal of the adenoids, reduction of unnecessary trauma, and effective control of bleeding.
Infectious Complications in Pediatric Cochlear Implants
Authors: Hopfenspirger Michael T. , Levine Samuel C. , Rimell Frank L. 
Published: February 2009

AbstractObjectives: Infectious complications may cause significant delay in cochlear implant device initiation and programming and be a source of additional morbidity. We reviewed our experience with infectious complications in the pediatric age group to determine specific sources that may not be seen in adults.Study Design: A retrospective analysis from a single implant center.Methods: Cases of pediatric cochlear implants were reviewed for data on infectious complications. Complications were identified as “major” or “minor,” “early” or “delayed.” Information was gathered regarding any comorbid, chronic health condition. Data related to the causative organism(s) were collected.Results: Two hundred sixty‐eight cases of pediatric implants were reviewed. Twenty‐two cases were identified (an infection rate of 8.2%), all classified as “major.” The majority, 12, were classified as “delayed” complications. Twenty‐one cases required explantation with 14 successfully reimplanted. Five cases (in 4 patients) or 23% were associated with a specific chronic pediatric condition including two children with tracheostomies. Among implanted children who had chronic health conditions, 42% developed implant‐related infections. Among otherwise healthy implanted children, only 6.6% developed implant‐related infections. Resistant bacterial infections were not identified.Conclusions: Health conditions in the pediatric age group were associated with 23% of our complications, a risk factor not previously identified in the literature. These children, demonstrating seven times the infection rate of healthy children, should be carefully observed postoperatively. Overall, cochlear implantation in children continues to be associated with a low risk of infectious complications.
Thyroid Cancer in Pregnancy
Authors: Fanarjian Nicole , Athavale Sanjay M. , Herrero Nicholas , Fiorica James , Padhya Tapan A. 
Published: February 2009

AbstractWe report a case of papillary thyroid cancer in pregnancy and discuss the various diagnostic and therapeutic challenges inherent to this condition. Several case series are reviewed. In addition, we examine the effect of pregnancy on the development and progression of thyroid malignancy.
Hyaluronan‐Based Scaffolds to Tissue‐Engineer Cartilage Implants for Laryngotracheal Reconstruction
Authors: Weidenbecher Mark , Henderson James H. , Tucker Harvey M. , Baskin Jonathan Z. , Awadallah Amad , Dennis James E. 
Published: February 2009

AbstractObjectives: Donor site morbidity, including pneumothorax, can be a considerable problem when harvesting cartilage grafts for laryngotracheal reconstruction (LTR). Tissue‐engineered cartilage may offer a solution to this problem. This study investigated the feasibility of using Hyalograft C combined with autologous chondrocytes to tissue engineer cartilage grafts for LTR in rabbits.Study Design: Animal study.Methods: Eighteen New Zealand white rabbits underwent LTR: 12 rabbits received autologous tissue‐engineered cartilage grafts and 6 animals, serving as a positive control group, native auricular cartilage. To determine any differences in response to the site of implantation and any potential immune response to the scaffold, a second piece of engineered neocartilage and a non–cell‐loaded scaffold were inserted paralaryngeally into a subset of the rabbits. The rabbits were sacrificed 3, 6, 8, 10, and 12 weeks after the LTR and their larynx examined.Results: None of the 18 rabbits showed signs of respiratory distress. A smooth, noninflammatory scar was visible intraluminally. Histologically, the native auricular cartilage implants showed excellent integration without any signs of inflammation or cartilage degradation. In contrast, all tissue‐engineered grafts and empty scaffolds revealed marked signs of an unspecific foreign body reaction, leading to a complete degradation of the neocartilage, whether implanted para‐ or intralaryngeally.Conclusion: In contrast to the success with which Hyalograft C has been applied in articular defect repair, our results indicate that, in rabbits, Hyalograft C initiates a foreign body reaction if implanted intra‐ or paralaryngeally, leading to cartilage degradation and possible graft failure. These findings suggest limitations on the environment in which Hyalograft C can be applied.