bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Volume Affects Outcomes in Laryngectomy Procedures
Authors: Mast Brenda , Petruzzelli Guy J , Johnson Tricia J 
Published: August 2008

ObjectiveTo determine whether statistical differences occur in total cost, length of stay, ICU days, and surgical complications, depending on the volume of laryngectomy procedures performed.MethodsSecondary laryngectomy data from 108 hospitals participating in the University Health System Consortium was examined. All laryngectomy surgical cases occurring from July 1, 2001, through June 30, 2005, with an ICD‐9 code of 30.3 or 30.4 were analyzed (N=4,551). The cases were divided into 3 categories based on the number of surgical laryngectomy cases performed by hospital. Those volume categories were high, as defined by organizations with 100–233 cases (n=1712); medium, between 60–99 cases (n=1353); and low, between 4–59 cases (n=1458). 4 dependent variables were examined including total cost, length of stay, ICU days, and complications.ResultsThe 4 dependent variables were analyzed for normality by performing a Kolmogorov‐Smirnov test. All 4 variables were non‐normally distributed. A Kruskal‐Wallis test was then performed on each variable to determine if a statistically significant difference appeared between the 3 volume categories. Each variable was found to have statistical significant differences between the groups, with the high volume hospitals having the lowest cost, shortest length of stay, shortest ICU days, and smallest complication rate.ConclusionsThis study showed that hospitals with higher surgeon volume for total laryngectomies had reduced total cost, length of stay, number of ICU days, and complication rate for their patients.
S103 – Mometasone Is Effective With or Without Oral Antihistamines
Authors: Marta Pimentel Joao Antonio 
Published: August 2008

ObjectivesClinical trials have demonstrated the efficacy of monotherapy with intranasal corticosteroids (INSs) for symptoms of allergic rhinitis (AR). ARIA guidelines suggest adding oral antihistamines to INS monotherapy when severe symptoms do not improve. An open‐label multicenter study assessed efficacy and safety of mometasone furoate nasal spray (MFNS) alone or combined with an oral antihistamine in subjects with AR.MethodsSubjects received MFNS 200 mcg QD for 56 days, with an oral antihistamine added at Day 28 or later if baseline symptoms (sneezing, nasal discharge/obstruction, tiredness, irritability) had not improved. Subjects rated individual symptom scores, daily routine and sleep limitations, and product attributes on Days 1, 28, and 56 on a scale of 0 to 10, and completed a compliance questionnaire on Day 56.ResultsMean scores for AR symptoms and limitations on sleep and daily routines significantly improved from baseline to Day 28 and from Day 28 to 56 (P less than 0.001 for all). At Days 28 and 56, 47/60 and 45/56 subjects, respectively, were receiving MFNS monotherapy, and 13 required a concomitant oral antihistamine at Day 28 or later. By Day 56, symptom severity improved in 92% of subjects receiving concomitant therapy. At study end, 88% of subjects reported compliance with QD MFNS. Average product attribute scores ranged from 7.2 to 8.4. No severe adverse events were reported.ConclusionsMFNS 200 mcg QD, alone or combined with an oral antihistamine, was safe and effective against AR nasal symptoms and limitations of sleep and daily activities.
S104 – Treatment of a Brown Recluse Spider Bite to the Face
Authors: Hamming Katherine K. , Hilger Peter A , Boyer Holly 
Published: August 2008

Objectives1) To raise awareness among otolaryngologists about the presentation, complications, and treatment options of brown recluse spider bites. 2) To present a case of a brown recluse spider bite to the face that was treated conservatively and had an excellent aesthetic result.MethodsA 48‐year‐old woman was referred to the otolaryngology clinic with a dermonecrotic wound on the left upper lip from a brown recluse spider bite. The lesion consisted of a 4mm eschar with surrounding erythema, and the necrosis extended almost through the lip, sparing only the oral mucosa. She was given antibiotics and followed clinically. The eschar was left in place without debridement or topical treatments, and it fell off on day 40.ResultsAfter the eschar fell off on its own, the patient was left with complete healing of the necrotic area and a 1mm scar with mild erythema, giving her an excellent aesthetic result.ConclusionsThis case represents conservative management of a self‐limited dermonecrotic lesion of the upper lip that resulted from a brown recluse spider bite. Conservative management should be considered with brown recluse spider bites, especially on the face, which has an excellent blood supply and where good aesthetic outcome is crucial.
S105 – Congenital Absence of the Left Lower Lateral Cartilage
Authors: Karimi Kian , Adelson Robert T , Herrero Nicholas A 
Published: August 2008

ObjectivesReview the embryology of the cartilaginous nasal skeleton. Present an anatomic varient of the nasal skeletal anatomy not previously described.MethodsCase report of an adult patient evaluated for nasal airway obstruction and suspected from clinical exam to have absence of the left lower lateral cartilage. Photographs document this first report of an absent lower lateral cartilage and surgical techniques to reconstitute the nasal tip.ResultsSurgical outcome of open structure rhinoplasty and photographs included. Patient pleased with functional and aesthetic results of procedure.ConclusionsThis previously unreported clinical entity extends the spectrum of congenital abnormalities of the nose and can be addressed successfully with open structure rhinoplasty techniques.
S109 – N‐2 MPG in Groin Flaps Subjected to Vein Occlusion
Authors: Gosselin Benoit J , Davies Louise 
Published: August 2008

ObjectivesIn a prior communication, we showed that ischemic rat groin flaps exposed to the free radical scavenger N‐2 mercaptopropionylglycine (MPG) at the time of arterial and venous occlusion had a higher rate of survival than untreated flaps. In this study, the objective is to test the efficacy and timing of administration of MPG in salvaging rat groin flaps subjected to venous occlusion alone.MethodsRandomized controlled trial. Main outcome is mean percentage of flap survival at 7 days. 30 mature Sprague‐Dawley rats were randomized to 3 groups based on timing of treatment with MPG: 1‐ flap raised, no MPG, no venous occlusion (sham group); 2‐ flap raised, no MPG, 10‐hour period of venous occlusion (control group); 3‐ flap raised, MPG after 10 hours venous occlusion (post‐reperfusion group).ResultsThere was no statistical difference noted in mean survival of venous occluded flaps when comparing the control and post‐reperfusion groups, after 7 days. Specifically, the mean flap survival in the control group at 7 days was 10.9% (median 0%, range 0–100%). The mean flap survival in the post‐reperfusion group was 14.6% (median 0%, range 0–100%). The mean flap survival in the sham group was 90.0% (median 100%, range 0–100%).ConclusionsPost‐reperfusion MPG administration is not helpful for flaps subjected to venous occlusion alone. The free‐radical scavenger activity of MPG is potentiated within the tissues prior to vein occlusion. Potential applications for free flap salvage would need further study.
S110 – Free Tissue Transfer Reconstruction of Fistula after ACDF
Authors: Rossmiller Sarah R. , Ghanem Tamer , Wax Mark K 
Published: August 2008

ObjectivesPharyngeal injury post‐anterior cervical disc fusion (ACDF) repair is a well‐recognized postoperative complication. It can lead to abscess formation, pharyngocutaneous fistula, and esophageal diverticulum. Various reconstructive procedures have been proposed, including primary repair or pedicled muscle flaps. In recalcitant cases, free tissue transfer can be used. We review our experience with patients undergoing free tissue transfer for repair of pharyngeal defects.MethodsRetrospective data review from January 2002 to February 2008 of patients undergoing pharyngeal repair following ACDF surgery.Results5 patients were identified for total of 6 reconstruction procedures. Presentation of the pharyngeal leak occurred from 8 days to 3 years after the ACDF procedure. 3 patients presented acutely with cervical abscesses requiring incision and drainage. 2 patients underwent hardware removal at the time of incision and drainage. 2 patients presented with dysphagia and a contained esophageal diverticulum. 4 of the patients underwent radial forearm fasciocutaneous free flap reconstruction, and 1 underwent anterolateral thigh musculocutaneous free flap reconstruction. One patient had a revision surgery for recurrent fistula formation after radial forearm free flap with rectus free flap reconstruction. There were no immediate postoperative leaks; however, on 1–51 months follow‐up, 4 out of 6 cases developed a diverticulum, with one of them developing a second fistula. 3 out of 5 patients had no evidence of diverticulum or fistula at last follow‐up, for a success rate of 60%.ConclusionsPharyngo‐esophageal perforation following an ACDF approach is difficult to repair even with free tissue transfer.
S112 – Fibula C‐Spine Reconstruction Following Retropharynx Abscess
Authors: Moche Jason , Gastman Brian 
Published: August 2008

Objectives1) Understand the pathogenesis and epidemiology of retropharyngeal abscess. 2) Appreciate the diagnostic dillema and rapid progression of untreated deep neck space infections. 3) Recognize the significance of free vascularized tissue grafting in the acute post‐infection setting of cervical osteomyelitis.MethodsA 42‐year‐old man presented with rapidly progressive odynophagia, respiratory distress, and lower extremity muscle weakness. A large odontogenic retropharyngeal abc‐scess had rapidly progressed to cervical osteomyelitis. Diagnostic imaging revealed C2‐C6 level involvement. A review of the literature reveals the unusual progression of this case.ResultsFollowing drainage, debridement, and anterior as well as posterior stabilization, the patient underwent reconstruction. An early successful second‐stage reconstruction was performed with vascularized free fibula graft. The patient did well postoperatively with resolution of paresis, pain, and airway compromise.ConclusionsWe present the first reported use of vascularized free fibula graft for anterior cervical spine reconstruction from a complicated odontogenic retropharyngeal abscess leading to cervical osteomyelitis. A review of the literature highlights the dangers of untreated deep neck space infections and the role of the reconstructive surgeon in their management.
S114 – Thresholds for Visual Perception of Facial Asymmetry
Authors: Farrag Tarik Y , Chu Eugene , Boahene Kofi , Byrne Patrick 
Published: August 2008

ObjectivesTo determine the degree of facial asymmetry which is required to trigger conscious perception in the observer.MethodsA normal face was manipulated typical to facial paralysis changes, using advanced computer program to create progressive images of increasing asymmetry, in one millimeter increments, up to 10 mm. This was performed on 1) brow, 2) oral commissure, and 3) combined brow and oral commissure. The study included both altered and unaltered versions of the model face, in addition to other unaltered images. Images were presented to volunteer observers unaware of the purpose of the study.ResultsI) Oral commissure asymmetry: the threshold for visual perception was 3 mm by the majority of people (73%) when each image was presented for 10 seconds. When up to 4 mm of mouth angle asymmetry was noticed, it was perceived as “noticeable, but acceptable” by 83%, while 6 mm or greater of asymmetry was perceived as “unacceptable” by 60%. Presenting the images for 2 sec/image (quick look) demonstrated that 53% detected the asymmetry at 5 mm. II) Brow asymmetry: 70% perceived the asymmetry at 3 mm. III) Combined oral commissure and eye brow: 100% of people perceived the oral commissure asymmetry at a lower threshold than the brow asymmetry.ConclusionsThe pilot data and the discussion will provide insight into the processes of visual perception of facial asymmetry, and guidance for surgeons and patients sorting through their options. Further efforts are under way to pursue these concepts in 3‐dimensional, dynamic subjects.
S115 – A New Treatment for Post‐tympanostomy Tube Otorrhea
Authors: Cheng Jeremiah , Cheng David , Rebecca Cheng , Timothy Chen 
Published: August 2008

ObjectivesTo discover whether tubes coated with antibiotic ointment can prevent the complication of post‐tympanostomy tube otorrhea.MethodsRetrospective chart analysis was done of the last 344 consecutive ears for tube surgery without ointment, and tube surgery with ointment, from Dec. 2006 to Oct. 2007. Only surgery using 7mm flouroplastic tubes were reviewed.ResultsA total of 128 ears had no ointment during the operation. Of the 128 ears, 12 ears developed otorrhea within 1 week, or an incidence of 9.4%. A total of 216 ears had antibiotic ointment coated onto the fluoroplastic tube during the operation and at time of tube insertion. Of the 216 ears, 7 ears developed post‐tympanostomy tube otorrhea within 1 week, or an incidence of 3.2%. Our analysis using the chi‐square test was statistically significant, with a p value of 0.02.ConclusionsPost‐tympanostomy tube otorrhea is a frequent complication of tympanostomy tube insertion, but by coating the tube with an antibiotic ointment at the time of surgery, we can decrease that incidence from 9.3% to 3.2%.
S119 – Tongue‐holding Maneuver Studied by High‐resolution Manometry
Authors: Umeki Hiroshi , Takasaki Kenji , Enatsu Kaori , Tanaka Fujinobu , Kumagami Hidetaka , Takahashi Haruo 
Published: August 2008

ObjectivesThis study aimed to investigate the effects of a tongue‐holding maneuver (THM) during swallowing, using a novel high‐resolution manometry (HRM) system.Methods27 asymptomatic adult Japanese controls were studied. A solid‐state HRM assembly with 36 circumferential sensors spaced 1 cm apart was positioned to record pressures during swallowing from the velopharynx to the upper esophagus. The maximum values of the dry swallowing pressures at meso‐hypopharynx, the upper esophageal sphincter (UES) and the mean values at meso‐hypopharynx with and without THM were measured.ResultsThe maximum values of dry swallowing pressures with and without THM were 195.0±77.2 (mmHg, mean ± standard deviation), and 178.1±53.0 at the meso‐hypopharynx, and 213.4±74.0 and 190.0±95.0 at the UES, respectively. The mean values with and without THM at meso‐hypopharynx were 47.4±11.9, and 44.0±11.2, respectively. The maximum value at UES (p=0.0347), and the mean value at the meso‐hypopharynx (p=0.0124) of dry swallowing pressures with THM were significantly higher than those without THM.ConclusionsThese findings indicate that the THM has a potential to facilitate compensatory swallowing power at the pharynx and upper esophagus. HRM will provide us with important information about the swallowing physiology, and pathophysiology along the velopharynx, and upper esophagus.
S122 – Cytotoxic T Lymphocytes Induced by HSCC Ag Derived Peptides
Authors: Peptides Ag Derived , Ono Takeharu , Nakashima Tadashi 
Published: August 2008

ObjectivesPreviously, we attempted to identify SCCA‐derived HLA‐A24 restricted peptides (SCCA112–120 and SCCA215–224) able to induce peptide‐specific CTLs in lung, uterine cervix, and esophageal HLA‐A24 + cancer patients. However, in head and neck HLA‐A24+cancer patients, CTL induction using these peptides has not been investigated. We studied CTL induction by these peptides in head and neck HLA‐A24+ cancer patients.MethodsPeripheral blood mononuclear cells of SCC‐cancer patients or healthy donors were stimulated in vitro with SCCA‐derived peptides, which were prepared based on the HLA‐A24 binding motif. The cytotoxity and peptide‐response to target cells was investigated by both 51Cr release assay and IFN‐gamma production.ResultsSCCA112–120‐specific CTLs were generated in PBMCs from 6 head and neck cancer patients, but not in PBMCs from healthy donors. SCCA215–224 peptide generated CTLs in PBMCs from 5 head and neck cancer patients, but not in PBMCs from healthy donors. SCCA112–120 and SCCA215–224 peptide were able to induce cancer‐reactive CTLs in the peripheral blood mononuclear cells of HLA‐A24+ head and neck cancer patients.ConclusionsThese SCCA‐peptides may thus be useful for specific immunotherapy for HLA‐A24+ head and neck cancer patients.
S123 – New Approaches to Infratemporal Fossa Foreign Body Removal
Authors: Scott Andrew R , Dodson Thomas B , Platt Michael P , Metson Ralph B 
Published: August 2008

Objectives1) To understand indications for removal of foreign bodies (FB) from the head and neck. 2) To be able to describe the use of new surgical technologies for FB removal from the head and neck region. 3) To understand the clinical applications of a novel, minimally‐invasive technique for removal of FB from the infratemporal fossa.MethodsA retrospective review of 2 cases of infratemporal fossa foreign bodies, which were referred to a tertiary care facility for management utilizing a novel transoral, endoscopic, image‐guided approach.ResultsBoth patients presented with pain and trismus following failed attempts to retrieve foreign bodies–1 broken hypodermic needle and 1 torn cottonoid sponge‐through open explorations. Use of endoscopic equipment for visualization and image‐guidance system for precise localization enabled both objects to be removed through a transoral approach. Surgical removal resulted in improvement in pain and trismus in both patients who were discharged within 24 hours.ConclusionsA new approach is now available for the minimally‐invasive retrieval of radio‐opaque foreign bodies in the infratemporal fossa, which avoids the need for extensive surgical dissection or an external incision.
S124 – A New Mucoadhesive Tablet Effective for Xerostomia
Authors: Brama Israel , Zhuang Lei 
Published: August 2008

ObjectivesEvaluate the clinical effectiveness of a new mucoadhesive tablet for treating xerostomia. Xerostomia is not a disease but can be a symptom of certain diseases. It can produce serious negative effects on the patient's quality of life, affecting dietary habits, nutritional status, speech, taste, tolerance to dental prosthesis, and increases susceptibility to dental caries.MethodsOraMoist, a new mucoadhesive tablet, was developed for patients with reduced salivary secretion. As active ingredients, this mucoadhesive tablet comprises of a combination of the natural lubricant tricaprin, xylitol, oral enzymes, buffering compounds, and saliva secretion inducers. 22 xerostomic patients took part in a randomized crossover clinical study using Biotene® mouthwash as a control. Each patient used a single tablet or mouthwash as often as needed during the 6 hours of monitoring. After a washout period of 1 week, each patient received the other treatment. Clinical assessment of xerostomia included evaluation of the saliva flow rate and the Total Xerostomic Score (TXS). Subjective assessment of each treatment was received by using a questionnaire.ResultsPatients treated with OraMoist showed an increase of saliva production of over 50% (p<0.05) compared to 10% among the control group. Both groups reported a statistically significant reduction in xerostomic sensation, but the moisturizing effect of OraMoist lasted longer than that of the mouthwash.ConclusionsIn conclusion, mucoadhesive tablet was superior or equal to Biotene® in improving xerostomia symptoms and in patients’ overall satisfaction.
S131 – Complicated Community‐Acquired MRSA Sinusitis: A Case Series
Authors: Stallworth Christian L , McMains K Christopher , Miller Frank 
Published: August 2008

ObjectivesParticipants should 1) understand the similarities and differences between nosocomial methicillin‐resistant Staphylococcus aureus (MRSA) and its community‐acquired counterpart (CA‐MRSA); 2) recognize MRSA as an evolving member of the bacterial pathogens responsible for acute bacterial rhinosinusitis (ABRS); and 3) raise suspicion of CAMRSA in the differential for cases of progressive sinusitis, with or without complications, despite conventional first‐line antimicrobial therapies.MethodsFollowing the retrospective review of patients presenting to an urban tertiary care institution, those patients presenting with complicated sinusitis were identified. Data collected from chart review included age, sex, presenting signs and symptoms, onset of illness, therapy initiated prior to emergent presentation, operative procedures performed and operative findings, culture organisms and sensitivities, postoperative course, and final outcomes.Results9 patients presented with periorbital complications following an antecedent sinusitis. All 9 patients developed infectious orbital complications including periorbital cellulitis, lid abscess, orbital abscess, and 1 case of ipsilateral blindness. Cultures identified CA‐MRSA as the primary pathogen which was characteristically sensitive only to vancomycin, clindamycin, doxycycline, and trimethoprim/sulfamethoxazole. All patients were treated with vancomycin with subsequent transition to oral antibiotics. In addition, all patients required early surgical intervention to manage their disease.ConclusionsWhile the vast majority of ABRS is easily treated using the guidelines established by the Sinus and Allergy Health Partnership, clinicians should consider CAMRSA sinusitis in those patients who fail to respond or who suffer disease progression. This presentation discusses the diagnosis and treatment of CA‐MRSA sinusitis with emphasis on bacterial resistance and appropriate antibiotic selection.
S132 – Toll‐like Receptors in Salivary Glands
Authors: Dezfoulian Farnaz , Ganesh Joshi Meghnad , Gert Henriksson , Holgersson Suchitra Sumitran , Stjarne Paer , Cardell Lars Olaf 
Published: August 2008

Objectives1) To understand pathophysiology of sialoadenitis. 2) To examine the expression of Toll‐like receptor 1–10 in human salivary glands, focusing on changes induced by sialoadenitis since recent research has given them a key role in the induction of various inflammatory disorders.MethodsBiopsies from parotid and submandibular glands were obtained from patients undergoing surgery due to benign neoplastic tumours or chronic/recurrent inflammation caused by sialolithiasis. In the former, a normal part of the gland was excised as far away from the tumour as possible and was used as control. In the latter, a biopsy was taken close to the centre of the inflammation. The mRNA expression of TLR 1 to 10 was quantified using real‐time polymerase chain reaction and the corresponding proteins were assessed using immunohistochemistry.ResultsA constant expression of TLR 1, 2, 3, and 5 were found in all specimens and an up‐regulation of TLR2 was seen in biopsies from patients with chronic sialoadenitis. The immunohistochemistry revealed moderate expression of TLR 3, 5, and 6 in serous glands and an intense TLR 2 expression in mucous acini.ConclusionsOur results suggest that a TLR‐mediated inflammatory component might be involved in the development of sialoadenitis, perpetuating lymphocytic infiltration and cytokine production.