bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic endonasal surgery for petrous apex lesions
Authors: Zanation Adam M. , Snyderman Carl H. , Carrau Ricardo L. , Gardner Paul A. , Prevedello Daniel M. , Kassam Amin B. 
Published: January 2009

AbstractBackground:Endoscopic endonasal approaches to the ventral skull base are categorized based on their orientation in coronal and sagittal planes. For all of these approaches, the sphenoid sinus is the starting point, and provides orientation to important vascular and neural structures. Surgical approaches to the petrous apex include 1) a medial approach, 2) a medial approach with internal carotid artery (ICA) lateralization, and 3) a transpterygoid infrapetrous approach (inferior to the petrous internal carotid artery). The choice of a surgical approach depends on the relationship of the lesion to the internal carotid artery (medial or inferior), degree of medial expansion, and pathology. The purpose of this paper is to discuss the anatomic and technical features of endoscopic surgical approaches to the petrous apex, provide a new classification for approaches that focuses on the relationship of the lesion to the petrous internal carotid artery, and provide outcomes data on our first 20 endoscopic petrous apex approaches.Methods:A retrospective clinical outcome study of endoscopic petrous apex surgeries was performed at the University of Pittsburgh Medical Center. The medical records from patients with endoscopic endonasal approaches to isolated petrous apex lesions were reviewed for demographics, diagnoses, presentation, endoscopic approach, and clinical outcomes. Patients with lesions that extended into the petrous apex but were not isolated to the petrous apex were excluded (e.g., clival chordoma with extension into the petrous apex).Results:Twenty patients were included in the analysis: 13 inflammatory cystic lesions (9 cholesterol granulomas and four petrous apicitis) and 7 solid lesions. Chondrosarcoma was the most common solid petrous apex lesion in our series. Twelve of 13 cystic lesions were drained endoscopically (one surgery was aborted early in the series). All drained patients had resolution of presenting symptoms. One patient had closure of the outflow tract without return of symptoms and one patient had revision endoscopic drainage due to scarring and neo‐osteogenesis and return of unilateral headache. No carotid injuries and no new cranial neuropathies occurred perioperatively. The advantages and limitations of the medial transsphenoidal approaches (with and without carotid mobilization) and the transpterygoid infrapetrous approach are discussed.Conclusions:The endoscopic endonasal approach to petrous apex lesions is safe and effective for appropriately selected patients in the hands of experienced endoscopic skull base surgeons. If offers advantages of removing the hearing and facial nerve risks from the transtemporal/transcranial approaches and allows for a larger and more natural drainage pathway into the sinuses. Laryngoscope, 119:19–25, 2009
Control of vocal fold cover stiffness by laryngeal muscles: A preliminary study
Authors: Chhetri Dinesh K. , Berke Gerald S. , Lotfizadeh Ali , Goodyer Eric 
Published: January 2009

AbstractObjectives:To perform preliminary measurements of the shear modulus of the vocal fold cover layer during intrinsic laryngeal muscle contraction.Study Design:Shear modulus was measured in an in vivo canine larynx and an ex vivo human larynx.Methods:Shear stress was applied to the transverse axis of the vocal fold using a modified linear skin rheometer (LSR) via an attached suction probe. The probe displacement in response to the applied force was measured at various levels of laryngeal muscle contraction. The force‐displacement data were used to derive the shear modulus using a simple shear model. In the ex vivo human larynx, lateral cricoarytenoid (LCA) muscle and cricothyroid (CT) muscle activity was simulated with arytenoid adduction and cricothyroid approximation sutures, respectively. In the in vivo canine, adductor muscle and CT muscle contraction was induced with graded stimulation of the recurrent laryngeal nerve (RLN) and the superior laryngeal nerves (SLN), respectively.Results:Baseline shear modulus was between 1,076 and 1,307 Pascals. In the ex vivo human larynx, the shear modulus increased gradually to a maximum of 1.6 times baseline value with graded arytenoid adduction and 3.7 times baseline value with cricothyroid approximation. In the in vivo larynx, the shear modulus increased to a maximum of 1.6 times baseline value with RLN stimulation and 2.5 times baseline value with SLN stimulation.Conclusions:Findings are in agreement with the cover‐body model in that cricothyroid muscle activity generates a greater change in cover stiffness than laryngeal adductors. The role of the individual laryngeal adductors (thyroarytenoid [TA] vs. LCA) in control of vocal fold cover stiffness remains to be further elucidated. Laryngoscope, 119:222–227, 2009
Application of the vibrant soundbridge® to unilateral osseous atresia cases
Authors: Frenzel Henning , Hanke Frauke , Beltrame Millo , Steffen Armin , Schönweiler Rainer , Wollenberg Barbara 
Published: January 2009

AbstractObjectives/Hypothesis:Patients with high‐grade atresia‐microtia suffer from a combined malformation of the outer and middle ears, typically leading to a severe hearing impairment. Long‐term results of middle ear reconstruction with tympanoplasty are often insufficient due to persistent air‐bone gaps, and new techniques in hearing rehabilitation are required. The objective of this research is to evaluate the active middle ear implant, the Vibrant Soundbridge® (VSB), for hearing rehabilitation of patients with unilateral osseous aural atresia.Study Design:Prospective analysis of a consecutive cohort of seven atresia patients (mean age = 15 years).Methods:During plastic auricular reconstruction of unilateral atresia‐microtia cases, an access through the bony atresia plate was drilled. The floating mass transducer was coupled to the stapes (or remaining stapes suprastructure), ossicular chain, or round window, depending on the anatomic needs of the patient. Audiometric testing, including pure‐tone thresholds, and speech testing in quiet and noise were performed.Results:The mean threshold with the VSB activated in the free field warble tone audiometry was 23.8 dB hearing level (HL). Mean functional gain was 45.5 dB HL. Mean aided free field speech discrimination in quiet was 64% at 50 dB, 99% at 65 dB, and 100% at 80 dB.Conclusions:By circumventing the malformed middle ear and directly stimulating the cochlea, the VSB provides a new rehabilitation option for atresia patients. We conclude that the procedure is safe and effective and can be implemented in combination with outer ear reconstruction. Laryngoscope, 119:67–74, 2009
Maxillary mucosal cyst is not a manifestation of rhinosinusitis: Results of a prospective three‐dimensional CT study of ophthalmic patients
Authors: Kanagalingam Jeeve , Bhatia Kunwar , Georgalas Christos , Fokkens Wytske , Miszkiel Katherine , Lund Valerie J. 
Published: January 2009

AbstractBackground:Mucosal cysts in the maxillary antrum (MMC) are a common finding in imaging of the paranasal sinuses. Their significance remains in doubt and their prevalence in the general nonrhinitic population is unknown.Objectives:To establish the prevalence of MMCs in patients without nasal complaints and identify any association with putative causative factors. To identify any correlation between objective radiologic evidence of chronic rhinosinusitis or dental disease and the presence of cysts.Study Design:Prospective case series.Methods:Computed tomography (CT) images from 257 patients undergoing scans of the orbits for ophthalmic reasons were entered into this study. Patients responded to a questionnaire prior to scanning inquiring about nasal complaints, treatment for nasal disorders, previous nasal injury, allergy, asthma, recent upper respiratory tract infection, and dental root disease of the upper jaw.Results:Overall 35.6% of patients studied had radiologic evidence of at least one maxillary mucosal cyst. There was no association between the presence of cysts and subjective or objective evidence of sinus or dental disease. Specifically, there was no correlation between the presence of cysts and the total and ostiomeatal complex Lund‐Mackay radiologic scores.Conclusions:Maxillary mucosal cysts are prevalent in nonrhinitic patients and do not reflect sinus or dental disease. Their presence should not be an indication for sinus surgery. Laryngoscope, 119:8–12, 2009
EMLA® Cream coated on the rigid bronchoscope for tracheobronchial foreign body removal in children
Authors: Yu Hai , Yang Xiao‐Yun , Liu Bin 
Published: January 2009

AbstractObjectives:Removal of a tracheal or bronchial foreign body is a common emergent surgical procedure in children. The anesthetic management can be challenging. EMLA® Cream (EC) has been widely used to provide topical anesthesia. In the present study, we evaluate the efficacy and safety of EC coated on the rigid bronchoscope for tracheobronchial foreign body removal in children undergoing intravenous anesthesia with spontaneous ventilation.Study Design:The authors conducted a randomized, double‐blind, placebo‐controlled clinical trial.Methods:Thirty patients were randomized to receive either EC or placebo (lubricant ointment) coated on the rigid bronchoscope. Intravenous anesthesia and spontaneous ventilation were performed in all patients. Heart rate, blood pressure, pulse oxygen saturation (SpO2) and frequency and degree of breath holding were recorded. After surgery, the bronchoscopist rated overall surgical manipulation as excellent, fair, and poor. The durations of postoperative care were also recorded.Results:Episodes of oxygen desaturation (SpO2 < 90%) occurred in 3/15 (20%) patients in the EC group and in 9/15 (60%) patients in the control group (P < .05). Occurrences and degrees of breath holding were less in the EC group than that in the control group (P < .05). Ranks of surgical manipulation were excellent in 80% of patients in the EC group versus 13% of patients in the control group (P < .05). The durations of postoperative care were shorter in the EC group than that in the control group (P < .05).Conclusions:EC coated on the rigid bronchoscope combined with intravenous anesthesia could provide more efficacious and safer anesthesia for tracheobronchial foreign body removal in children under spontaneous ventilation. Laryngoscope, 119:158–161, 2009
Long‐term outcomes of intraoral submandibular stone removal in children as compared with adults
Authors: Woo Seung Hoon , Jang Jeon Yeob , Park Ga Young , Jeong Han‐Sin 
Published: January 2009

AbstractObjectives:To investigate the long‐term outcomes of intraoral submandibular stone removal in children as compared with those in adult patients.Study Design:Retrospective clinical review.Methods:We retrospectively analyzed the medical records of 17 children and 48 adult patients who had undergone intraoral stone removal for submandibular sialolithiasis and followed up for more than 24 months. The mean durations of follow‐up were 43.4 months and 49.4 months for children and adults, respectively. The long‐term outcomes were compared between the two age groups.Results:Intraoral submandibular stone removal achieved the status of “symptom‐free” in 82.4% of child and 83.3% of adult patients. Recurrence in the affected gland was not found in any children but was found in two adult patients (4.2%). In pediatric patients with calculi around the hilum, a higher incidence (50%) of having long‐term complaints was noted as compared with cases with calculi in the proximal and distal duct (P = .029). However, this difference was not evident in adult patients.Conclusions:Intraoral removal of submandibular stones is an effective treatment option with an acceptable long‐term outcome for children. Nevertheless, in cases with calculi around the hilum, a careful surgical approach is required. Laryngoscope, 119:116–120, 2009
Efficacy and safety of OK‐432 immunotherapy of lymphatic malformations
Authors: Smith Mark C. , Zimmerman M. Bridget , Burke Diane K. , Bauman Nancy M. , Sato Yutaka , Smith Richard J. H. ,   the OK‐432 Collaborative Study Group
Published: January 2009

AbstractObjectives:To determine the efficacy and safety of the immunostimulant OK‐432 (Picibanil) as a treatment option in the management of children with cervicofacial lymphatic malformations.Study Design:A prospective, randomized, multi‐institutional phase II clinical trial at 27 U.S. academic medical centers.Methods:182 patients with lymphatic malformations (LM) were enrolled between January 1998 and November 2004. Of the 151 patients with complete case report forms, 117 patients were randomized into immediate or delayed treatment groups; 34 patients were nonrandomized and assigned to the open‐label group. Treatment consisted of a four‐dose intralesional injection series of OK‐432 at eight‐week intervals. Patients randomized into the delayed treatment group served as observational controls for spontaneous regression. Response to therapy was measured radiographically by quantitating change in lesion size and graded as complete (90%–100%), substantial (60%–89%), intermediate (20%–59%), or none (<20%).Results:Of 117 patients randomized with intent‐to‐treat, 68% demonstrated a complete or substantial response to OK‐432 immunotherapy. Response data for macrocystic LM were higher, with a complete or substantial response in 94% of patients; 63% of patients with mixed macrocystic‐microcystic LM responded to treatment; no patients with microcystic LM responded to treatment. Spontaneous resolution occurred in less than 2% of patients. Median follow‐up of 2.9 years demonstrated a 9% recurrence rate. Major adverse effects related to therapy occurred in 11 patients. As compared to historical surgical data on LM, OK‐432 immunotherapy is more effective (P < .001) and has a lower morbidity (P < .001).Conclusions:OK‐432 immunotherapy is an effective, safe, and simple treatment option for the management of macrocystic cervicofacial LM.Trial Registration:ClinicalTrials.gov Identifier: NCT00010452. Laryngoscope, 119:107–115, 2009
Glossopharyngeal schwannomas: A 100 year review
Authors: Vorasubin Nopawan , Sang U Hoi , Mafee Mahmood , Nguyen Quyen T. 
Published: January 2009

AbstractObjectives:To review the literature on glossopharyngeal schwannomas with a focus on clinical presentation, radiologic/audiologic characteristics, and management options, and to propose a mechanism explaining the nature of vestibulocochlear dysfunction seen with these tumors.Study Design:Contemporary review.Methods:English literature search for cases of primary isolated glossopharyngeal schwannomas and chart review of two new cases.Results:A total of 42 glossopharyngeal schwannoma cases between 1908–2008 were reviewed. Of these 84% presented with vestibulocochlear symptoms whereas only 30% presented with glossopharyngeal symptoms. Tumors can occur anywhere along the CNIX; however, the majority of symptomatic cases are intracranial/intraosseous, which present with vestibulocochlear dysfunction. Reviewed cases typically described the caliber of CNVII and VIII on CT/MRI as normal. We present a case where notching and displacement of CNVIII by the tumor can be appreciated on MRI, allowing for the first correlation between clinical symptoms and imaging findings. Mid frequency SNHL was prevalent in contrast to the high‐frequency pattern typical of vestibular schwannomas. Tonotopic studies of CNVIII mapped low‐to‐mid frequency fibers along the posterior medial surface corresponding to the area of greatest compression by glossopharyngeal schwannomas.Conclusion:Glossopharyngeal schwannomas usually present with vestibulocochlear rather than glossopharyngeal symptoms, likely due to CNVIII compression and displacement by tumor, which can be better appreciated with modern imaging. The tumor's location posterior and medial to CNVIII combined with the complex CNVIII tonotopic organization may account for the preferential mid‐frequency hearing loss seen in these patients. Laryngoscope, 119:26–35, 2009
IgE response to staphylococcal enterotoxins in adenoid tissues from atopic children
Authors: Shin Seung‐Youp , Choi Gil‐Soon , Lee Kun‐Hee , Kim Sung‐Wan , Cho Joong‐Saeng , Park Hae‐Sim 
Published: January 2009

AbstractObjectives/Hypothesis:To evaluate local production of staphylococcal superantigen (SAg)‐specific IgE in adenoid tissue and to compare its prevalence with that in the tonsil and serum, as well as its relationship with markers of allergic inflammation within adenoid tissue.Study design:Prospective randomized study.Methods:We recruited 18 atopic children who had rhinitis symptoms and were sensitized to more than one common aeroallergen, and 22 nonatopic children undergoing adenotonsillectomy. Immunoassays were performed using adenoid tissue homogenate to quantify the levels of three staphylococcal SAg‐specific IgE (SEA, SEB, and TSST‐1), total IgE, eosinophil cationic protein (ECP), mast cell tryptase, and soluble CD23.Results:Three kinds of SAg‐specific IgE were detected in the adenoid and tonsil tissues of atopic patients, but not in those of nonatopic patients. In atopic children, the prevalence of SEA‐, SEB‐, and TSST‐1‐specific IgE in adenoid tissues (61.1%, 27.8%, 33.3%, respectively) were higher than those in tonsil tissues (38.9%, 5.6%, 11.1%, respectively) and in sera (11.1%, 27.8%, 16.7%, respectively). Subjects with high SEA levels showed significantly higher serum and adenoid total IgE, with higher eosinophilia. Significant correlations were noted between SAg‐specific IgE levels and tryptase levels in adenoid tissue.Conclusions:Local specific IgE response to staphylococcal SAgs, especially SEA may contribute to ongoing allergic inflammation in adenoid tissue from atopic children. Laryngoscope, 119:171–175, 2009
Reflux as a cause of tracheoesophageal puncture failure
Authors: Pattani Kavita M. , Morgan Matthew , Nathan Cherie‐Ann O. 
Published: January 2009

AbstractObjective:To evaluate the response to empiric reflux management in treatment of tracheoesophageal punctures (TEP) failures.Methods:A retrospective chart review of patients with failed TEP was performed (n = 37). Only those patients without any documented anatomic cause for failure (n = 22) were then further reviewed to determine if empiric treatment for reflux improved voicing. Evidence of reflux was determined by either using video flexible scope of the neopharynx, barium swallows, 24‐hour pH probes, and /or transnasal esophagoscopy (TNE). In 13 of 22 patients who had voicing difficulties and no evidence of reflux on these tests, empiric treatment with antireflux medications had been documented. The 22 patients were closely monitored to determine the role of reflux therapy and subsequent voicing outcomes.Results:Of the 22 patients studied, 9 were noted to have granulation tissue on the tracheal side of the prosthesis. All nine patients had complete resolution of the granulation tissue after antireflux treatment, and seven of nine were able to voice again. Of the patients with no obvious reason for TEP failure who were empirically treated for reflux, 62% (8 of 13) had TEP voice after treatment. Seventy‐seven percent of our patients (17 of 22) had a positive response to treatment with aggressive reflux therapy.Conclusions:Previous studies have demonstrated patients with a total laryngectomy and/or radiation therapy have increased reflux. This study addresses reflux as a potential cause of TEP voicing problems. We noted 41% (9 of 22) of patients with voicing difficulties had granulation tissue surrounding the prosthesis as a result of reflux. Aggressive antireflux therapy proved beneficial in eradicating this problem. Prophylactic antireflux therapy may be warranted for patients undergoing TEP to reduce voicing problems. Laryngoscope, 119:121–125, 2009
EGFR expression in primary squamous cell carcinoma of the thyroid
Authors: Long Jennifer L. , Strocker Ali M. , Wang Marilene B. , Blackwell Keith E. 
Published: January 2009

AbstractWe present the case of a 57‐year‐old male with primary squamous cell carcinoma of the thyroid (PSCCT). Epidermal growth factor receptor (EGFR) staining was strongly positive. Pharmaceuticals targeting EGFR may provide an additional therapeutic option for this rare disease with extremely poor prognosis. Laryngoscope, 119:89–90, 2009
Drilling speaking valves: A modification to improve vocalization in tracheostomy dependent children
Authors: Brigger Matthew T. , Hartnick Christopher J. 
Published: January 2009

AbstractPediatric tracheostomy dependence is associated with a variety of sequelae. Vocalization delay is commonplace and may result in long‐term communication disability. Passy‐Muir speaking valves are routinely used to allow such children to vocalize. Unfortunately, not all tracheostomy dependent children can tolerate the placement of a speaking valve. Elevated transtracheal pressures are often associated with failure. We describe a method of modifying a standard Passy‐Muir valve to decrease transtracheal pressures and thus improve tolerance of the valve. In our practice, the modification allows a broader range of children experience the benefit of speaking valve placement. Laryngoscope, 119:176–179, 2009
Prolonged stenting of the frontal sinus
Authors: Orlandi Richard R. , Knight Jesse 
Published: January 2009

AbstractObjectives:Stenting of the frontal sinus outflow tract is occasionally used following surgery to prevent stenosis. The optimal length of stent retention has not been defined and some experts advocate up to 6 months prior to removal. The tolerance of even longer periods of stenting is unknown.Study Design:Retrospective review.Methods:We identified adult patients in a tertiary rhinology practice with frontal sinus stents placed between July 2000 and December 2006 and in place at least 6 months. Length of stenting and condition at last follow‐up were determined.Results:During the 6‐year study period, 10 frontal sinus stents were placed out of over 450 endoscopic frontal sinus surgery procedures. Each patient had only one stent placed. Of these 10 patients, one was excluded because the stent was electively removed at eight weeks. None of the remaining nine has been lost to follow‐up. The mean length of stenting was 32.6 months (median 17, range 11 to 73). One patient had the stent removed at 61 months because of infection. Another had the stent removed at 11 months because of pain and edema. The remaining seven patients remain asymptomatic with patent stents and no granulation tissue seen on nasal endoscopy.Conclusions:In this group, long‐term frontal stenting was rarely used but relatively well tolerated with only two of nine patients requiring removal up to 6 years after placement. With the optimal length for frontal stenting unknown, risks and benefits of removal at each evaluation point must be weighed. Laryngoscope, 119:190–192, 2009
Verarbeitung von feinen Spritzwerkstoffen zur Verbesserung von Korrosions‐ und Verschleißschutzeigenschaften von thermisch gespritzten Schichten
Authors: Bach Fr.‐W. , Möhwald K. , Bause T. , Erne M. 
Published: January 2009

AbstractIm Rahmen eines Forschungsvorhabens wurden die Spritzwerkstoffe Cr2O3, Cr3C2 NiCr und WCCoCr betrachtet. Es konnten Prozessparameter, welche die Verarbeitung dieser Spritzwerkstoffe in Korngrößen von < 25 μm mit Plasma‐ bzw. Hochgeschwindigkeitsflammspritzsystemen erlauben, erfolgreich bestimmt, optimiert und validiert werden. Neben verbesserten Schichteigenschaften wie z. B. einem niedrigen Porenanteil und einer erhöhten Korrosionsbeständigkeit eröffnet sich damit die Möglichkeit, maßhaltige Beschichtungen zu realisieren. Ein dadurch verringerter Nachbearbeitungsaufwand, z. B. aufgrund verkürzter Schleifzeiten, kann zur weiteren Rationalisierung von thermischen Spritzprozessen beitragen.