bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe Posterior Epistaxis–Endoscopic Surgical Anatomy
Authors: Pádua Francini G. M. , Voegels Richard L. 
Published: February 2009

AbstractObjective: To describe the anatomy of the sphenopalatine foramen (SPF) region and possible anatomical variations.Study Design: Prospective study accomplished from September, 2006, to January, 2007.Methods: The sphenopalatine foramen (SPF) of 61 cadavers were carefully dissected. Presence of the ethmoidal crest, location of sphenopalatine and accessory foramens, and the number of arterial branches emerging through foramens were observed. Data were analyzed in relation to gender, racial group, and symmetry of the cadaver. Prediction of the presence of accessory foramen was evaluated.Results: Mixed race cadavers prevailed in 122 nasal fossae dissected (75% males). Ethmoidal crest was present in 100% of the cadavers, being anterior to the SPF in 98.4% of the cases. The most frequent SPF location was the transition of the middle and superior meatus (86.9%). Mean distance from the SPF and accessory foramen to anterior nasal spine was 6.6 cm and 6.7 cm, respectively. Accessory foramen was present in 9.83% of the cases. A single arterial stem emerged through the SPF in 67.2% of the cases, and 100% through accessory foramens. The prevalence analyses showed no differences that were statistically significant (P > 0.05) between gender and racial group. The symmetry analyses showed a strong conformity (P < 0.01) between nasal fossae in relation to the SPF location. There was no statistically significant conformity between nasal fossae and accessory foramen (P = 0.53). None of the variables of interest presents any statistically significant (P > 0.05) association with the presence of the accessory foramen.Conclusions: There are anatomical variations in the lateral nose wall that should be considered for successful endoscopic surgical treatment of severe epistaxis.
Active Noise Reduction Audiometry: A Prospective Analysis of a New Approach to Noise Management in Audiometric Testing
Authors: Bromwich Matthew A. , Parsa Vijay , Lanthier Nicole , Yoo John , Parnes Lorne S. 
Published: February 2009

AbstractObjectives: To develop a new method of screening audiometry that reduces the adverse effects of low frequency background noise by using active noise reduction (ANR) headphone technology.Design: Prospective testing within an anechoic chamber evaluated the physical properties of ANR headphones. A prospective clinical crossover study compared standard audiometry with ANR headphone audiometry.Methods: Bose Aviation X circum‐aural ANR headphones were tested for both active and passive attenuation properties in a hemi‐anechoic chamber using a head and torso simulator. Thirty‐seven otology clinic patients then underwent standard audiometry and ANR audiometry, which was performed in a 30‐ and/or 40‐dB sound field.Results: Objective ANR headphone attenuation levels of up to 12 dB were achieved at frequencies below 2,000 Hz. In standard audiometric testing, 40 dB of narrow‐band background noise decreased patient pure tone thresholds by 24 dB at 250 Hz. The use of ANR technology provided 12 dB of additional attenuation. This resulted in a significant improvement in test results despite the 40 dB of background noise (P = <0.001). In a 30‐dB sound field, standard audiometric thresholds were shifted down by an average of 12 dB. The use of ANR technology completely attenuated this effect and resulted in a significant improvement in results (P = <0.01). These results were identical to those obtained in a quiet sound booth.Conclusions: Despite a 30‐dB sound field, ANR audiometry can produce an audiogram identical to that obtained in a double‐walled sound booth. ANR headphone audiometry improves the sensitivity of audiometric screening for mild low‐frequency hearing loss. This technology may have important applications for screening in schools, industry, and community practices.
Middle Turbinate Medialization With Bovine Serum Albumin Tissue Adhesive (BioGlue)
Authors: Friedman Michael , Schalch Paul 
Published: February 2009

AbstractMiddle turbinate (MT) medialization without resection is an approach designed to both preserve the MT and prevent lateralization, which may cause obstruction of the outflow of the ethmoid, maxillary, and frontal sinuses after endoscopic sinus surgery. Many techniques for medialization have been described. We present a quick and easy technique that involves using the microdebrider to create small areas of denuded mucosa on opposite surfaces of the MT and the nasal septum followed by an application of a bovine serum albumin tissue adhesive to promote the formation of controlled synechiae without the need for nasal packing.
Superficial Musculoaponeurotic System Elevation and Fat Graft Reconstruction After Superficial Parotidectomy
Authors: Curry Joseph M. , Fisher Kyle W. , Heffelfinger Ryan N. , Rosen Marc R. , Keane William M. , Pribitkin Edmund A. 
Published: February 2009

AbstractObjective/Hypothesis: Elevation of the superficial musculoaponeurotic system (SMAS) with or without fat graft interposition during superficial parotidectomy prevents a concave facial deformity and Frey's syndrome.Study Design: Retrospective, case‐control study.Methods: Charts for 248 patients who underwent superficial parotidectomy were reviewed for pathologic, radiographic, clinical, and operative data. Sixteen patients who underwent SMAS elevation and 34 patients who underwent SMAS elevation with fat graft interposition were included in two study groups. Nonreconstructed controls were randomly selected from a pool of patients who had unilateral, superficial parotidectomy and were matched based on pathologic specimen volume. Patients were surveyed for their postoperative symptoms.Results: Patients undergoing SMAS elevation alone (n = 16) compared with controls (n = 19) had greater facial symmetry (12% vs. 32%, P = .147) and a lower incidence of symptomatic Frey's syndrome (6.3% vs. 18.6%, P = .382). Patients undergoing SMAS elevation and fat graft interposition (n = 34) compared with controls (n = 38) had less facial asymmetry (9% vs. 39%, P = .002) and a lower incidence of symptomatic Frey's syndrome (6% vs. 28%, P = .04). Complications among the study and control groups were comparable.Conclusions: Simultaneous reconstruction of a superficial parotidectomy defect using SMAS elevation with or without fat grafting may improve postoperative facial symmetry and decrease the incidence of symptomatic Frey's syndrome without increasing complications.
Can Intratympanic Dexamethasone Added to Systemic Steroids Improve Hearing Outcome in Patients With Sudden Deafness?
Authors: Ahn Joong Ho , Yoo Myung Hoon , Yoon Tae Hyun , Chung Jong Woo 
Published: February 2009

AbstractObjective: To evaluate the therapeutic efficacy of intratympanic dexamethasone (ITD) injections added to systemic steroids in patients with idiopathic sudden sensorineural hearing loss (HL).Materials and Methods: A total of 120 patients diagnosed with sudden HL were treated with ITD injections (0.3 mL on days 1, 3, and 5) plus 48 mg methylprednisolone (ITD group) or methylprednisolone alone (control group).Results: The total recovery rate after the treatment was 73.3% in the ITD group and 70.0% in the control group. Although improvements in pure‐tone average were the same in the two groups, the ITD group showed significantly better hearing improvement at 250 Hz than the control group.Conclusion: The addition of ITD to systemic steroids did not result in significant improvements in the treatment of idiopathic sudden HL.
Nasal Surgery for Snoring in Patients With Obstructive Sleep Apnea
Authors: Li Hsueh‐Yu , Lee Li‐Ang , Wang Pa‐Chun , Chen Ning‐Hung , Lin Ying , Fang Tuan‐Jen 
Published: February 2009

AbstractObjective: To evaluate the efficacy of nasal surgery to relieve snoring and to identify predictive factors.Study Design: Prospective comparative study.Methods: Fifty‐two consecutive patients (51 males; mean age, 38 yr; body mass index, 25.4 ± 5.2 kg/m2) were enrolled. All patients had been previously diagnosed with obstructive sleep apnea (apnea/hypopnea index, 38.5 ± 33.2 events/hr) and symptomatic nasal obstruction secondary to deviated nasal septum. Septomeatoplasty alone was the treatment in this study cohort. Snoring was assessed by Snore Outcome Survey (SOS), and nasal obstruction was assessed by visual analogue scale (VAS) and anterior rhinomanometry at baseline and approximately 3 months after nasal surgery.Results: Body mass index remained unchanged (P > .05) after surgery. Significantly improved SOS (P < .001), VAS (P < .001), and total nasal resistance (P = .002) were noted after nasal surgery. Eighty‐six percent of patients had improved SOS scores, and average improvement was 46%. Complete relief of snoring was reported by the sleep partners of six (12%) patients. Change in SOS scores (22.5 ± 14.5 vs. 10.1 ± 10.4) significantly differed (P = .01) between tonsil size grade (TON) 0/I and TON II/III groups. Other baseline variables did not significantly differ (P > .05) in SOS score changes.Conclusions: In patients with obstructive sleep apnea suffering from both snoring and nasal obstruction, nasal surgery for deviated septum relieves snoring in 12%. The tonsil size affects the outcome of nasal surgery for snoring.
Dual Action of TGF‐β1 on Nasal‐Polyp Derived Fibroblasts
Authors: Little Stewart C. , Early S Brandon , Woodard Charles R. , Shonka David C. , Han Joseph K. , Borish Larry , Steinke John W. 
Published: February 2009

AbstractObjectives: Transforming growth factor β‐1 (TGF‐β1) is a known fibrogenic factor with immunosuppressive properties. We wanted to determine the effect of stimulation with TGF‐β1 on nasal polyp‐derived fibroblasts and assess the role this molecule would have in polyp formation and growth.Study Design: Nasal‐polyp derived fibroblasts were cultured with or without TGF‐β1, and proliferation and cytokine secretion were measured.Methods: Fibroblasts were isolated from nasal polyps following endoscopic surgery. Cells were plated and grown until confluent, after which they were split and used in assays. Cells were stimulated with TGF‐ β1 and mRNA collected after 16 hours, supernatants after 72 hours, and proliferation measured after 96 hours of culture.Results: TGF‐β1 significantly (P < .02) increased proliferation of nasal‐polyp derived fibroblasts. We examined the expression of inflammatory cytokines and found that TGF‐β1 decreased expression of CCL2 (MCP‐1), CCL5 (RANTES), CCL11 (eotaxin), granulocyte‐colony stimulating factor (G‐CSF), and GM‐CSF (P < .05). In contrast, incubation with TGF‐β1 increased fibronectin, procollagen, vascular endothelial growth factor (VEGF), and TGF‐β2 protein production (P < .05). For select samples, we confirmed that the increased protein production was due to increased mRNA expression.Conclusion: These studies suggest that TGF‐β1 expression in polyp tissue can have dual effects. One role is to act as an anti‐inflammatory agent shown by the ability to inhibit pro‐inflammatory mRNA and protein production. At the same time, TGF‐β1 expression leads to increases in factors involved in fibrosis and angiogenesis, promoting remodeling and cell growth.
Long‐Term Results of Provox ActiValve, Solving the Problem of Frequent Candida‐ and “Underpressure”‐Related Voice Prosthesis Replacements
Authors: Soolsma Jessica , van den Brekel Michiel W. , Ackerstaff Annemieke H. , Balm Alfons J. , Tan Bing , Hilgers Frans J. 
Published: February 2009

AbstractObjectives: To assess the long‐term results of the Provox ActiValve, a prosthesis for voice rehabilitation after total laryngectomy that was designed to lessen the need for frequent replacements caused by Candida and “underpressure.”Patients and Methods: Retrospective assessment of device lifetime, indications for replacement, voice quality, and maintenance issues, measured by a structured trial specific questionnaire, in a cohort of 42 laryngectomized patients, experiencing a short Provox2 device lifetime (median, 21 days).Results: The median device lifetime of Provox ActiValve, replaced for leakage through the device and those still in situ at the date of data collection (N = 32), was 337 days (mean 376 days): a statistically significant 16‐fold increase compared to the Provox2 prosthesis (P < .001). In 10 patients, replacement was fistula‐related (median after 86 days): esophageal pouch (N = 4), fistula granulation (N = 3), extrusion of the device (N = 2), and periprosthetic leakage (N = 1). Eighty‐six percent of the patients used a special lubricant to diminish “stickiness” of the valve. Provox ActiValve was preferred by 90% of the patients who completed the trial‐specific questionnaire.Conclusions: For patients requiring frequent device‐related replacements, Provox ActiValve, also long‐term, provides a true solution and thereby is a valuable addition to prosthetic voice rehabilitation.
“Not One Single Case of Throat Irritation”: Misuse of the Image of the Otolaryngologist in Cigarette Advertising
Authors: Samji Hussein A. , Jackler Robert K. 
Published: February 2009

AbstractEarly in the last century, when questions about the health effects of smoking became a topic of widespread discussion, tobacco companies undertook a multi‐faceted campaign to allay the public's fears. As terms like “smoker's cough” and “coffin nails” (referring to cigarettes) began to appear in the popular vernacular, tobacco marketers recognized the need to counter this threat to their livelihood. One strategy was to use endorsements by healthy and vigorous‐appearing singers, radio stars, and actors. Another was to raise fears over weight gain: “Reach for a Lucky instead of a sweet.” Among the more reprehensible tactics was the utilization of the image of the noble and caring physician to sell cigarettes: doctors were depicted both as satisfied and enthusiastic partakers of the smoking habit (e.g., “More doctors smoke Camels”). Images of medical men (and a few token women) appeared under warm reassurances of the safety of smoking. Frequently, images appeared of a head‐mirrored “throat doctor,” smiling benignly, while indicating that the company's product would do no harm. Indeed, many cigarette ads, especially for menthol brands, suggested a therapeutic soothing benefit from smoking. Liberal use was also made of pseudo‐scientific medical reports and surveys. Our intention is to tell, principally through advertising images–the story of how, between the late 1920s and the early 1950s, tobacco companies used deceptive and often patently false claims in an effort to reassure the public of the safety of their products.
Long‐Term Results of a Phase III Randomized Trial of Postoperative Radiotherapy With or Without Carboplatin in Patients With High‐Risk Head and Neck Cancer
Authors: Argiris Athanassios , Karamouzis Michalis V. , Johnson Jonas T. , Heron Dwight E. , Myers Eugene , Eibling David , Cano Elmer , Urba Susan , Gluckman Jack , Grandis Jennifer R. , Wang Yun , Agarwala Sanjiv S. 
Published: February 2009

AbstractBackground:The role of postoperative radiotherapy and carboplatin in squamous cell carcinoma of the head and neck (SCCHN) has not been established.Methods:Patients with macroscopically resected stage III/IV SCCHN with high‐risk pathologic features (≥3 lymph nodes, extracapsular extension, perineural or angiolymphatic invasion, or involved margins) were randomized to receive postoperative radiotherapy alone (arm A) or the same radiotherapy plus carboplatin 100 mg/m2intravenously once weekly during radiation (arm B). The primary endpoint was 2‐year disease‐free survival.Results:Seventy‐six patients were randomized, of whom 72 were eligible and analyzable (36 in each arm). The study was prematurely closed because of slow accrual. With a median follow‐up of 5.3 years, the disease‐free survival at 2 and 5 years was 71% and 53% in arm B versus 58% (P= .27) and 49% (P= .72) in arm A. The overall survival at 2 and 5 years was 74% and 47% in arm B versus 51% (P= .04) and 41% (P= .61) in arm A. Serious toxicities were infrequent in both arms.Conclusions:We could not demonstrate a benefit with the addition of carboplatin to postoperative radiotherapy, possibly because of insufficient sample size.
In Vitro Activity of Mupirocin on Clinical Isolates of Staphylococcus aureus and its Potential Implications in Chronic Rhinosinusitis
Authors: Ha Kien R. , Psaltis Alkis J. , Butcher Andrew R. , Wormald Peter‐John , Tan Lor Wai 
Published: February 2009

AbstractBackground: It has been postulated that bacterial biofilms are involved in the pathogenesis of chronic rhinosinusitis (CRS). Biofilms present on sinus mucosa are difficult to eradicate with conventional antibiotic therapy and are thought to provide a nidus for recurrent infection. Topical delivery of antibiotics via nasal irrigation may present a way of delivering high concentrations of antibiofilm agents with potentially low systemic absorption and side effects. This study investigates the effectiveness of mupirocin and two other antibiotics, ciprofloxacin and vancomycin, on established in vitro biofilms of Staphylococcus aureus isolated from patients with CRS.Methods:
S. aureus American Type Culture Collection 25923 and 12 clinical isolates were investigated for their ability to form biofilms in an in vitro setting using a 96 well microtiter crystal violet (CV) plate assay and confocal scanning laser microscopy (CSLM). Antimicrobial susceptibility tests to determine minimum inhibitory concentrations were performed on planktonic and biofilm forming strains. In addition, established biofilms were subjected to the antimicrobial agents at a twofold dilution series. A CV analysis of biofilm mass was performed after 1 and 24 hours of treatment, and minimum biofilm inhibition concentrations at 50% (MIB50) and 90% (MIB90) biofilm inhibition were recorded.Results: With use of a 96‐well microtiter plate CV assay, 8 of the 12 clinical isolates formed mature biofilms after 8 days of culture. These results correlated with findings from CSLM analysis of in vitro biofilms grown on Permanox chamber slides. Increased antimicrobial resistance was observed in the biofilm isolates when compared with planktonic counterparts. Mupirocin was capable of reducing biofilm mass by greater than 90% at concentrations of 125 μg/mL or less in all S. aureus isolates. Ciprofloxacin and vancomycin were largely ineffective in attaining MIB90 concentrations within safe dosage ranges.Conclusions: The topical application of mupirocin via nasal irrigation may be useful in eliminating S. aureus biofilms present on the sinus mucosa of patients with CRS and may offer an additional treatment to patients with recalcitrant sinusitis.
Prognostic Value of Electroneurography and Electromyography in Facial Palsy
Authors: Grosheva Maria , Wittekindt Claus , Guntinas‐Lichius Orlando 
Published: February 2009

AbstractObjectives: To compare the prognostic value of electroneurography (ENG) and needle electromyography (EMG) to estimate facial function outcome after acute facial palsy.Study Design: Retrospective study using electrodiagnostic data and medical chart review.Methods: Two hundred one patients treated 1995 to 2004 were included. Initial and final facial function was established clinically by the House‐Brackmann (HB) scale. ENG results were classified into amplitude loss less than 75% and amplitude loss 75% or greater to predict complete recovery and defective healing, respectively. Initial and follow‐up EMG results were classified into neurapraxia and predicted complete recovery. In contrast, axonotmesis/neurotmesis and mixed lesions predicted, by definition, defective healing.Results: Initial HB was II to IV in 154 patients and V to VI in 47 patients. The etiology was idiopathic palsy in 139, iatrogenic lesion in 29, traumatic in 18, and herpes zoster in 15 patients. Finally, 134 (67%) patients showed a full recovery. Sixty‐seven (33%) patients showed signs of defective healing. ENG presented a sensitivity, specificity, accuracy, positive predictive value (to predict defective healing), and negative predictive value of 60%, 79%, 73%, 59%, and 80%, respectively. The values for the initial EMG were 66%, 98%, 89%, 91%, and 89%. The best results showed the follow‐up EMG with 85%, 100%, 97%, 100%, and 96%. EMG results were not classifiable in 32 (16%) patients.Conclusions: EMG showed higher prognostic values than ENG, especially when repeated during the time course of the facial palsy. ENG might be helpful if the EMG result is not classifiable.
Persistent Allergic Rhinitis Includes Different Pathophysiologic Types
Authors: Ciprandi Giorgio , Cirillo Ignazio , Pistorio Angela 
Published: February 2009

AbstractBackground: Allergy rhinitis is typically classified as seasonal allergy rhinitis (SAR) and perennial allergy rhinitis (PAR). More recently, the Allergic Rhinitis and its Impact on Asthma document proposed the intermittent (ITR) and persistent forms (PER). However, it has been previously reported that each single allergen may induce different clinical and pathophysiologic features.Objective: The aim of the study was to test the hypothesis that the type of causal allergen might characterize pathophysiologic differences in a cohort of patients with PER.Methods: Three hundred nineteen patients, sailors of the Italian Navy, with moderate‐severe PER were prospectively and consecutively evaluated with clinical evaluation, skin prick test, rhinomanometry, and nasal decongestion test.Results: Patients with pollen allergy showed significantly more severe symptoms, lower nasal airflow, and higher response to decongestion test than patients with allergy to perennial allergens (P < .0001).Conclusion: This study provides evidence that patients with PER may show different pathophysiologic patterns depending on the type of causal allergen.
Impact of Evolution on the Eustachian Tube
Authors: Bluestone Charles D. 
Published: February 2009

AbstractI posit that humans appear to be the only species that develops otitis media. If animals in the wild had developed middle‐ear disease to any significant degree, they would have been selected out during evolution because they would not have survived their predators given the associated hearing loss. Why do humans have otitis media? Evolution has had a significant impact. It is well known that humans are born 12 months too early, which is the result of adaptations to bipedalism and our big brain that, over time, resulted in a relatively small female pelvic outlet compared with nonhuman primates. As a consequence of too early a birth, not only is our immune system immature, but the eustachian tube is too short and floppy in the first year of life. But why is otitis media still common in older individuals? What other adaptation is uniquely human? We developed speech that was associated with descent of the larynx and hyoid bone, which, along with a decrease in prognathism (i.e., facial flattening), resulted in a change in palatal morphology as compared with other primates. Comparative anatomic and physiologic studies have demonstrated significant differences between humans and monkeys, especially in the muscles of the eustachian tube. Paradoxic constriction, as apposed to dilation, on swallowing is a common tubal dysfunction in humans and certain monkey models with chronic middle‐ear effusion. My hypothesis is that chronic otitis media with effusion in patients with tubal constriction is a consequence of adaptation for speech and that, most likely, the levator veli palatini muscle is the cause.