bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mandibular osteotomies for tumor extirpation: The advantages of rigid fixation
Authors: Sullivan Patrick K. , Fabian Richard , Driscoll Dan 
Published: October 2006

AbstractAdequate exposure of intraoral tumors occupying the posterior oral cavity, base of tongue, tonsil, and superior hypopharynx for wide‐field primary surgical resection is critical to precise tumor ablation. The exposure resulting from a mandibular osteotomy has greatly assisted the tumor ablation of these areas. This procedure has also been beneficial in providing exposure to the anterior skull base, pterygomaxillary, and infratemporal space, clivus, and nasopharynx. In evaluating various osteotomy sites and methods of fixation, we reviewed 26 patients treated for benign or malignant neoplasia of the head and neck requiring mandibulotomy. The osteotomy complication rate was 2 (29%) of 7 for wire osteosynthesis and 1 (5.3%) of 19 for plate osteosynthesis. All patients with osteotomy complications had received preoperative radiation therapy. The one complication in the plated group was associated with a lateral stairstep osteotomy and two screws on either side of the osteotomy.This study suggests advantages of absolute rigid internal fixation of mandibular osteotomies used for tumor ablation. It is also concluded that a midline osteotomy reapproximated with rigid internal fixation has the benefits of 1. primary bone healing by means of plating counteracting the balanced forces acting on the symphysis; 2. improved reapproximation with minimal bony loss, improving occlusion; 3. decreased incidence of osteoradionecrosis as the symphysis lies outside the usual radiation ports; 4. preservation of the neurovascular bundle; and 5. maintenance of osteotomy‐site immobility in an infected field.This review helped identify surgical techniques that decrease the complications that are commonly associated with mandibular osteotomies for precise tumor ablation.
Angioedema: 5 Years' experience, with a review of the disorder's presentation and treatment
Authors: Megerian Cliff A. , Arnold James E. , Berger Melvin 
Published: October 2006

AbstractAngioedema is a problem that the otolaryngologist—head and neck surgeon is often asked to treat. This report concerns 17 patients admitted for care during a 5‐year period. At their initial presentation, 94% of these patients manifested signs and symptoms of angioedema in the head and neck; three of them required urgent tracheotomy or intubation. As treatment of complement‐mediated angioedema is distinct, an etiology‐specific diagnostic and treatment protocol is presented.Of the patients, 35% had recent initiation of angiotensin‐converting enzyme (ACE) inhibitor therapy for hypertension, and 6% demonstrated classic hereditary angioedema. However, the majority of them (59%) had unclear etiologies for their symptoms. Since angioedema is the final result of several possible abnormalities, a thorough knowledge of the differential diagnosis and clinical presentation is vital to patient management.
Neoadjuvant chemotherapy in multiple synchronous head and neck and esophagus squamous cell carcinomas
Authors: Guillot Thierry , Spielmann Marc , Kac Jean , Luboinski Bernard , Tellez‐Bernal Eduardo , Munck Jean‐Nicolas , Bachouchi Mounir , Armand Jean‐Pierre , Cvitkovic Esteban 
Published: October 2006

AbstractA consecutive series of 22 patients with multiple synchronous squamous cell carcinomas of the upper aerodigestive tract was retrospectively reviewed. These patients were treated initially with cis‐platinum combination chemotherapy before definitive locoregional therapy (surgery and/or radiation therapy).Sixteen of 21 patients had simultaneous head and neck and esophageal primaries, 3 patients had multiple synchronous head and neck primaries, 2 patients had head and neck (HN) and a bronchial epidermoid cancer, and 1 patient had simultaneous esophageal and bronchial carcinomas of epidermoid lineage.Sixteen (77%) of the 21 patients responded to chemotherapy in all the tumor sites evaluated, and a clinically complete response was obtained in 6 (29%). After definitive locoregional treatment, the complete local control rate was 68%, with 34 complete responses for 50 primary tumor sites in 21 patients.Twelve patients were free of disease after locoregional treatment. Six patients are still alive 27 to 57 months after complementary definitive locoregional treatment and a minimum follow‐up of 27 months. Median survival for the overall group is 17 months. The response to chemotherapy is remarkable, which may be due to the small tumoral volume present in many of the cases (T1 to T2). Nevertheless, the present report stresses the importance of an aggressive combined therapeutic approach in this difficult clinical situation.
Nasoantral windows: An experimental study in rabbits
Authors: Perko Darko , Karin Rom R. 
Published: October 2006

AbstractAn experimental study was designed to compare the effects of enlargement of the maxillary ostium to inferior meatal antrostomy. In 10 rabbits, the sinus ostium was enlarged (osteoplasty group), and in 10 other animals, a window of the same size was created far from the ostium (antrostomy group). The control groups were 7 rabbits in which no surgery was performed and 6 rabbits in which only the surgical approach was performed. At reexploration 14 and 84 days after surgery, it was observed that rabbits in the osteoplasty group had significantly more infections of the sinuses than the antrostomy group and both control groups (P <.05). Possible reasons for the difference in infection rate are discussed. These data indicate that, in normal maxillary sinuses of rabbits, disruption of the ostium results in an increased incidence of infection.
Evaluation of a bedtime dose of a combination antihistamine/analgesic/decongestant product on antigen challenge the next morning
Authors: Majchel Abraham M. , Proud David , Kagey‐Sobotka Anne , Witek Theodore J. , Lichtenstein Lawrence M. , Naclerio Robert M. 
Published: October 2006

AbstractThe effects of CAAD (diphenhydramine hydrochloride, 50 mg; pseudoephedrine hydrochloride, 60 mg; acetaminophen, 1 g in 10% ethanol) were evaluated in a double‐blind, three‐way, placebo‐controlled, cross‐over study on 18 volunteers with allergic rhinitis. The number of sneezes following nasal challenge with antigen was significantly reduced after a bedtime dose of CAAD (P <.005) and a single dose of diphenhydramine (P <.001) given 2 hours before the challenge. The levels of N‐alpha‐tosyl‐L‐arginine methyl ester (TAME) activity decreased after diphenhydramine treatment, while histamine levels following challenge were not different. The drowsiness reported after CAAD was equal to placebo, but significantly less than diphenhydramine (P<.002 for both). The active treatments reduced the actions of histamine without suppressing its release from mast cells. The effect of CAAD persists 10 hours after administration without inducing drowsiness.
Nasal and paranasal sinus anomalies in children with chronic sinusitis
Authors: Milczuk Henry A. , Dalley Robert W. , Wessbacher Frank W. , Richardson Mark A. 
Published: October 2006

AbstractFunctional endoscopic sinus surgery (FESS) is being advocated to treat children with chronic sinusitis. The surgeon performing FESS needs an intimate understanding of the anatomy to adequately treat disease and avoid complications. One hundred thirty‐six patients who had endoscopic sinus surgery were reviewed. Preoperative direct coronal computed tomography scans were available for review in 114 patients. Several nasal and paranasal sinus anomalies were uncovered during this evaluation. The most common was hypoplasia of the maxillary sinuses. All hypoplastic maxillary sinuses had diseased mucosa. Eleven patients were found to have a laterally deviated uncinate process and abnormal anatomy of the maxillary ostia. Other anomalies such as concha bullosa, Haller's cells, and paradoxic curvature of the middle turbinate were found, and their respective frequencies in this population were determined.
Verrucous carcinoma of the larynx: Role of human papillomavirus, radiation, and surgery
Authors: Hagen Patrick , Lyons George D. , Haindel Christian 
Published: October 2006

AbstractThere is confusion regarding verrucous carcinoma of the larynx, an enigmatic, well‐differentiated variant of squamous cell carcinoma known for local recurrence and anaplastic transformation following irradiation. This report adds 12 new cases and reviews the literature concerning radiation results versus surgical results. Treatment of 37 patients with primary radiotherapy resulted in a 49% cure rate and a 51% failure rate; the death rate from anaplastic transformation was 11%. Primary surgery on 144 patients resulted in a 92.4% cure rate, a 7.6% initial failure rate, and a 3.5% rate of deaths attributed to neoplasm. Isolation of human papillomavirus type 16 (HPV‐16) DNA sequences indicates that the lesion is genetically abnormal. Radiation‐induced DNA breaks may activate these sequences. These findings support a surgical approach. Treatment recommendation for T1 lesions is carbon dioxide laser excision to minimize tissue trauma and local recurrence. For T2 to T4 lesions, the recommendation is sound oncologic extirpation. Neck dissection is not indicated.
Transpalatal advancement pharyngoplasty for obstructive sleep apnea
Authors: Woodson B. Tucker , Toohill Robert J. 
Published: October 2006

AbstractUvulopalatopharyngoplasty (UPPP) is a commonly performed procedure for obstructive sleep apnea (OSA). However, results are inconsistent. Patients in whom the UPPP procedure has failed have a smaller change in airway size as compared to responders, and also many demonstrate continued obstruction at the palate. We present a modification, transpalatal advancement pharyngoplasty, that increases upper oropharyngeal and retropalatal airway size by advancing the soft palate. Eleven patients with severe OSA and multiple sites of airway narrowing were corrected by this method. Three patients had prior UPPP and 5 patients had concomitant tongue‐base procedures. Overall results demonstrate clinical enlargement of the retropalatal space. In the 6 patients who had transpalatal advancement pharyngoplasty alone, 4 (67%) were successful responders as defined by a respiratory disturbance index (RDI) of less than 20 events per hour. RDI decreased from 52.8 ± 12.2 to 12.3 ± 2.8 events per hour. For the entire group, RDI decreased from 73.3 ± 29.4 to 25.1 ± 28.2 events per hour (P<.001). There were four complications, including a transient oronasal fistula(1), transient dysphagia(2), and serous otitis media(1).Transpalatal advancement pharyngoplasty potentially may offer an alternative to increasingly aggressive resection with UPPP in an effort to increase the upper oropharyngeal and retropalatal airway and may be appropriate in carefully selected patients as part of the surgical treatment of OSA.
Aberrant expression of epidermal growth factor receptor in aural cholesteatoma
Authors: Bujia J. , Holly A. , Schilling V. , Negri B. , Pitzke P. , Schulz P. 
Published: October 2006

AbstractA monoclonal antibody recognizing an epitope of the external domain of the human epidermal growth factor (EGF) receptor was used in an alkaline phosphatase‐antialkaline phosphatase (APAAP) technique to compare the distribution of this protein in normal human skin and aural cholesteatoma. EGF receptors appear to be highly expressed on the basal layer of the epidermis, in hair follicle apocrine sweat glands, and in the capillary system of normal skin. Cholesteatoma epithelium showed increased positive reactions in the suprabasal layers. A heterogeneity in the expression was found in different parts of the cholesteatoma. These results suggest the presence of an aberrant regulation and persistence of EGF receptors in cholesteatoma and confirm the hyperproliferative character of the cholesteatoma epithelium.
Intrasubject test‐retest variability in clinical electrocochleography
Authors: Roland Peter S. , Rosenbloom Jeff , Yellin Wende , Meyerhoff William L. 
Published: October 2006

AbstractSeventeen healthy volunteers without a history of auditory or vestibular difficulty and with normal screening audiometry had bilateral (34 ears) electrocochleography performed repeatedly at 1‐week intervals. Each subject had from four to seven electrocochleograms performed on each ear. Measurements were made in the external auditory canal using a gold‐foil “TIPtrode.” Amplitude and latency for the summating potential (SP) and action potential (AP) were measured and SP/AP ratios were calculated. Averages and standard deviations for amplitude, latency, and SP/AP ratios were computed. The average SP/AP ratio was 0.22 with a standard deviation of 0.06. The range was 0.04 to 0.50. The average difference between the highest and lowest SP/AP ratio for a given individual was 0.155 (i.e., the range 0.03 to 0.31) with a standard deviation of 0.07. These normative data are useful in assessing the results of dehydration electrocochleography and in establishing how much test‐retest variation is required to suggest pathology.
Penetrating trauma of the oropharynx in children
Authors: Radkowski Diana , Mcgill Trevor J. , Healy Gerald B. , Jones Dwight T. 
Published: October 2006

AbstractPenetrating trauma of the oropharynx is not an uncommon problem in the pediatric population. Innocuous injuries with minor soft‐tissue trauma have been associated with severe neurologic sequelae. A review of 77 oral trauma cases that occurred from 1981 to 1990 at Boston Children's Hospital was undertaken to see if constant factors could be identified so that a treatment protocol might be outlined for these patients. Twenty‐three (30%) patients sustained injury to the soft palate and peritonsillar area. Fifty percent of these cases required surgical debridement and repair. None of the 23 patients developed neurological sequelae. Physical examination may not correlate with the development of symptoms nor the mechanism of injury. Care should be taken during the examination to identify any neurological problems that may not relate to the degree of injury. Conservative management can be entertained if no abnormal neurologic findings are noted.
Endoscopic sinus surgery: 4‐year follow‐up on the first 100 patients
Authors: Schaitkin Barry , May Mark , Shapiro Adam , Fucci Michael , Mester Sara J. 
Published: October 2006

AbstractEndoscopic sinus surgery has been reported to be successful, but lack of a standardized classification system hampers comparison of results between studies, and long‐term results of surgery have not been reported in a series of consecutive patients. The results of our first 100 endoscopic sinus surgery procedures, reported previously after an average 9‐month follow‐up, were reviewed with the application of a new classification scheme and in light of a longer (4‐year) follow‐up. Surgery was successful in all patients whose sinus symptoms resulted from anatomical variations or suppurative infection, but failed in some patients with hyperplastic disease or polyps. In addition, the presence of reactive airway disease or the acetylsalicylic acid (ASA) triad was a bad prognostic sign. The overall success of the procedure in relieving sinus symptoms decreased from 98% at early follow‐up to 91% at 4‐year follow‐up. Sixty‐six percent were successful after one procedure and 25% required more than one procedure to achieve success. The decline in success since our first report in 1990 was mostly attributable to late failure in patients with recurrent symptomatic polyposis. Because symptoms may not recur in these patients for up to 3 years, long‐term results of surgery for this disorder are necessary. Symptoms of recurrent polyposis can be controlled medically or by revision surgery.
Nasal mucosal congestion after treatment with bromocriptine
Authors: Bende Mats , Bergman Boinge , Sjögren Christer 
Published: October 2006

AbstractNine women were given bromocriptine a few days after delivery in order to inhibit lactation. Nasal airway resistance to airflow (NAR) was recorded and blood samples were taken before treatment with bromocriptine, 2 to 3 hours after the first dose of this drug, and after 3 to 5 days on this treatment. All the women had increased nasal congestion after bromocriptine and NAR rose significantly. The prolactin, estradiol, and progesterone hormone levels decreased significantly, but no significant difference was found in the levels of thyroid‐stimulating hormone (TSH) and vasoactive intestinal polypeptide (VIP). The bromocriptine effect may be caused by different mechanisms.
Measurement of laryngeal resistance in the evaluation of botulinum toxin injection for treatment of focal laryngeal dystonia
Authors: Witsell David L. , Weissler Mark C. , Martinkosky Stanley J. , Kathleen Donovan M. , Howard James F. 
Published: October 2006

AbstractIn the past, there has been no consistent, objective method of following patients undergoing botulinum toxin injections for treatment of laryngeal dystonia. Herein, the application of translaryngeal resistance measurements to 15 dysphonic patients is described. Laryngeal resistance is calculated from analysis of translaryngeal pressure and airflow during the utterance /pi/, and found to fall predictably after successful toxin injection. In our series of patients, laryngeal resistance dropped by 69.1% after initial toxin injection. The changes in resistance over time correlate with subjective impressions of voice quality. Translaryngeal resistance measurements can be used objectively to follow patients longitudinally after injection and to collect objective data for analysis. No previously described measurements have met all these criteria. Laryngeal resistance measurement is an ideal method of documenting the results of botulinum toxin injection for the treatment of focal laryngeal dystonia.
The vienna cochlear implant in patients with obliteration of the cochlea
Authors: Kürsten R. , Cozzarini W. , Eisenwort B. , Denk D. M. , Zrunek M. , Burian K. 
Published: October 2006

AbstractTwelve deaf patients with obliterated or ossified cochleas received the extracochlear version of the Vienna Cochlear Implant. Four patients, 1 of them a child, developed open speech comprehension. Obliteration of the cochlea could not always be predicted by conventional tomography of the temporal bone. Short duration of deafness, wide dynamic range, and good ability of time resolution (small temporal difference limen [TDL]) are predictors for good postoperative results. Obliteration or ossification of the cochlea per se is no contraindication to cochlear implantation.
Histopathology of temporal bone fractures: Implications for cochlear implantation
Authors: Morgan Warren E. , Coker Newton J. , Jenkins Herman A. 
Published: October 2006

AbstractTemporal bone fractures often cause loss of audiovestibular function. Those patients with bilateral profound sensorineural hearing losses secondary to temporal bone fractures become candidates for cochlear implantation. The authors present the histopathology of five temporal bone fractures in three patients, evaluating specifically the traumatic effects on the neural elements of the inner ear. Transverse fractures of the temporal bone result in severe loss of hair cells, ganglion cells, and other supporting cells in the inner ear. Occasionally labyrinthitis ossificans may occur as a consequence of trauma or infection. While longitudinal fractures do not violate the otic capsule, these same neural elements may be damaged by concussion.
Selective inner hair cell ototoxicity induced by carboplatin
Authors: Wake Mark , Takeno Sachio , Ibrahim Danyal , Harrison Robert 
Published: October 2006

AbstractCarboplatin is a second‐generation platinum antineoplastic agent. It has biological activity similar to cisplatin and is currently recommended for the treatment of ovarian cancer. In clinical use, carboplatin appears less ototoxic than cisplatin. This paper reports the ototoxic effects of carboplatin, in doses equivalent to the clinical use of the drug, in the chinchilla. Intravenous carboplatin 200 to 400 mg/m2 by bolus injection caused significant ototoxicity in this model as revealed by brainstem evoked responses (ABR audiometry). The cochlear pathology as seen by scanning electron microscopy revealed predominantly inner hair cell (IHC) stereocilia damage. Furthermore, the extent (grade) of the morphological lesions appears to be well correlated with the auditory brainstem response pattern of threshold elevation.
Airway obstruction in the pierre robin sequence
Authors: Tomaski Sharon M. , Zalzal George H. , Saal Howard M. 
Published: October 2006

AbstractAirway obstruction and feeding difficulties vary among patients with Pierre Robin sequence (PRS). Treatment is challenging and the appropriate management may not be readily identified, leading to delay in securing the airway.A retrospective review of 90 children with PRS was done to identify subgroups at a higher risk of developing severe airway obstruction using oxygen and apnea monitoring, sleep studies, and response to treatment. Patients with isolated PRS (group I, 27 patients) and Stickler syndrome (group II, 32 patients) do not suffer from debilitating airway and feeding difficulties when compared to those with unique syndromes (group III, 16 patients) and recognized named syndromes (group IV, 15 patients). Feeding difficulties were universal with the severity proportional to airway obstruction. Aggressive intervention should be considered early in group III and IV patients.
Atypical stromal cells in inflammatory nasal polyps: Immunohistochemical and ultrastructural analysis in defining histogenesis
Authors: Nakayama Meijin , Wenig Bruce M. , Heffner Dennis K. 
Published: October 2006

AbstractThe authors investigated 29 cases of sinonasal polyps with atypical stromal cells (ASC). The clinicopathologic features of these lesions were of benign inflammatory polyps except for the presence of ASC. Misinterpretation of these cells resulted in contributor diagnosis of sarcoma (rhabdomyosarcoma). Immunohistochemical study of the ASC demonstrated the presence of actin (smooth muscle and muscle specific), KP‐1, and vimentin; no reactivity was seen with desmin, myoglobin, S‐100 protein, or glial fibrillary acidic protein (GFAP). Unexpectedly, cytokeratin reactivity was identified in more than 75% of the cases analyzed. Ultrastructural analysis revealed that the ASC shared morphologic features in common with fibroblasts and smooth muscle cells. Based on the light microscopic, immunohistochemical, and ultrastructural findings, it was concluded that the ASC represent reactive myofibroblasts and not a neoplastic proliferation. Follow‐up data supported this contention indicating the absence of an aggressive biological course. Misinterpretation as a malignant neoplasm might result in unwarranted and unnecessary therapeutic intervention.
The use of a laryngotracheal separation procedure in pediatric patients
Authors: Lawless Stephen T. , Cook Steven , Luft Jay , Jasani Melinda , Kettrick Robert 
Published: October 2006

AbstractThe objective of this study was to review experience, outcome, and satisfaction after a laryngotracheal separation (LTS) procedure in pediatric patients. Chart reviews and phone questionnaires were used. Factors reviewed included hospitalizations and infections prior to and after LTS, morbidity, and impact on quality of life.Twenty‐one pediatric patients ranging in age from 8 to 172 months underwent LTS. Follow‐up time ranged from 1 to 49 months. Complications were minor. Eighty‐eight percent of patients had fewer hospitalizations or were discharged for the first time after LTS. Number of pneumonias and suctioning frequency decreased, mobility increased in patients with prior tracheostomies, and care requirements decreased in 95% of patients. Parents reported satisfaction and improved quality of life. LTS is a low‐risk, successful procedure which increases quality of life and decreases morbidity in pediatric patients with irreversible upper airway dysfunction.