bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coblation vs electrocautery tonsillectomy: Postoperative recovery in adults
Authors: Leong Tan Alvin Kah , Hsu Pon Poh , Eng Soh Ping , Ng Yuk Hui , Sun Lu Peter Kuo , Tan Su Meng , Say Jia Huey , Chan Yiong Huak 
Published: October 2006

ObjectiveComparison of coblation and monopolar electrocautery tonsillectomy in terms of postoperative pain and recovery.Study DesignProspective double‐blind randomized controlled trial.MethodsPatients with recurrent tonsillitis requiring tonsillectomy were randomized to 2 groups: coblation or monopolar electrocautery tonsillectomy. Postoperative pain, complications, and days taken to return to work and normal diet were compared and analyzed with the aid of a pain diary, given to the patient.Results67 patients were recruited. Patients undergoing coblation tonsillectomy were able to return to normal diet in a shorter space of time following surgery. Patients undergoing coblation tonsillectomy were more likely to recommend the surgery than patients undergoing electrocautery tonsillectomy. No significant differences in the daily visual analog score for pain were seen for both groups of patients.ConclusionsOur results showed that coblation tonsillectomy has a faster recovery period and may offer advantages when compared to monopolar electrocautery tonsillectomy.
Frontal sinus fractures: A 28‐year retrospective review
Authors: Strong E. Bradley , Pahlavan Nima , Saito David 
Published: October 2006

OBJECTIVESTo analyze 202 consecutive frontal sinus fracture (FSF) patients treated between 1974 and 2002 at the University of California, Davis.METHODSA retrospective chart review was performed, including all patients with frontal sinus fractures from 1987 to 2002. This and 72 previously reported patients (1974‐1986) were analyzed, comparing age, gender, fracture type, associated fractures, procedure type, and complications.RESULTSFrontal sinus fractures resulting from motor vehicle accidents (MVAs) decreased from 71% to 52% (P < 0.05). Fractures from assaults increased from 9% to 21% (P < 0.05). The incidence of “through and through” fractures decreased from 40% to 11% (P < 0.05). Whereas combined anterior/posterior table fractures increased from 36% to 57% (P < 0.05).CONCLUSIONThe etiology and severity of FSF has changed from 1974 to 2002. This is reflected in a reduced number of fractures resulting from MVAs as well as a reduced severity of injury. The most likely explanation is the use of safety belts and airbags.
Transcutaneous electrical stimulation versus traditional dysphagia therapy: A nonconcurrent cohort study
Authors: Blumenfeld Liza , Hahn Yoav , LePage Amanda , Leonard Rebecca , Belafsky Peter C. 
Published: October 2006

OBJECTIVEThe purpose of this investigation was to critically evaluate the efficacy of electrical stimulation (ES) in treating persons with dysphagia and aspiration.STUDY DESIGNNonconcurrent cohort study.METHODOLOGYThe charts of 40 consecutive individuals undergoing ES and 40 consecutive persons undergoing traditional dysphagia therapy (TDT) were reviewed. Pre‐ and post‐therapy treatment success was compared utilizing a previously described swallow severity scale. A linear regression analysis was employed to adjust for potential confounding variables.RESULTSThe swallow severity scale improved from 0.50 to 1.48 in the TDT group (P < 0.05) and from 0.28 to 3.23 in the ES group (P < 0.001). After adjusting for potential confounding factors, persons receiving ES did significantly better in regard to improvement in their swallowing function than persons receiving TDT (P = 0.003).CONCLUSIONSThe results of this nonconcurrent cohort study suggest that dysphagia therapy with transcutaneous electrical stimulation is superior to traditional dysphagia therapy alone in individuals in a long‐term acute care facility.
Reconstruction of upper digestive tract: Reducing morbidity by laparoscopic pull‐up
Authors: DePaula Aureo L. , Macedo Antonio L.V. , Cernea Claudio R. , Schraibman Vladimir , Pinus Jacques , Milanez José R. , Succi José E. , Hojaij Flávio C. , de Carlucci Dorival , Nishio Sunao 
Published: October 2006

BACKGROUNDGastric pull‐up is a useful method for reconstruction of the upper digestive tract, with considerable morbidity/mortality, especially in esophageal cancers (EC)OBJECTIVETo analyze the experience of a multidisciplinary team with a laparoscopic gastric pull‐up (LGPU) method, with or without thoracoscopy, in a series of 120 patients with EC.STUDY DESIGNRetrospective.PATIENTS AND METHODSFrom 1992 to 2004, 120 EC [cervical/cervicothoracic (3.0%), middle third (15.0%), and inferior third (82.0%)]. Most were squamous cell carcinomas (47.0%) and adenocarcinomas (34.0%). Stomach was dissected and mobilized exclusively by laparoscopy. Occasionally, laparoscopic approach was extended cranially, until connecting with cervical dissection. In other cases, dissection of thoracic esophagus was accomplished through a thoracoscopic approach.RESULTSEighty‐one patients (68.0%) had LGPU; 39 (32.0%) needed thoracoscopy. Mortality was 5.9%. Complications were fistula (10.0%) and pneumonia (10.0%). All fistulae closed spontaneously; 89.2% of patients could swallow a normal oral diet.CONCLUSIONLow morbidity/mortality of LGPU for EC compared favorably with conventional techniques.
Validation of a new grading system for endoscopic examination of adenoid hypertrophy
Authors: Parikh Sanjay R. , Coronel Mark , Lee James J. , Brown Seth M. 
Published: October 2006

ObjectiveTo propose and validate a new subjective grading system of adenoid size with flexible fiberoptic evaluation.Study Design and SettingDigital video clips of 24 flexible fiberoptic nasopharyngeal exams were presented to 24 examiners (otolaryngology resident and consultant physicians) at a tertiary care institution. Examiners were asked to use the proposed grading system to rate adenoid hypertrophy. Kappa statistical analysis was used to evaluate the degree of intergrader agreement or disagreement.ResultsStatistical analysis of intergrader agreement demonstrated an overall Kappa score of 0.71 suggesting a “substantial” strength of agreement. The Kappa strength of agreement was found to be 0.83 (almost perfect) among consultant physicians and 0.62 (substantial) among resident physicians.ConclusionsThe proposed adenoid staging system is a reliable and consistent method of staging adenoid tissue size.SignificanceThis new validated grading system may be a useful standard for reporting adenoid size in future clinical outcome studies.
Implantable Doppler flow system: Experience with 24 microvascular free‐flap operations
Authors: Pryor Shepherd G. , Moore Eric J. , Kasperbauer Jan L. 
Published: October 2006

ObjectiveMicrovascular reconstruction requires postoperative monitoring to prevent vascular occlusion and flap failure. These methods require skilled personnel and can delay diagnosis and treatment of threatened flap failures. The Cook‐Swartz implantable Doppler flow system provides continual feedback on vascular pedicle status, which in turn provides rapid assessment of minute‐to‐minute changes in flap vasculature that may allow intervention before total vascular occlusion and expeditious reexploration for threatened flap failure, possibly improving flap salvage.Study Design and SettingCharts of 24 patients with microvascular free‐flap reconstruction and implantation of Doppler flow system at Mayo Clinic Rochester were retrospectively reviewed. Surgical technique and flap outcomes were evaluated.ResultsMicrovascular reconstruction and implantation of Doppler flow system were successful in all patients. Complications were minimal, and postoperative monitoring system facilitated rapid reexploration when necessary. Flap viability was 96%.ConclusionDoppler flow system is reliable for monitoring minute‐to‐minute changes in microvascular flap vascular status postoperatively, and allows rapid recognition of complications and facilitating reexploration. This is a valuable, easily mastered tool for microvascular reconstructive surgery.SignificanceMay alter postoperative monitoring techniques of microvascular surgeons.
Innervation of the trapezius muscle: Is cervical contribution important to its function?
Authors: Zhao Wen , Sun Jian , Zheng Jia‐Wei , Li Jun , He Yue , Zhang Zhi‐Yuan 
Published: October 2006

ObjectiveTo study the effect of the cervical plexus and the accessory nerve to the function of the trapezius muscle.Study Design and SettingEighteen adult male Sprague‐Dawley rats were randomly divided into three groups. The neurotomies were performed in the left sides and the right sides served as within‐subject controls. In group A, the accessory nerve was transected. The C2‐5 were transected in group B, and both of the accessory nerve and C2‐5 were cut in group C. The electrophysiologic, myophysiologic, and histologic changes of the muscles were measured.ResultsThere were significant differences (P < 0.05) between the three groups in the recovery rates of the transverse area of the muscles. The CMAP recorded from the experimental sides in group B were similar to the control sides. The values of the maximum tension of the tetanus contraction between the two sides showed no differences either (P > 0.05).ConclusionThe accessory nerve supplies the most important motor input to the trapezius. Motor innervations of the cervical plexus are not very significant.
Endoscopic transeptal surgery for choanal atresia with a stentless folded‐over‐flap technique
Authors: Cedin Antonio C. , Fujita Reginaldo , Oswaldo Laércio M. Cruz 
Published: October 2006

OBJECTIVETo analyze long‐term results of a new stentless surgical technique for choanal atresia that also used no packing.STUDY DESIGNProspective study.METHODSTen patients (3 bilateral and 7 unilateral), with ages ranging from 4 days to 30 years, were operated on. The follow‐up was 6 months to 36 months. This approach allowed resection of the posterior portion of the vomer, atretic plate, and part of the medial pterygoid process. Flaps were fashioned from septal, nasal, and pharyngeal mucosa from the atretic plates and fixed with fibrin glue. Postoperative control included nasal endoscopy and computerized tomography (CT).RESULTSAdequate functional nasal breathing was maintained during follow‐up.CONCLUSIONSThis technique was satisfactory and safe, allowing fast recovery in a one‐step surgery, using neither stents nor nasal packing. Long‐term patency with no reduction in functional quality was also observed.
Determinants of success in endoscopic cerebrospinal fluid leak repair
Authors: Basu Devraj , Haughey Bruce H. , Hartman James M. 
Published: October 2006

OBJECTIVESTo identify factors influencing success in endoscopic repair of CSF leaks of the anterior skull base.METHODSThrough retrospective chart review, 24 endoscopic closures of anterior skull base CSF leaks were analyzed for factors correlating with initial repair outcome.RESULTSThirteen patients with either spontaneous leaks or iatrogenic leaks arising from FESS were repaired with significantly lower recurrence rate (8%) than 11 patients with leaks induced by skull base procedures (45%). However, in the latter group, only 14% recurred when the dural defect was directly visualized, whereas leaks always recurred when bony dehiscences were patched in the absence of visible dural defects. Such defects were least frequently localized in patients with craniotomy‐induced leaks. A trend toward morbid obesity was also noted among repair failures.CONCLUSIONSDirect visualization of the dural defect is essential for endoscopic repair of anterior skull base CSF leaks, with craniotomy‐induced leaks being the most challenging to localize. Obesity is another likely factor contributing to repair failure.
Toxic metabolic encephalopathy after parathyroidectomy with methylene blue localization
Authors: Kartha Swapna S. , Chris Chacko E. , Bumpous Jeffrey M. , Fleming Muffin , Lentsch Eric J. , Flynn Michael B. 
Published: October 2006

OBJECTIVETo determine the correlation between methylene blue use and toxic metabolic encephalopathy in patients undergoing surgery for primary hyperparathyroidism.STUDY DESIGN AND SETTINGA retrospective study of 193 patients was performed to collect demographic, perioperative, and postoperative data. Patients were divided into two groups: Group A (postoperative neurological sequelae) and Group B (no neurological sequelae). All data points were compared between the groups.RESULTSTwelve of 193 patients were placed in Group A; 181 patients were placed in Group B. Ten patients in Group A were female, and 10 patients were older than 60 years. Of the patients in Group A, 100% were taking a serotonin reuptake inhibitor (SRI). In Group B, 8.8% of patients were taking an SRI.CONCLUSIONAll the patients who experienced transient neurological events were taking an SRI. A correlation can be made between methylene blue infusion and SRI usage.SIGNIFICANCEPatients taking SRIs may represent a high‐risk group for postoperative neurological events when methylene blue is utilized.
Comparison of frontal pneumatization patterns between Koreans and Caucasians
Authors: Cho Jae Hoon , Citardi Martin J. , Lee Walter T. , Sautter Nathan B. , Lee Heung‐Man , Yoon Joo‐Heon , Hong Seok‐Chan , Kim Jin Kook 
Published: October 2006

OBJECTIVETo evaluate the prevalence of specific frontal recess cells in Korean and Caucasian populations; to evaluate and compare the relationship between anterior skull base length and frontal recess pneumatization in these two populations.MATERIALS AND METHODSFrontal recess anatomy was studied with high resolution sinus CT scans obtained in 60 Korean adults and 41 Caucasian adults. None of the subjects had a history of frontal sinus disease or trauma. The anterior cranial base length (ACBL, distance between the nasion and center of the pituitary fossa) and anterior ethmoid length (AEL, distance between the nasion and upper attachment of basal lamella) was also measured on each side.RESULTSSupraorbital ethmoid cells were more common in Caucasians whereas suprabullar cells and recessus terminalis were more common in Koreans. The prevalence of some frontal recess pneumatization patterns (specifically supraorbital ethmoid cell, suprabullar cell, and recessus terminalis) were more commonly associated with race rather than with ACBL or AEL.CONCLUSIONFrontal recess pneumatization patterns differ in the Korean and Caucasian adult populations. Because corresponding differences in skull base length were not identified, these differences seem likely to reflect other factors. Such information has clinical significance for frontal recess surgery in these patient populations.
Minimally invasive nonendoscopic thyroidectomy
Authors: Cavicchi Ottavio , Piccin Ottavio , Rinaldi Ceroni Alberto , Caliceti Umberto 
Published: October 2006

OBJECTIVESMinimal‐access thyroid surgery, using various techniques, is increasingly being reported. The present study reviews our experience with thyroid surgery using a minimally invasive approach (MIT).STUDY DESIGNBetween October 2002 and December 2004, a prospective nonrandomized study of patients undergoing thyroid surgery was performed to evaluate the variables that might condition the indications to minimally invasive nonendoscopic approach.RESULTS296 patients underwent thyroid surgery; 46 of these were eligible for MIT through a 2.5‐ to 3‐cm incision. There was one case of transient inferior laryngeal nerve palsy and no postoperative definitive hypoparathyroidism. MIT was converted to conventional thyroidectomy only in two cases. Cosmetic results were considered excellent by all patients.CONCLUSIONSMinimal‐access thyroid surgery is a safe and feasible alternative to conventional thyroid surgery in selected cases. The advantage that this technique offers, in addition to low morbidity, is an improved cosmetic result.
Perceptual voice analysis of patients with subglottic stenosis
Authors: Ettema Sandra L. , Tolejano Carol Jorgensen , Thielkes Robert J. , Toohill Robert J. , Merati Albert L. 
Published: October 2006

OBJECTIVESTo characterize the perceptual assessment of vocal quality in subglottic stenosis (SGS) patients and to identify risk factors for dysphonia.STUDY DESIGN AND SETTINGRetrospective review, academic center.METHODSPerceptual voice assessment using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain); patient characteristics determined for 31 SGS cases.RESULTSThe mean GRBAS (0 to 3 scale, 0 = normal quality) for SGS patients at their initial visit was G(1.4)R(1.2)B(0.5) A(0.5)S(1.1). For males vs females: G(2.1 vs 1.1)R(2.0 vs 0.8)B(1.0 vs 0.4)A(1.0 vs 0.3)S(1.7 vs 0.9). The Grade (P < 0.03), Breathiness (P < 0.04), and Asthenia (P < 0.02) assessments were significantly more dysphonic in patients with multilevel stenosis; vocal fold motion impairment (VFMI) also impacted overall Grade (P < 0.01). Overall Grade (P < 0.002), Roughness (P < 0.007), and Breathiness (P < 0.006) were significantly worse in patients with prior airway surgery.CONCLUSIONSGS patients demonstrate a mild to moderate change in perceptual voice characteristics with males in this series being more affected than females. Negative risk factors include multiple stenoses, VFMI, and previous airway surgery.SIGNIFICANCEThis is the first systematic report of perceptual voice assessment in subglottic stenosis. SGS patients have notable degrees of dysphonia with identifiable risk factors.
Nasal polyposis: Prevalence of positive food and inhalant skin tests
Authors: Collins Melanie M. , Loughran Sean , Davidson Pauline , Wilson Janet A. 
Published: October 2006

OBJECTIVESTo investigate the etiology of nasal polyps and its relationship to allergy. The prevalence of positive food and inhalant skin tests in patients with nasal polyps and nonatopic controls was compared.STUDY DESIGN AND SETTINGProspective controlled study in tertiary referral rhinology clinic.RESULTSSeventy percent (70%) of the patients with nasal polyps had positive skin tests to an average of four foodstuffs, compared to 34 percent of controls (P = 0.006). Only 35 percent of the nasal polyp patients also had positive inhalant skin tests. Overall, the prevalence of positive inhalant skin tests was similar in the nasal polyp patients and controls.CONCLUSIONSThese findings suggest that the positive skin tests to foods are not merely a reflection of the general atopic status of patients with nasal polyps. It may be that non‐IgE‐mediated hypersensitivities, such as to ingested foods, play a role on the basis of a significant number of patients with positive intradermal skin tests to foods.SIGNIFICANCEEvaluation of the allergic status of patients with polyposis is important. Dietary manipulation may be indicated, though its role needs further investigation.
Otomycosis: Clinical features and treatment implications
Authors: Ho Tang , Vrabec Jeffrey T. , Yoo Donald , Coker Newton J. 
Published: October 2006

OBJECTIVESTo determine the clinical presentation, predisposing factors, complications, and treatment outcomes of otomycosis.STUDY DESIGN AND SETTINGRetrospective review of 132 patients with a clinical diagnosis of otomycosis treated from 1998 to 2004 in an academic otology practice.RESULTSOtalgia and otorrhea were the most common presenting complaints (48%). Prior otologic procedures increase the risk of developing otomycosis. Residual disease was observed in 13% and recurrence in 15% of the subjects. The presence of a mastoid cavity was associated with higher recurrent and residual disease rates. Topical ketoconazole, cresylate otic drops, and aluminum acetate otic drops were all relatively effective with >80% resolution rate on initial application, although topical ketoconazole had a higher resolution rate and lower rate of disease recurrence.CONCLUSIONS AND SIGNIFICANCEOtomycosis can usually be diagnosed by clinical examination and often occurs in the setting of persistent otorrhea. Complications are not uncommon but usually resolve with application of appropriate topical antifungal agents. Eradication of disease is more difficult in the presence of a mastoid cavity.
Factors influencing intraoral removal of submandibular calculi
Authors: Park June Sik , Sohn Jin Ho , Kim Jeong Kyu 
Published: October 2006

OBJECTIVESTo assess the effectiveness of intraoral removal of submandibular calculi based on several factors that may influence the results of surgery.STUDY DESIGN AND SETTINGWe retrospectively reviewed 172 patients who underwent intraoral removal of submandibular sialolithiasis. Results of surgery were divided into complete removal, partial removal, and failure. The effect of location, palpability, size, and presence of infection of the calculi on the results was estimated.RESULTSUnivariate analysis showed that palpability and presence of infection were statistically significant factors affecting intraoral removal. Palpability was the only significant factor after multivariate analysis. Twelve of 13 patients with recurrent calculi underwent repeat intraoral removal successfully.CONCLUSIONSThe palpability of submandibular calculi is the most important factor influencing their successful intraoral removal.SIGNIFICANCEIntraoral removal can be performed successfully regardless of location, size, presence of infection, or recurrence of calculi, if the calculi are palpable.
Panel reviews NASA science plan
Authors: Kumar Mohi 
Published: October 2006

The draft science plan of the NASA Science Mission Directorate lacks a clear strategy, and the agency may need to either abandon flagship missions or the ability to execute a balanced program due to rising costs, according to a 15 September report by the U.S. National Research Council.Carl Wunsch, a member of the committee that authored the report and an oceanographer at the Massachusetts Institute of Technology, said that cutbacks and mission cancellations announced by NASA have led to “a general worry that the plan might be just a paper document. [The plan] does not really talk in any way about what implementation would cost or what has been dropped from earlier such plans.”
U.S. weather satellite program over budget
Authors: Zielinski Sarah 
Published: October 2006

Because the next generation of U.S. weather satellites, the Geostationary Environmental Operational Satellite Series‐R (GOES‐R), would run several billion dollars over budget if constructed as originally planned, the U.S. National Oceanic and Atmospheric Administration (NOAA) will cancel development of at least one advanced sensor and is considering other options that would reduce costs, NOAA Administrator Conrad Lautenbacher, Jr., testified at a 29 September hearing before the U.S. House of Representatives Committee on Science.GOES‐R would be the latest in a series of geostationary satellites that have been launched since the 1970s. NOAA currently operates two such satellites—one each over the U.S. east and west coasts—which provide images and oceanic, atmospheric, and climatic data over the continental United States and Hawaii. This information is used to forecast weather and provide warnings of severe weather.
Restoring Hetch Hetchy Valley: The role of modeling in policy
Authors: Null Sarah E. , Lund Jay R. 
Published: October 2006

In 1923, following years of opposition and debate, the City of San Francisco, Calif., completed the O'Shaughnessy Dam, which flooded Hetch Hetchy Valley in California's Yosemite National Park. Today the future of Hetch Hetchy Valley is still debated.Current discussion of restoring the valley has arisen within the state, and the idea of restoration has been largely supported by the use of system optimization and simulation modeling. Mathematical modeling provides thorough and systematic analysis of water supply systems and can suggest improvements to incorporate additional water uses or changing priorities. CALVIN (California Value Integrated Network),an economic‐engineering optimization model, was one of two models used to evaluate the water supply and hydro‐power implications of removing the O'Shaughnessy Dam [Null, 2003; Null and Lund, 2006].