bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pigmented Nevus of the External Auditory Canal
Authors: Fei‐Peng Lee 
Published: July 2006

OBJECTIVETo present the clinical experience during an 18‐year period of a series of 11 cases of pigmented nevus of the external auditory canal (EAC).STUDY DESIGN AND SETTINGRetrospective medical review of 11 consecutive patients with lesions seen in 2 departments of otolaryngology in Taiwan.RESULTS12 pigmented nevi, 2 to 12 mm (average, 6.4 mm) in diameter, were excised under otomicroscopy, and the EAC was packed with a temporary Penrose stent. One large lesion developed a postobstructive external auditory canal cholesteatoma (EACC). Histopathologic examination revealed 11 intradermal nevi and 1 compound nevus. There have been no recurrences or stenoses of EACs after 3 months to 17 years (average, 6 years) of follow‐up.CONCLUSIONIf a pigmented nevus causes symptoms, especially when it is large enough to obstruct the lumen of the EAC and has the possibility of developing into an EACC, it should be excised.EBM rating: C‐4
Office‐Based Intralesional Cidofovir Injections for Nasal Septal Papilloma: A Pilot Study
Authors: Shemen Larry J. , Shnayder Yelizaveta 
Published: July 2006

OBJECTIVESTo determine if nasal septal papilloma is responsive to intralesional cidofovir injections.METHODSFive adult males, ages 37 to 57, presented with nasal septal or columellar papilloma. Three lesions had been previously excised with the laser and recurred. The lesions were injected with cidofovir on a monthly basis until complete resolution or any residual lesion was excised afterwards with the laser.RESULTSAll patients achieved disease remission sustained over 10 to 24 months. Overall doses were much lower than those described for laryngeal papillomatosis and no toxic effects were observed.CONCLUSIONSOffice‐based intralesional injections of cidofovir may show benefit in the treatment of nasal septal papilloma.EBM rating: C‐4
Association of HLA‐DR3 and HLA‐DR4 with Sinonasal Polyposis in Mexican Mestizos
Authors: Jaqueline Ramírez‐Anguiano , Jesús K. Yamamoto‐Furusho , Rodrigo Barquera , Olga Beltrán , Julio Granados 
Published: July 2006

OBJECTIVEThe pathogenesis of sinonasal polyposis (SNP) is not clear; it has been suggested that it is polygenic and multifactorial. The major histocompatibility complex is a useful tool to predict genetic susceptibility to diseases, especially to autoimmune diseases. Since such susceptibility is influenced by ethnicity, it is necessary to have a wide knowledge of the structure of the population to which the patient belongs. The purpose of the study was to determine the association of HLA‐DRB1 alleles with sinonasal polyposis in the Mexican Mestizo population.STUDY DESIGNWe studied the HLA‐DR alleles in 34 adult Mexican Mestizo patients with SNP and compared them to those present in 99 healthy controls.METHODSGenomic DNA from mononuclear cells was obtained by using the “salting out” technique and high‐resolution DNA typing of the HLA‐DRB1 alleles was performed after PCR amplification.RESULTSWe found a statistically significant increased frequency of the HLA‐DRB1∗03 allele (P = 0.03, odds ratio [OR] = 2.9, 95% confidence interval [CI]: 1.0–7.8) and of the HLA‐DRB1∗04 allele (P = 0.009, OR = 2.2, 95% CI: 1.2–4.2) in patients with SNP as compared to controls, and a statistically significant decreased frequency of the HLA‐DRB1∗08 allele (P = 0.01, OR = 0.2, 95% CI: 0.05–0.8).CONCLUSIONThe HLA‐DR locus seems to be associated with the genetic susceptibility to develop SNP in Mexicans.EBM rating: B‐2b
Reliability of Interpretation of CT Examination of the Larynx in Patients with Glottic Laryngeal Carcinoma
Authors: Hoorweg J.J. , Kruijt R.H. , Heijboer R.J.J. , Eijkemans M.J.C. , Kerrebijn J.D.F. 
Published: July 2006

INTRODUCTIONReports in literature suggest that tumor volume, cartilage invasion, and cartilage sclerosis are independent prognostic factors for tumor control in radiotherapy as primary treatment of laryngeal carcinomas.OBJECTIVEAssessment of the interobserver variability and prognostic value in the measurement of tumor volume, cartilage invasion, and sclerosis.MATERIALS AND METHODSRetrospective analysis of 55 CT scans by three independent observers. Volume measurements and determination of cartilage invasion, cartilage sclerosis, and tumor localization were calculated. Correlation between the prognostic factors and radiotherapy was calculated for each observer.RESULTSValues for interobserver agreement varied substantially; cartilage invasion (κ value: −0.02 to 0.66), cartilage sclerosis (κ value: 0.13 to 0.57), tumor localization of subsites (κ value: 0.03 to 0.60), and tumor volume (correlation: 0.34 to 0.73). The found interobserver variation makes it impossible to establish accurate prognostic factors.CONCLUSIONDetermination of tumor volume, cartilage invasion, and cartilage sclerosis on the basis of CT imaging shows considerable interobserver variation; clinical significance appears to be limited.EBM rating: B‐3a
Nationwide Survey on the use of Image‐Guided Functional Endoscopic Sinus Surgery
Authors: Hepworth Edward J. , Bucknor Matthew , Patel Ankit , Vaughan Winston C. 
Published: July 2006

OBJECTIVETo evaluate impressions and usage of sinus surgery image‐guided surgical (IGS) systems by ENT surgeons in the United States.STUDY DESIGN AND SETTINGA survey was mailed to selected practicing ENT physicians, investigating regional information, practice type, IGS usage patterns, perceived benefits and limitations, and usage of the 61795 surgery code.RESULTSSeventy‐three percent of respondents use IGS. Nonusers respond that it provides no benefit or is too expensive. Eighty percent of respondents replied that IGS may allow for increased safety in certain procedures. Most users attempt reimbursement with the 61795 code.CONCLUSIONIGS usage is increasing but appears to be perceived as expensive and nonbeneficial in certain situations. Most respondents, however, felt that IGS may lead to safer surgery in certain situations, including revision and frontal procedures. Several factors appear to limit routine use including ease of use, technical setup, code reimbursement, and initial purchase costs.SIGNIFICANCEIGS use appears to be increasing. The most frequent users appear to agree with the previously issued AAO‐HNS guidelines regarding appropriate indications. Expanded use may depend on ease of use, reimbursement, and affordability.EBM rating: D‐5
Sensory Neuropathic Cough: A Common and Treatable Cause of Chronic Cough
Authors: Bastian Robert W. , Vaidya Abhay M. , Delsupehe Kathelijne G. 
Published: July 2006

OBJECTIVETo describe our experience with chronic sensory neuropathic cough and its response to amitriptyline in a first group of patients.STUDY DESIGN AND SETTINGA prospective cohort of patients is described in detail. Each was referred to an academic laryngological practice after extensive prior negative workup for cough and failure to respond to various treatments. Each of these patients was treated with amitriptyline and asked to report the effect on the cough at fixed intervals by means of telephone interviews.RESULTSA first cohort of 12 consecutive patients with a chronic, nonproductive cough that lasted between 2 months and 20 years, with no (formerly) discernible cause is described. Purely clinical criteria of inclusion and exclusion are proposed. All patients had at least 40% reduction of self‐reported symptoms, with most describing between 75% to 100% short‐term relief.CONCLUSIONSensory neuropathic cough can be diagnosed clinically in patients with chronic idiopathic cough. A trial of amitriptyline 10 mg or of other antineuralgia type medications may be helpful. Longer term and controlled trials are warranted to validate this entity and prove efficacy of neurologic medication in chronic sensory neuropathic cough.EBM rating: C‐4
Estrogen Blockade Reduces Auditory Feedback in CBA Mice
Authors: Thompson K. Scott , Xiaoxia Zhu , Frisina D. Robert 
Published: July 2006

OBJECTIVETo examine the effects of estrogen suppression on age‐related changes in distortion product otoacoustic emissions (DPOAEs) and contralateral suppression (CS) of DPOAEs in CBA mice.STUDY DESIGN AND SETTINGYoung CBA mice received a slow‐release shoulder implantation of either tamoxifen or placebo. Serial DPOAEs and CS of DPOAEs were obtained at 3‐week intervals over a period of 9 weeks.RESULTSAlthough DPOAEs were maintained over the study interval, CS of DPOAEs decreased significantly with age in the experimental group. No such declines were observed in either the control animals or the untreated male mice.CONCLUSIONSEstrogen suppression negatively affects the MOC efferent feedback system.SIGNIFICANCEOur results support the hypothesis that estrogen plays an important role in the maintenance of auditory integrity. Additionally, our findings raise intriguing questions about auditory effects of hormonal shifts in humans resulting from menopause, hormone supplements such as oral contraceptives, and hormone replacement therapy as well as antiestrogens.
Long‐Term Results of Endonasal Laser Dacryocystorhinostomy
Authors: Neel Umapathy , Sukman Kalra , Derek W. Skinner , Robert B. Dapling 
Published: July 2006

OBJECTIVETo determine the long‐term success rate of endonasal laser dacryocystorhinostomy (DCR) in our unit.MATERIALS AND METHODSThis was a retrospective study including all the consecutive cases of endonasal laser DCR (ELDCR) between November 1996 and December 1999. Patients who underwent revision DCR were excluded. The absence or improvement of symptoms as reported by the patients was defined as successful outcome. Conversely, recurrence of epiphora was considered as failure. The results were reviewed at 1 year in the clinic and at further 3 years and 5 years by telephone consultation.RESULTSThere were 65 patients (73 procedures) in the study cohort, with a mean follow‐up period of 74 months (range, 60–97). Early failure was noted in 13 patients at 1 year. Only 28 patients (of the possible 50) were free from epiphora after 5 years postsurgery.CONCLUSIONWe found that the success rate of ELDCR has gradually declined over the years to 56% (confidence interval, 38–69) in patients who had at least 5 years of postoperative data. We do not advocate the use of laser in endonasal DCR for patients with epiphora.EBM rating: C‐4
Preliminary Findings for Preemptive Analgesia with Inhaled Morphine: Efficacy in Septoplasty and Septorhinoplasty Cases
Authors: Selami Ateş Önal , Erol Keleş , Gonca Çağlar Toprak , İsmail Demirel , Alpay H. Cengiz , Levent Avci 
Published: July 2006

OBJECTIVEThe aim of this study was to assess the efficacy of inhaled morphine for preemptive analgesia in patients who undergo septoplasty or septorhinoplasty.STUDY PLAN AND METHODSEighty ASA I‐II patients scheduled for septoplasty or septorhinoplasty were recruited and randomly divided into 2 groups that received different treatments 10 minutes prior to induction. The preemptive analgesia group (Group P, n = 40) received 65 μg kg−1 morphine sulphate (a 3‐mL volume) via an oral nebulizer, and the control group (Group C, n = 40) received 3 mL 0.9% sodium chloride (physiological saline) via the same type of nebulizer. Blood pressure, oxygen saturation, heart rate, time to first requirement for analgesia, and occurrence of nausea/vomiting were recorded.RESULTSThere were no significant differences between Groups P and C with respect to age, body weight, sex distribution, or duration of surgery. There was also no significant difference between the group frequencies of postoperative nausea/vomiting. The time to first requirement for analgesia was significantly longer in Group P than Group C.CONCLUSIONThe results of this preliminary study suggest that a single dose of inhaled morphine administered preemptively prior to septoplasty or septorhinoplasty provides effective postoperative analgesia.EBM rating: B‐3b
Laryngeal Reconstruction with Porous High‐Density Polyethylene
Authors: Iseri Mete , Ustundag Emre , Yayla Berna , Kaur Ahmet 
Published: July 2006

OBJECTIVEThis study was undertaken to evaluate the use of the Medpor (Porex Surgical, College Park, GA) implant in laryngeal reconstruction and to discuss potential indications of this material in head and neck surgeries.METHODTwelve rabbits were used in this particular study. Laryngoplasties were performed by extracting 5 × 10‐mm thyroid cartilage and replacing it with Medpor implant. Animals were sacrificed in the 1st, 2nd, and 4th weeks and 2, 6, and 9 months after implantation. The degree of fibrous capsule formation, histiocytic reaction, foreign body giant cell reaction, lymphocytic and neutrophilic reactions, vocal fold changes, and hyaline cartilage formation in the implant bed were evaluated.RESULTSFibrous capsule was formed around the implant in 2 weeks. Four weeks after the implantation cellular reaction in the implant bed decreased significantly. Foreign body giant cell reaction was detected only the first 2 weeks after the implantation.CONCLUSIONAccording to the results of this study, the Medpor implant can be safely used in laryngeal reconstruction.
The Effects of Intradermal and Topical Mitomycin C on Wound Healing
Authors: Porter Glen T. , Gadre Swarupa A. , Calhoun Karen H. 
Published: July 2006

OBJECTIVETo determine the effect of intradermal and topical mitomycin C (MMC) on skin wound healing.STUDY DESIGN/SETTINGA prospective, controlled study in a rat wound model performed in an academic medical center.RESULTSIntradermal and topical MMC application decreased wound integrity when compared with saline‐treated animals at 1 week, 2 weeks, 1 month, and 6 months. Skin necrosis occurred in animals that received intradermal MMC. Hemotoxylin and eosin and immunohistochemical staining showed no consistent difference between treatment arms. Fibrosis and collagen deposition were reduced in MMC‐treated wounds on trichrome staining.CONCLUSIONSMMC‐treated wounds showed decreased wound strength compared with controls. Intradermal MMC can cause skin necrosis. Histologic findings did not always correspond with clinical data.SIGNIFICANCEThe data suggest cautious use of MMC in clinical situations when wound breaking strength is critical.
Differentiation Plasticity of Human Fetal Articular Chondrocytes
Authors: Cui Ying , Wang Hong , Yu Minjun , Xu Tianri , Li Xuepei , Li Lingsong 
Published: July 2006

OBJECTIVETo test chondrogenic differentiation potential, we examined the differentiation plasticity of isolated human fetal articular chondrocytes (HFACs).STUDY AND DESIGN SETTINGCulture‐expanded human fetal articular chondrocytes (HFACs) were analyzed for chondrogenic, adipogenic, osteogenic capacity and neural differentiation ability in defined in vitro culture systems.RESULTSThe different assays demonstrated that culture‐expanded HFACs have potential to form cartilage in pellet mass culture, to form adipose cells, osteogenic cells, and neural cells in monolayer culture.CONCLUSIONSThese results suggest that within human fetal articular cartilages there are MSC‐like cells that exhibit differentiation plasticity that is comparable with that of BM‐MSCs and they may be a new kind of seeding cells for head and neck cartilage reconstruction.
Vagal Nerve Stimulator Implantation: An Otolaryngologist's Perspective
Authors: Ghanem Tamer , Early Stephen V. 
Published: July 2006

OBJECTIVEThis study was conducted to compare an otolaryngologist's experience with a cohort of epilepsy patients implanted with a vagal nerve stimulator (VNS) to previously published data.METHODSDemographics, preoperative seizure frequency, medications, and complications were retrospectively collected from patients implanted by the senior author. Postoperative medications and seizure frequency were obtained from referring neurologists.RESULTSSeventeen patients were implanted over a 24‐month period. Average age was 28.3 years. Patients presented with petit mal (n = 3), tonic‐clonic (n = 6), complex partial (n = 5), and grand mal (n = 8) seizures. Mean follow‐up postimplantation was 13.5 months. Most patients had at least a 50% reduction of seizure frequency, with 3 patients being seizure free. There were no postoperative infections. One patient had left vocal cord immobility. The most common side effect was voice disturbance during device activation.CONCLUSIONOtolaryngologists are well equipped to perform VNS implantation and to diagnose and treat possible laryngeal side effects.EBM rating: C‐4
Postoperative Radiation Therapy for T1 and T2 Primary Parotid Carcinoma: Is it Useful?
Authors: Peter Zbären , Michel Nuyens , Marco Caversaccio , Richard Greiner , Edouard Stauffer 
Published: July 2006

OBJECTIVEThe benefit of postoperative radiation for advanced primary parotid carcinoma has been reported previously, whereas studies to evaluate the usefulness of postoperative radiation for T1 and T2 parotid carcinomas have never been performed.STUDY DESIGN AND SETTINGRetrospective analysis on 58 previously untreated patients with T1 and T2 parotid carcinomas. In 34 patients, postoperative radiation was included in the treatment protocol and in 24 patients, no postoperative radiation was applied.RESULTSA local recurrence was observed in 8 of 24 (33%) patients withoht and in 1 of 34 (3%) patients with postoperative radiation (P < 0.5). The 5‐year actuarial and disease‐free survival rate was 83% and 70% for patients without postoperative radiation and 93% and 92% for patients with postoperative radiation.CONCLUSION AND SIGNIFICANCELocal recurrence was less often observed in patients with postoperative radiation. Nevertheless, prospective randomized studies are needed to confirm the usefulness of postoperative radiation in early carcinomas.EBM rating: B‐3b
Simplifying Second‐order Belief Attribution: What Facilitates Children’s Performance on Measures of Conceptual Understanding?
Authors: Coull Greig J. , Leekam Susan R. , Bennett Mark 
Published: July 2006

AbstractThis study investigated how 4‐ to 7‐year‐old children’s second‐order belief attribution might be facilitated by either reducing information processing or varying the sequence of task questions. In Experiment 1, compared withPerner and Wimmer’s (1985) original second‐order false‐belief task, a new task with reduced information‐processing demands promoted better second‐order reasoning. In Experiment 2, half the stories included a second‐order ignorance question before a second‐order belief question. The ignorance question promoted second‐order belief understanding, superseding the improvement induced by lowered processing demands. Together, the findings suggest that second‐order belief performance can be facilitated if children focus on the concept of ignorance during the sequence of questioning.
Visualization of cervical nerve roots and their distal nerve fibers by diffusion-weighted scanning using parallel imaging
Authors: Tsuchiya K. , Fujikawa A. , Tateishi H. , Nitatori T. 
Published: June 2006

Purpose: To report a technique developed for visualizing cervical nerve roots and distal nerve fibers using diffusion-weighted magnetic resonance imaging employing parallel imaging. Material and Methods: We performed maximum intensity projection for a stack of isotropic axial diffusion-weighted images obtained with parallel imaging applying a motion-probing gradient in six directions with a b-value of 500 s/mm2 in a preliminary series of 13 subjects. Results: This method worked well for visualizing the spinal cord and most of the nerve roots, the dorsal root ganglia, and proximal peripheral nerves. Conclusion: Although the technique remains limited in depicting the brachial plexus and distal nerves, the ability to visualize the proximal peripheral nervous system at the cervical level is promising.
Magnetic resonance imaging comparison of intra-articular cavernous synovial hemangioma and cystic synovial hyperplasia of the knee
Authors: De Filippo M. , Rovani C. , Sudberry J. J. , Rossi F. , Pogliacomi F. , Zompatori M. 
Published: June 2006

Purpose: To identify and compare magnetic resonance imaging (MRI) characteristics, with and without intravenous contrast medium, of cavernous synovial hemangiomas and cystic synovial hyperplasia. Material and Methods: Four cases of cavernous synovial hemangioma and five of cystic synovial hyperplasia of the knee were studied retrospectively. The patients (5 F and 4 M; 15–25 years of age) all had long-standing knee pain. At clinical examination we observed elastic swelling and pain without significant joint effusion. The patients underwent conventional radiography and MRI without and following intravenous contrast medium before arthroscopic biopsy. Results: The radiographs were interpreted as negative in all patients. MRI examination without contrast medium revealed a similar multicystic appearance for both lesions. Following intravenous contrast agent administration, cavernous synovial hemangiomas demonstrated avid, rather homogenous enhancement, whereas cystic synovial hyperplasia demonstrated less intense, peripheral enhancement only. Arthroscopy with histological examination of the lesions confirmed the MRI diagnosis in every case. Conclusion: In our experience, cavernous synovial hemangioma and cystic synovial hyperplasia have a similar appearance on unenhanced MRI, but can be reliably differentiated on the basis of enhancement characteristics following intravenous contrast administration.
Long‐Term Results of Boerema Anterior Gastropexy in Children
Authors: Kloek J.J. , van de Laar G.A.G. , Deurloo J.A. , Aronson D.C. , Benninga M.A. , Taminiau J.A.J.M. , Heij H.A. 
Published: July 2006

ABSTRACTObjectives:To analyze the long‐term results of Boerema anterior gastropexy using the Visick grading system in a university teaching hospital.Methods:Retrospective review of 247 children with severe or complicated gastroesophageal reflux disease (GERD). Patients who underwent primary gastropexy between 1990 and 2001 were divided in 3 groups: (A) neurologic impaired patients (n = 83); (B) esophageal atresia patients (n = 36); and (C) patients without underlying disease (n = 128). The median length of follow‐up after gastropexy was 7 years and 8 months (range, 1.5‐13 years). Follow‐up was carried out using a standardized questionnaire and was obtained by telephone. Postoperative recurrence of symptoms during follow‐up was considered as failure of the operation.Results:Postoperative complications occurred in 20 patients (24%) in group A, in 13 patients (36%) in group B and in 23 patients (18%) in group C. Thirty‐three patients died during the follow‐up period, 5 of whom during the postoperative period. Six children could not be traced; thus, 208 were available for long‐term follow‐up. Postoperative failures occurred in 12 patients (23%) in group A, in 11 patients (31%) in group B and in 17 patients in group C (14%). Reoperation for recurrence of symptoms due to GERD was performed in 6 patients in group A, in 7 patients in group B and in 2 patients in group C. The final outcome at the time of interview was successful in 81% of group A, in 88% of group B and in 91% of group C.Conclusions:In the long term, Boerema anterior gastropexy is an effective operation for complicated GERD in children without underlying disease as well as in neurologically impaired children and patients with esophageal atresia.