bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acoustic Neuroma in a Private Neurotology Practice: Trends in Demographics and Practice Patterns
Authors: Chen Douglas A. 
Published: February 2009

AbstractObjectives/Hypothesis: To determine whether changes in demographics and management of patients with acoustic neuromas occurred between the years 1990 and 2005.Study Design: Retrospective chart review.Methods: Charts of all 614 patients with a diagnosis of acoustic neuroma, excluding neurofibromatosis‐2, from 1990 through 2005 were reviewed. Age at diagnosis, tumor size, hearing, and initial therapy (observation, stereotactic radiation, or surgical excision) were obtained. Patients were grouped by time period (1990–1994, 1995–2000, 2001–2005).Results: Mean age at diagnosis increased slightly from the middle period (53.4 yr) to the most recent (56.9 yr) (P ≤ .025). The proportion of patients 65 years or older increased from 21% to 29% to 32%, respectively, but the change was not significant. Average tumor size decreased from 1.7 cm initially to 1.4 cm most recently (P ≤ .039). There were no significant changes in hearing. Although surgical excision remains our most common treatment (58.5% in 2001–2005), it is becoming less frequent (>80% in earlier periods) (P ≤ .001). Observation with serial imaging was recommended in 37.3% in 2001 to 2005 as compared with 18.3% and 11.6% in the previous two time periods (P ≤ .001). These changes in initial treatment choices occurred for all age groups and primarily for small tumors. Use of radiation has increased only slightly, to 4.2% in the recent period.Conclusion: Patients with acoustic neuroma are presenting with increased age and smaller tumors compared with 16 years ago. However, these changes cannot totally account for the large change in treatment trends. Technology and demographics are influential in these changes, but other difficult to measure forces, such aspatient influence and patient use of the Internet, are also factors.
The Cytology and Microbiology of Persistent Paranasal Sinus Secretions After Endoscopic Sinus Surgery: A Controlled Study
Authors: Bhattacharyya Neil 
Published: February 2009

AbstractObjective: To determine the cellular composition and influence of microbiology on persistent paranasal sinus secretions after endoscopic sinus surgery (ESS).Methods: Persistent sinus secretions from a consecutive series of patients after ESS were studied with cytopathology and cultures for aerobic, anaerobic, and fungal organisms. A control group consisting of patients without persistent secretions after ESS was also studied. Epithelial, neutrophil, and eosinophil cell presence was semiquantitatively assessed on a 4‐point scale and compared between control and diseased groups. Cellular composition was then stratified and analyzed according to the presence of microorganisms.Results: A total of 50 diseased and 24 control patients were studied. Both diseased and control patients demonstrated sloughed epithelial cells in secretions (53.1% and 66.7%, respectively, P = .131). The diseased group exhibited significantly higher eosinophilic or eosinophilic/neutrophilic cellularity than the controls (P = .048). The average neutrophil infiltration score was 0.82 versus 0.54 for the controls (P = .104). For the diseased group, the mean eosinophil score was 1.56 versus 0.96 in the control group (P = .035). Pathogenic bacteria were identified in 64% of the diseased group patients versus 54.2% in controls (P = .454). Only two fungal cultures were positive (diseased group). Microbiological analysis indicated that in the absence of bacteria, diseased group patients mainly manifested an eosinophilic presence, whereas in the presence of bacteria, the neutrophil response was enhanced in diseased patients and eosinophil response was enhanced in controls.Conclusions: Persistent sinus secretions after ESS are primarily driven by an eosinophilic presence. Patients without inflammatory exudate after ESS respond to bacteria with increased eosinophilia, whereas hypersecretory patients demonstrate both increased neutrophil and eosinophil presence.
Association of Extraesophageal Reflux Disease and Sinonasal Symptoms: Prevalence and Impact on Quality of Life
Authors: Pasic Thomas R. , Palazzi‐Churas Kerrin L. , Connor Nadine P. , Cohen Stacy B. , Leverson Glen E. 
Published: February 2009

AbstractObjectives: The purpose of this study was to investigate the prevalence of extraesophageal reflux disease symptoms and their association with sinonasal disorders within a general sample of adults in our community and to determine how these conditions affect perception of general health, sinus‐related quality of life (QOL), and perception of reflux and digestive function.Study Design/Methods: A community‐dwelling sample of 1,878 adults completed symptom and QOL surveys in a two‐stage prospective design: an initial screening questionnaire (n = 1,878) and disease‐specific (sinus and reflux/digestion) and general health‐related QOL instruments (n = 1,073). Demographic and response data were summarized and analyzed for prevalence and correlations among data sets.Results: Sinonasal symptoms were reported in 71% of subjects who completed the initial screening questionnaire, and reflux‐related symptoms were reported by 59% of respondents. The co‐occurrence of sinonasal and reflux symptoms was reported by 45% of respondents. Subjects with both sinonasal and reflux symptoms scored significantly worse on the disease‐specific and general physical and mental QOL scales than subjects with only reflux or sinonasal symptoms or no symptoms.Conclusions: Symptoms associated with inflammatory sinonasal disorders and gastroesophageal reflux disease are common in the general U.S. adult population and co‐occur in the same individuals to a greater degree than can be attributed to chance alone. Co‐occurrence was found to be associated with significant declines in both disease‐specific and general physical and mental QOL. This finding has implications with regard to pathogenesis and treatment of these disorders.
Effect of Glucocorticoid on the MUC4 Gene in Nasal Polyps
Authors: Bai Chang Hoon , Song Si‐Youn , Kim Yong‐Dae 
Published: February 2009

AbstractObjectives/Hypothesis: Among the airway mucin genes, the MUC4 gene is an important gene in its response to inflammatory diseases of the upper airway. However, the expression and regulation of the MUC4 gene in the nasal polyps remains unclear.Study Design: The purpose of this study was to evaluate the expression of MUC4 mRNA and synthesis of mucin glycoprotein in the nasal polyps before and after treatment with a topical steroid in vivo and in vitro.Methods: Nasal polyps were obtained from 20 patients with chronic rhinosinusitis and were subsequently cultured. The level of MUC4 mRNA was measured by reverse‐transcription polymerase chain reaction, and the amount of the MUC4 mucin glycoprotein was estimated by the enzyme‐linked immunosorbent assay method.Results: The expression of MUC4 mRNA was found to be significantly higher in the nasal polyps than in the inferior turbinate (P < .05). The addition of interleukin (IL)‐1β and lipopolysaccharide (LPS) increased the expression of MUC4 mRNA and mucin glycoprotein synthesis in cultured nasal polyp epithelial cells. Treatment with glucocorticoid inhibited the expression of MUC4 mRNA in the nasal polyps; it also inhibited the expression of IL‐1β and LPS‐induced MUC4 mRNA and mucin glycoprotein synthesis in cultured nasal polyp epithelial cells. The inhibitory effects of glucocorticoid were restored by treatment with a glucocorticoid receptor antagonist (RU‐486).Conclusions: These results suggest that the MUC4 gene is expressed in the nasal polyps and that glucocorticoid can control the expression of the MUC4 gene and mucin glycoprotein synthesis.
Effect Of N‐Acetylcysteine on Carboplatin‐Induced Ototoxicity and Nitric Oxide Levels in a Rat Model
Authors: Okur Erdogan , Kilinc Metin , Yildirim Ilhami , Kilic M Akif , Tolun Fatma Inanc 
Published: February 2009

AbstractObjective: The aim of the present study is to investigate the effect of N‐acetylcysteine (NAC) given 30 minutes before carboplatin administration on carboplatin‐induced ototoxicity and nitric oxide (NO) levels in a rat model.Study Design: Animal study.Methods: Eighteen Sprague‐Dawley rats were divided into three groups that each contained six animals. Intraperitoneal injection of physiologic saline was performed in group 1 twice with an interval of 30 minutes. Group 2 was treated with a single bolus administration of carboplatin at a dose of 256 mg/kg 30 minutes after the intraperitoneal injection of physiologic saline. Group 3 was treated with a single bolus administration of carboplatin at a dose of 256 mg/kg 30 minutes after the intraperitoneal injection of NAC at a dose of 400 mg/kg. Pretreatment and posttreatment distortion product otoacoustic emissions (DPOAE) were performed in rats from all groups. Then, the animals were sacrificed on the fourth day, and cochlear tissue NO and glutathione peroxidase (GSH‐Px) levels were measured.Results: The comparison of pre‐ and posttreatment DPOAE responses did not demonstrate any significant changes for groups 1 and 3. Results of group 2 showed a decrease of the DPOAE amplitude. Cochlear NO levels were significantly higher in rats treated with carboplatin than in controls and in those treated with carboplatin plus NAC (P < .05). Cochlear GSH‐Px levels were higher in rats treated with carboplatin plus NAC than in those treated with carboplatin, but the difference did not reach statistical significance (P = .079).Conclusions: The present study showed that carboplatin at higher doses induced hearing loss and increased NO levels in the cochlea of rats. NAC appears to have a protective effect against carboplatin‐induced ototoxicity, which may be related to its inhibitory effect on NO production.
Incision and Drainage Followed by Mattress Suture Repair of Auricular Hematoma
Authors: Giles William C. , Iverson Kenneth C. , King Jonathan D. , Hill Frank C. , Woody Edward A. , Bouknight Anna L. 
Published: February 2009

AbstractObjective: Auricular hematoma is a condition requiring early and effective management to prevent pathogenesis of the unsightly cauliflower ear. The objective of this study is to review cases of auricular hematoma and present incision and drainage followed by through‐and‐through whip‐type absorbable mattress sutures without bolsters as an effective treatment.Study Design: Retrospective chart review of auricular hematoma cases.Methods: A 5‐year retrospective evaluation of auricular hematomas presenting to an otolaryngology group was performed. Patients' charts were reviewed and data regarding the treatment and follow‐up of auricular hematomas were assembled and analyzed.Results: Twenty‐two patients were found to present with auricular hematoma. One patient was lost to follow‐up. Twenty‐eight treatments were performed on 23 ears. Seven hematomas were treated with needle aspiration, two were treated with incision and drainage with iodoform wick placement, and 19 were treated with incision and drainage followed by absorbable mattress sutures. There were five hematoma reaccumulations requiring an additional procedure after treatment by an otolaryngologist. Three followed needle drainage; one followed incision and drainage with wick placement, and one followed incision and drainage with absorbable mattress sutures.Conclusion: Incision and drainage followed by through‐and‐through absorbable mattress sutures appears to be a superior method of treatment with rare reaccumulation of hematoma. This method of treatment was shown to be simple and well tolerated, and it had few complications.
Scala Tympani Cochleostomy II: Topography and Histology
Authors: Adunka Oliver F. , Radeloff Andreas , Gstoettner Wolfgang K. , Pillsbury Harold C. , Buchman Craig A. 
Published: February 2009

AbstractObjective: To assess intracochlear trauma using two different round window‐related cochleostomy techniques in human temporal bones.Methods: Twenty‐eight human temporal bones were included in this study. In 21 specimens, cochleostomies were initiated inferior to the round window (RW) annulus. In seven bones, cochleostomies were drilled anterior‐inferior to the RW annulus. Limited cochlear implant electrode insertions were performed in 19 bones. In each specimen, promontory anatomy and cochleostomy drilling were photographically documented. Basal cochlear damage was assessed histologically and electrode insertion properties were documented in implanted bones.Results: All implanted specimens showed clear scala tympani electrode placements regardless of cochleostomy technique. All 21 inferior cochleostomies were atraumatic. Anterior‐inferior cochleostomies resulted in various degrees of intracochlear trauma in all seven bones.Conclusion: For atraumatic opening of the scala tympani using a cochleostomy approach, initiation of drilling should proceed from inferior to the round window annulus, with gradual progression toward the undersurface of the lumen. While cochleostomies initiated anterior‐inferior to the round window annulus resulted in scala tympani opening, many of these bones displayed varying degrees of intracochlear trauma that may result in hearing loss. When intracochlear drilling is avoided, the anterior bony margin of the cochleostomy remains a significant intracochlear impediment to in‐line electrode insertion.
Overall Evaluation of Effectiveness of Type II Thyroplasty for Adductor Spasmodic Dysphonia
Authors: Sanuki Tetsuji , Isshiki Nobuhiko 
Published: February 2009

AbstractObjective/Hypothesis: To assess the effectiveness of type II thyroplasty with a titanium bridge in adductor spasmodic dysphonia (AdSD).Study Design: Retrospective chart review, patient response to a questionnaire on the ease of phonation and voice quality, and pre‐ and postoperative fiberoptic laryngoscope findings.Subjects: Forty‐one patients who underwent type II thyroplasty with a titanium bridge between December 2002 and December 2005 who have been followed for at least 12 months postoperatively.Results: Six patients were male, and 35 were female. The voice was recorded before and at least 6 months after surgery. Initially, 97.6%, 61%, and 48.8% of the patients had a strangulated, interrupted, or tremulous voice, respectively. The mean ratings of strangulation, interruption, and tremor were calculated. The respective mean pre‐ and postoperative scores were 1.51 and 0.46 for strangulation, 0.76 and 0.05 for interruption, and 0.65 and 0.048 for tremor. In the postoperative questionnaire, 70% of the patients judged their voice as excellent and the remaining patients as improved to good or fair.Conclusions: Type II thyroplasty is a highly effective therapy for AdSD. The voice in AdSD may roughly be classified into strangulated, tremulous, and interrupted types. The outcome measures justify the continued treatment of AdSD with type II thyroplasty.
Role of Albumin Coating of Tympanostomy Tubes: Long‐Term Clinical Evaluation
Authors: Kinnari Teemu J. , Rihkanen Heikki , Laine Timo , Salonen Eeva‐Marjatta , Jero Jussi 
Published: February 2009

AbstractObjective: Our previous work has shown that albumin coating of tympanostomy tubes prevented adhesion of proteins or bacteria on the tube surface in vitro and in a 9‐month prospective follow‐up study. This study was continued until all tubes were extruded.Study Design: A prospective, clinical trial.Methods: The randomized, double‐blind clinical trial had 149 patients. The randomization was revealed after the follow‐up period of 9 months. The number of tube sequelae in ears with human serum albumin (HSA)‐coated titanium tympanostomy tubes was compared with the contralateral ears with uncoated, otherwise identical titanium tubes. The follow‐up continued until all tubes were extruded, followed by evaluation of each tympanostomized patient.Results: No significant difference between the two tube types emerged after the 9‐month follow‐up. Among the patients younger than 2 years, one of the three typical bacteria causing acute otitis media (AOM), Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, was found in 45% of all bacterial cultures taken during AOM. However, among patients older than 2, one of these bacteria appeared in 17% of all the bacterial cultures and in 8% of cultures taken during the summer.Conclusions: After the first 9 follow‐up months, no difference was found in the sequelae related to uncoated and HSA‐coated tubes. The typical bacteria causing AOM were found less frequently among patients older than 2 years. A profile of tympanostomy patients in Finland will be given.
Ototoxicity of Topical Moxifloxacin in a Chinchilla Animal Model
Authors: Daniel Sam J. , Duval Melanie , Sahmkow Sofia , Akache Fadi 
Published: February 2009

AbstractObjective: Ciprofloxacin is currently the only proven nonototoxic topical antibiotic. However, its widespread use has resulted in the emergence of antimicrobial resistance. There are also concerns that there is currently no safe alternative to ciprofloxacin for patients with a nonintact eardrum. We thus wished to evaluate whether a moxifloxacin solution is ototoxic when used topically in chinchilla ears in the presence of a pressure‐equalizing tube (PET).Study Design: A prospective, randomized, controlled trial was conducted in an animal model.Methods: Twenty chinchillas were included in this study. After bilateral insertion of PETs, four drops of a moxifloxacin solution were delivered twice daily for 7 days in the randomly assigned experimental ear. The control ear received an equal amount of a solution of Ringer's lactate. Distortion product otoacoustic emissions (DPOAE) were recorded at baseline (after PET insertion) and at days 1, 3, 7, 14, and 28 after treatment initiation.Results: When baseline DPOAE measurements were compared with the final measurements at day 28, moxifloxacin caused a statistically significant (P < .05) hearing loss (HL) in the experimental ears for the frequencies between 3.7 and 15 kHz. There was no significant change in hearing in the control ears.Conclusion: This represents the first study on the ototoxicity of topical moxifloxacin. Our results demonstrate that moxifloxacin causes HL when used with a nonintact tympanic membrane in a chinchilla animal model.
Modified Retrograde Approach to Upper Eyelid Static Loading
Authors: Kim David W. , Ali M Jafer 
Published: February 2009

AbstractObjectives/Hypothesis: Upper eyelid static weight loading is a technique commonly used to treat paralytic lagophthalmos. The traditional approach using the pretarsal crease incision leads to interruption of the anterior levator muscle fibers that attach to the face of the tarsus at its upper two thirds. This disruption can lead to permanent upper eyelid blepharoptosis. The retrograde approach avoids this problem but results in an incision at the lid margin, the dependent aspect of the weight. This increases the risk of implant extrusion. We hypothesize that a newly described modified retrograde approach is a safe and effective approach that avoids the pitfalls of previously described techniques.Study Design: Retrospective review.Methods: Eight patients were evaluated with preoperative and 3 to 6 month postoperative photographs with the eyes in the open and closed positions for the degree of lagophthalmos and blepharoptosis present. Patients were also evaluated for development of complications such as implant extrusion, pain, or infection. The surgical technique uses a supratarsal skin crease incision, supramuscular dissection to the lid margin, entry into the tarsal plane at its inferior‐most aspect, creation of a pocket for implant insertion, and layered closure.Results: All patients had complete correction of lagophthalmos. No patients experienced infection, extrusion, or eye pain after surgery. All patients had less than 2‐mm ptosis after surgery, with no patients experiencing any visual field disruption.Conclusions: The modified retrograde approach to upper eyelid static loading for paralytic lagophthalmos provides advantages over other techniques described. It is a safe, efficacious procedure, well tolerated by patients.
A New Model of Laryngitis: Neuropeptide, Cyclooxygenase, and Cytokine Profile
Authors: Lima‐Rodrigues Manuel , Valle‐Fernandes Ana , Lamas Nuno , Cruz Andrea , Baltazar Fátima , Milanezi Fernanda , Nunes Rui , Reis Rui M. , Pedrosa Jorge , Castro António G. , Almeida Armando 
Published: February 2009

AbstractObjectives/Hypothesis: To develop and characterize a new model of laryngeal inflammation by analyzing the presence of neurogenic peptides and expression of cyclooxygenases (COX) and cytokines in the mucosa.Study Design: Laryngitis induced by nasogastric intubation (NGI) was evaluated by histopathologic changes of the mucosa, alterations in calcitonin gene related peptide (CGRP) and substance P (SP) neuropeptides in sensory fibers, and COX‐1,2, and cytokine (interleukin [IL]‐1, IL‐6, IL‐10, tumor necrosis factor [TNF]‐α) expression in the laryngeal mucosa.Methods: Rats submitted to NGI for 1 to 5 weeks were compared with controls. Laryngeal sections were immunostained for stereologic analysis of SP and CGRP fiber density and number of mucosal cells expressing COX‐2. Alterations in inflammatory mediators were evaluated by quantitative reverse‐transcriptase polymerase chain reaction.Results: NGI induced metaplasia of the epithelium and narrowing of the laryngeal lumen because of hypertrophy of laryngeal glandules and edema. An initial decrease in CGRP‐ and SP‐immunoreactive fibers in the laryngeal mucosa (1–3 wk) was reverted with time (5 wk). COX‐2 expression in mucosal cells increased progressively, reaching a maximum level at 5 weeks, and was observed in mononuclear immune cells, which is indicative of a chronic inflammatory process. In regard to mRNA expression levels of inflammatory mediators, TNF‐α was increased during the 5 week NGI, and IL‐10 decreased during the 5 weeks,whereas IL‐1β, IL‐6, and COX‐2 increased in the first 1 to 2 weeks and returned to baseline at 5 weeks.Conclusions: This NGI model results in laryngeal chronic inflammation without direct mechanical aggression of the mucosa and may contribute to the study of future therapeutic approaches to this pathology.