bluuebunny/crossref_metadata_2025_split huggingface dataset:
S283 – Invasive Fugal Sinusitis: Pathognomic Presentation in MRI
Authors: Min Jinyoung , Chung Seung‐Kyu , Dhong Hun‐Jong , Kim Hyo‐Yeol , Jung Yonggi , Kim Hyung‐Jin 
Published: August 2008

ObjectivesThe aim of this study was to evaluate the pathognomic findings of magnetic resonance image(MRI) and determine the benefit of MRI in early diagnosis of invasive fungal sinusitis(IFS).MethodsWe retrospectively reviewed 15 cases of biopsy‐proven IFS. The preoperative MRI was reviewed to identify the pathognomic findings and correlation between radio‐graphic and surgical findings were investigated.ResultsThe MRI findings included decreased signal intensity on T1‐weighted images with no enhancement on contrast‐enhanced images and markedly decreased signal intensity on T2‐weighted images in all cases. In our series, the interval between the onset of symptom and timing of MRI was from 48 hours to 2 weeks. Radiographic findings were correlated with histopathologic findings in 13 of 15 patients.ConclusionsWe could find typical MRI findings in IFS. MRI should be considered early in patients at high risk for IFS.
S285 – Long‐Term Efficacy of RF Turbinoplasty for Allergic Rhinitis
Authors: Lin Hsin‐Ching , Friedman Michael 
Published: August 2008

ObjectivesTo study the long‐term outcomes of radiofrequency turbinoplasty for the treatment of allergic rhinitis.Methods146 consecutive patients who underwent radio‐frequency turbinoplasty due to allergic rhinitis refractory to medical therapy were enrolled in this study. A 0–10 visual analog scale (VAS) was used to assess the allergic symptoms including nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes preoperatively and 5 years postoperatively. The long‐term clinical benefits and complications were reviewed. Statistical analysis was determined by paired t‐test.ResultsNone of the patients had obvious discomfort except mild numbness over the teeth (27/146, 18.5%) during operation. No long‐term adverse reactions, including bleeding, infection, adhesion, or olfactory change were encountered. 119 patients had a minimum follow‐up of 5 years and complete data available for analysis. The response rate was 60.5% (72/119). 18 patients received additional nasal surgery due to no obvious response to the surgery. These patients were excluded from the final analysis. 5 years after the treatment, the other 101 patients obtained improvement of nasal obstruction, with the VAS degree changing from 6.65 ± 1.92 to 4.45 ± 2.54 (p<0.0001). The VASs of rhinorrhea, sneezing, itchy nose, and itching eyes changed from 5.90 ± 2.79 to 3.79 ± 2.97, 5.15 ± 2.77 to 3.50 ± 2.77, 3.67 ± 3.03 to 2.41 ± 2.30 and 2.94 ± 3.02 to 2.02 ± 2.42, respectively (all p<0.0001).ConclusionsThe long‐term study demonstrated that radiofrequency turbinoplasty appears to still be effective and safe for treating allergic rhinitis refractory to medical therapy.
S286 – UV Phototherapy of Nasal Polyps: Results of a Pilot Study
Authors: Bella Zsolt , Kadocsa Edit , Koreck Andrea , Kemeny Lajos 
Published: August 2008

ObjectivesNasal polyps (NPs) are characterized by high recurrence rates despite medical and\or surgical treatment. Recently, it has been shown that exposure of NPs to ultraviolet light (UV) results in induction of apoptosis of inflammatory cells. Therefore phototherapy may represent a new therapeutic approach in NPs. A pilot feasibility study was performed to assess the clinical efficacy and tolerability of phototherapy and to identify the clinical effective UV dose range in NPs.MethodsA dose‐titration study was conducted in 13 subjects with bilateral grade 1–3 NPs. Patients were exposed to gradually increasing doses of UV light over a 12‐week period (3 exposures/week). Subjects rated their nasal obstruction symptom scores weekly on a visual analogue scale from 0 to 6. The NOSE quality of life questionnaire was used at baseline and end of treatment period. Adverse events were monitored by endoscopy.Results10 subjects completed the study. Nasal obstruction symptom scores improved at end of treatment compared to baseline. Improvement of quality of life (NOSE) at end of treatment compared to baseline was also noted. Treatments were well tolerated and no device‐related adverse events were reported. In most subjects, symptom improvement was observed after a certain threshold UV dose was reached. Therefore, the study was also informative about the clinically effective doses which will be tested in future studies of much shorter duration.ConclusionsThe results suggest that phototherapy may represent a potential new treatment option in NPs.
S287 – Microbiological Study of Nosocomial Sinusitis in ICU
Authors: Filho Leonardo Lopes Balsalobre , Cavalcante Ricardo , Stefanini Renato , Vieira Fernando , Santos Rodrigo de Paula , Gregorio Luis‐Carlos , Stamm Aldo Eden Cassol 
Published: August 2008

Objectives1) Identifying the bacteria causing sinusitis in an intensive care unit (ICU) through the nasal swab and puncture of maxillary sinus. 2) Comparing their results with the cultures and antibiograma.Methods22 patients in the ICU with uni‐ or bilateral maxillary sinusitis diagnosed by computed tomography were submitted to nasal swab and puncture of the maxillay sinus. The materials were sent to culture and antibiograma and their results were compared.ResultsThe present study evaluated 22 patients. There was exact correlation among the isolated microbial agent in the swab and in the puncture in 14 of the 22 cases (63%). The prevalence of the aerobic gram negative was: Pseudomonas aeruginosa (29%), Proteus mirabillis (26%) and Acinetobacter baumanni (14%). The antibiograma presented a high index of resistance to the antibiotics used in daily practice.ConclusionsThe nasal swab was of little value to the diagnosis, while the direct puncture of the maxillary sinus could assess the specific bacterial agents, allowing a right‐to‐the‐point therapeutic. The early and specific treatment decreases the morbi‐mortality in these patients.
S288 – Balloon Dilation for Treatment of Recurrent Choanal Atresia
Authors: Silver Natalie Lea , Tassler Andrew B , Malekzadeh Sonya , Harley Earl 
Published: August 2008

Objectives1) To investigate alternative methods of maintaining choanal patency in patients with choanal atresia. 2) To assess the feasibility and efficacy of balloon dilation in maintaining patency of repaired choanal atresia.MethodsChoanal atresia is the developmental failure of the nasal cavity to communicate with the nasopharynx. Several approaches have been described for primary repair of choanal atresia. A transnasal endoscopic approach has been fully developed and is now the preferred method of primary repair. Restenosis is known to occur after surgical correction and primary patency rates after all surgical procedures have been reported to be 55% to 75%. We reviewed the charts of 3 patients at a single institution with a diagnosis of choanal atresia (2 bilateral, 1 unilateral). All were primarily repaired with traditional methods but subsequently developed restenosis; 1 patient developed complete restenosis of her choanae. All 3 underwent serial endoscopic dilation with sinuplasty balloons.ResultsAfter endoscopic serial dilation with the use of sinuplasty balloons, all 3 patients have maintained patent choanae on follow‐up examination up to 1 year postoperatively.ConclusionsDilation of a restenosed choanal atresia with sinuplasty balloons may be an effective new application of this technology. The procedure is simple to perform and can be easily repeated to increase long‐term patency for these patients.
S290 – Sinonasal Pathology and Severity of Bronchiectasis
Authors: Guilemany Jose Maria , Alobid Isam , Silvia Centellas , Bernal‐Sprekelsen Manuel S , Miret Joaquim Mullol I 
Published: August 2008

Objectives1) To investigate the prevalence of nasal symptoms, nasal polyposis, and sinusal opacification in patients with bronchiectasis. 2) To investigate the association between the degree of sinusal opacification and the bronchiectasis extension.Methods88 consecutive patients with stable non‐cystic bronchiectasis were prospectively evaluated for nasal symptoms (RASP, 0–3), polyp size (nasal endoscopy, 0–3), sinusal occupation (CT, 0–24), and chest HRCT (0–18).ResultsFollowing EP3OS criteria, 77% of patients presented had chronic rhinosinusitis (CRS). Nasal congestion (incidence: 90%; score: 1.6±0.1) Anterior (99%; 1.9±0.1) and posterior (91%; 1.8±0.1) rhinorrhea, were reported by patients as the major complaints. Nasal polyps (NP) of a mild‐moderate size (1.6±0.3) were found in 25% of patients. Sinonasal CT was abnormal in patients with CRS, with a CT score of 8.4±0.4, with predominance in maxillary sinus (2.1±0.1), anterior ethmoid sinus (1.9±0.1), and ostiomeatal complex (2.2±0.2). Patients with CRS had significantly worse scores on chest HRCT (CRS: 3.7±0.7; no CRS: 7.2±0.5).ConclusionsMore than 75% of patients affected with BQs fulfil EP3OS criteria of CRS and 25% of patients presented NP. Patients with CRS presented more affectation on chest HRCT scan. We conclude that patients with bronchiectasis should be evaluated to assess the presence of chronic rhinosinusitis and nasal polyposis.
S291 – A Public Health Survey of Epistaxis Management
Authors: Hissett Graham , Watson Joanna , Kanegaonkar Rahul , Stevenson Justina 
Published: August 2008

ObjectivesTo assess the level of knowledge held by the general public regarding the treatment of epistaxis.MethodsWe have conducted a survey of patients and relatives attending the ENT outpatient department at Medway Maritime Hospital, Kent, England, during November and December 2007. The survey entailed 5 multiple choice questions regarding the immediate management of epistaxis and the risk factors predisposing to episodes of epistaxis.ResultsOf the 500 questionnaires distributed, 477 were completed legibly. Only 15.2% of respondents knew that to control epistaxis they should compress the lower part of the nose. 7.6% of patients knew the optimum period of compression to be greater than 10 minutes. 47.0% of patients knew to adopt a sitting position with the head held forward during compression. 52.7% knew the correction positioning of an ice‐pack would be over the bridge of the nose, and 10.2% of respondents recognised that both aspirin and Warfarin led to an increased occurrence of epistaxis.ConclusionsThe results of the survey reveal the need for greater public awareness of the initial management of this common ENT emergency. We have designed posters and leaflets to distribute to the outpatient departments and the surgeries of general practitioners.
S292 – Health Outcomes for Endonasal DCR Measured by GBI
Authors: Hathorn Iain , Spielmann Patrick , Ahsan Farhan , Cain Angus , White Paul 
Published: August 2008

ObjectivesTo measure the effect of Endonasal Dacrocystorhinostomy (DCR) on the health status of patients, using a validated outcomes measure, the Glasgow Benefit Inventory.MethodsPostal questionnaire with telephone follow‐up of patients undergoing Endonasal DCR in two otolaryngology (ORL) departments in Scotland between 2005 and 2007. All adult patients who had achieved greater than 12 months follow‐up since surgery were included in this study. The GBI score ranged from −100 to +100 with 0 reflecting no change.Results92 of 123 patients (75%) completed the questionnaire; the mean age was 59 years and the sex ratio m:f was 1:1.8. The mean overall GBI for this intervention was +32.7 (95% confidence intervals 27.8‐; 37.6). The ‘general wellbeing’ subset improvement was +44.2 (38.5 − 49.9), physical wellbeing +12.9 (6.9‐18.9) & social wellbeing +14.0 (8.4‐19.5). The patients were grouped according to the indication for intervention: Obstruction of lacrimal system GBI +32.7 (26.3‐37.1), mucocele +40.1 (28.7‐514), dacrocystitis +19.4 (10.0‐28.9) & functional +9.7 (‐31.1‐; 50.56). There were 16 revision cases, the GBI for these patients was +49.5 (35.3‐63.7).ConclusionsThe GBI provides a measure of the effect of an ORL intervention on the health of a patient. Endonasal DCR scores highly when compared with a number of other rhinological procedures including rhinoplasty (GBI +20), endoscopic sinus surgery (GBI +23), and septal surgery (mean ranges from +6 to +24). Endonasal DCR is a successful intervention with demonstrable health benefits to the patient, especially for revision cases.
S294 – Pre‐op Prevalence of MRSA in Intranasal Surgery Patients
Authors: Nicholas Brian , Bhargave Geeta , Heffelfinger Ryan , Rosen Marc R , Pribitkin Edmund A 
Published: August 2008

Objectives1) Understand the extent of methicillin‐resistant Staphylococcus aureus among those undergoing intranasal surgery. 2) Be able to describe potential risk factors for MRSA colonization. The purpose of this study is to outline a prevalance of MRSA colonization among those undergoing inranasal surgery, with an exploration of potential risk factors for colonization.MethodsPatients undergoing intranasal surgery (endoscopic sinus surgery, rhinoplasty, septoplasty, etc) at a tertiary care medical center had preoperative nasal swab cultures. The primary endpoint was positive culture of methicillin‐resistant Staphylococcus aureus (MRSA). Patient demographic information was also collected to ascertain potential risk factors for colonization of MRSA.ResultsEarly results have demonstrated that the prevalence of MRSA in patients is less than the reported prevalence in hospital inpatient populations. Of the initial 25 patients enrolled in this study, none were shown to be colonized with methicillin‐resistant Staphylococcus aureus (0/25), with 1 patient having reported a history of MRSA infection (4%).ConclusionsPreliminary data suggests that the prevalence of methicillin‐resistant Staphylococcus aureus among patients undergoing intranasal surgery is less than the prevalence of inpatient populations as reported in several previous studies. While preliminary data suggests a potential decreased prevalence of MRSA in this population, a much larger sample of patients is needed to make a more definitive statement. In the coming weeks and months, as more data is gathered and the sample size included in the study grows, it will be interesting to note whether the initial trend, as suggested here, continues.
S299 – Videolaryngoscopy in Patients with Obstructive Sleep Apnea
Authors: Siupsinskiene Nora , Toohill Robert J. , Adamonis Kestutis , Grebliauskaite Milda , Woodson B. Tucker 
Published: August 2008

ObjectivesTo evaluate symptoms and videolaryngoscopic findings common in reflux in patients with obstructive sleep apnea (OSA) and to determine the relationship between laryngeal inflammation and OSA severity.MethodsData of 38 adult outpatients with first‐proven OSA verified in overnight polysomnography during 2006–2007 were prospectively analyzed. Symptoms common in laryngopharyngeal reflux were self‐rated using reflux symptoms index (RSI). Videolaryngoscopic laryngeal changes were evaluated with reflux finding score (RFS). Body mass index (BMI) was calculated for all patients.Results30 males and 8 females with mean age of 49.5 years were assessed. BMI of patients ranged from 23.1 to 46.6 kg/cm2 showing 86.8% of patients overweight. 52.6% of selected patients had mild OSA, 10.5%‐ moderate, 36.8‐ severe. Mean value of self‐rated RSI was 13.8 points. Abnormal RSI was detected in 52.6% of patients. The most common symptoms indicated medium to severe problem were chronic throat clearing‐; 48.6% of patients, increased amount of mucus coming into the nasopharynx‐; 40.5%, and globus sensation‐; 35.1%. The inflammation of the larynx was diagnosed for 78.9% of patients with mean RFS value of 10.1 points. The pronounced findings were vestibular folds hypertrophy‐; 81.6%, posterior commissure hypertrophy‐ 73.7%, thick endolaryngeal mucus‐; 63.2%, and vocal folds edema‐; 44.7% of patients. Only diffuse laryngeal edema showed significant positive correlation with increasing of AHI.ConclusionsA high prevalence of laryngeal symptoms and inflammation indicating reflux in OSA patients was identified. Direct significant correlation between laryngeal inflammation and OSA severity was not determined.
Analysis of Flap Tension in Midface Surgery
Authors: Herrero Nicholas A , Ethan Sherman , Adelson Robert T. 
Published: August 2008

ProblemDespite a large volume of literature addressing rejuvenation of the midface, there is an absence of objective data addressing the various approaches to midface lifting. This study compares flap tensions generated by midface lifts though transblepharoplasty (TB) and transtemporal (TT) surgical approaches, with and without the additional intervention of a transoral periosteal release.Methods12 fresh cadaver heads underwent standard TB and TT approaches for midface lifting with Endotine (Coapt Systems, Inc, Palo Alto, CA) fixation devices. A machined apparatus, designed for this experiment, pulled the midface flap one centimeter along a posterior‐superior vector while a precision digital load cell recorded the generated tension (grams). A transoral periosteal release was performed and flap tensions were measured again after this intervention. Green‐house‐Geisser test allowed analysis of the three‐way interaction between surgical approach, periosteal release, and the number of times the test was repeated.ResultsFlap tension decreased significantly during testing with each sequential repeated pull on the midface (p<0.0001). Average flap tension for TB approach did not differ significantly from that of TT approach, whether or not a periosteal release was performed. However, while no particular approach was found to have a significant reduction in flap tension, a transoral periosteal release produced a significant reduction in flap tension (12%) when compared to trials without periosteal release (p=0.0191).ConclusionA significant reduction in flap tension as a result of transoral periosteal release is demonstrated in both transtemporal and transblepharoplasty approaches for midface lifting. This objective reduction in flap tension may allow the surgeon greater mobility of the midface tissues and perhaps less tension opposing flap fixation.SignificanceThe objective reduction in flap tension by employing a transoral subperiosteal release may allow the surgeon greater mobility of the midface tissues and perhaps less tension opposing flap fixation.SupportCoapt Systems, Inc, (Palo Alto, CA) provided the endotine devices utilized in the experiment.
Electrical Pacing of Paralyzed Orbicularis Oculi Muscle
Authors: Sanderson Jeremy Drew , Otto Randal A 
Published: August 2008

ProblemIn this study, the authors investigated the feasibility of restoring function by direct electrical stimulation of the paralyzed orbicularis oculi muscle in the dog model.MethodsSeven mongrel dogs underwent bilateral surgical resection of a 1cm portion of their proximal facial nerves followed by bilateral placement of an electrical pacing device with electrodes placed directly into the orbicularis oculi muscles. One eye was stimulated and the other used as a control. The eye was stimulated for 24 hours daily for 90 days. The function of the electrical stimulation in reproducing a normal protective blink was then graded on a scale of 0 to 3. The worst grade of 0 was assigned if no movement or only the slightest twitch could be visualized in the eyelid, a grade of 1 with slight closure, 2 for a protective blink and 3 for overclosure.ResultsA total of 22 eyelids were stimulated and graded in the 7 dogs. The overall average blink grade in the stimulated eyes was 1.7 and the range of the averages was from 0.06 to 2.8. An average blink grade in all the unstimulated eyes was 0. Thirty‐two percent of the stimulated eyelids obtained a blink considered to be protective or obtained over closure corresponding to a blink grade of 2–3.ConclusionAlthough current spread leading to a poor functional result was a common problem, the results when this complication could be overcome were very encouraging. To our knowledge this represents the first report of functional electrical stimulation of the paralyzed orbicularis oculi muscle on a continuous basis for 90 consecutive days.SignificanceThe findings of this study support the feasibility of employing direct electrical stimulation to restore the function of the orbicularis oculi muscle.SupportThis study was funded through a grant from Medtronics, Inc (Minneapolis, MN)
Expression of VEGF and VEGF Receptors in Port‐Wine Stains
Authors: Ramakrishnan Jeevan B , Fan Chun‐Yang , Cetin Neslihan , Buckmiller Lisa M , Vural Emre A. 
Published: August 2008

ProblemPort‐wine stains (PWS) are vascular anomalies that may cause significant functional and psycho‐social ramifications worsening by age. Traditional management of port‐wine stains involves pulsed dye laser treatments, however only 10% of these lesions show complete response and 35% of these recur even after complete response. Therefore, there is still a need for an effective treatment for PWS. Vascular endothelial growth factor (VEGF) ‐a potent angiogenic molecule‐has been shown to be associated with various vascular anomalies such as hemangiomas and arterio‐venous malformations. However, the possible pathophysiological relationship of VEGF and PWS has not been investigated previously. The purpose of this study is to investigate if VEGF and VEGF‐receptors are overexpressed in PWS as a key step in developing a potential targeted treatment approach for this disfiguring disease.Methods12 surgically resected PWS specimens and 12 normal skin specimens were immunohistochemically stained by using anti‐VEGF and anti‐VEGF receptor 2 antibodies.ResultsPWS specimens revealed significantly higher levels of expression of both VEGF molecule and VEGF‐receptor 2 than the control specimens.ConclusionVEGF and VEGF‐receptor 2 may play a role in pathophysiology of PWS. Overexpression of these molecules may suggest that PWS could have proliferating potential in addition to their hypertrophic growth pattern. Therefore, targeted approaches against VEGF and its receptors may have a potential role in the treatment of these disfiguring lesions.Significance1. Expression of VEGF and VEGF receptors in PWS has not been investigated previously. 2. The results of this study may suggest that PWS could have proliferating potential, in contrast to the common belief that PWS progress by hypertrophy rather than hyperplasia. 3. Targeted approaches against VEGF and its receptors may have a potential role in the treatment of these disfiguring lesions.SupportThis study was supported by Medical Research Endowment Award at university of Arkansas for Medical Sciences.