bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Rhinosinusitis With Nasal Polyps is Associated With Decreased Expression of Mucosal Interleukin 22 Receptor
Authors: Ramanathan Murugappan , Spannhake Ernst W. , Lane Andrew P. 
Published: February 2009

AbstractIntroduction: Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disorder of the sinonasal mucosa that is frequently associated with microbial colonization. Innate defense mechanisms at the mucosal surface are critical in protecting the host from airborne environmental pathogens. Recent studies of skin and gastrointestinal tract inflammatory diseases have shown that stimulation of the interleukin‐22 receptor (IL‐22R1) nonspecifically increases innate immune responses. The potential role of IL‐22R1 in the pathogenesis of CRSwNP has never been explored.Study Design: Prospective.Methods: Nine controls and 19 subjects with CRS were prospectively enrolled prior to undergoing endoscopic sinus surgery. Nasal epithelial cells were cultured from surgically obtained ethmoid mucosa and IL‐22R1 protein expression was examined via flow cytometry. RNA was extracted from whole mucosal samples and real‐time polymerase chain reaction (PCR) was employed to determine expression of IL22 and IL‐22R1. Subjects were followed for at least 6 months postoperative to assess for recurrence or persistence of polyps.Results: Flow cytometry demonstrated the expression of IL‐22R1 protein on the surface of cultured nasal epithelial cells. IL‐22R1 mRNA was expressed in 100% of the controls and CRSsNP. However, IL‐22R1 was only expressed in 55% of patients with recalcitrant CRSwNP. Additionally, levels of IL22R1 were significantly lower in recalcitrant CRSwNP compared to controls and CRSsNP. IL22 levels did not reach statistical significance.Conclusions: In this study, we demonstrate IL‐22R1 mRNA and protein expression on nasal epithelial cells. Failure of medical and surgical therapy in CRSwNP is associated with significantly decreased expression of IL‐22R1. Further research is needed to determine the potential of IL‐22R1 as a therapeutic target in CRSwNP.
Tracheal Ceramic Rings for Tracheomalacia: A Review After 17 Years
Authors: Göbel Gyula , Karaiskaki Niki , Gerlinger Imre , Mann Wolf J. 
Published: February 2009

AbstractBackground: Despite different support techniques, the surgical management of tracheomalacia is still a challenging problem. Satisfactory results after internal stenting are above 80%, whereas, when performing external stenting using biocompatible ceramic rings, results are reported at over 90%.Objective: The purpose of this study was to examine the efficiency of surgical treatment in patients with segmentary tracheomalacia using external ceramic ring grafts.Methods: In this retrospective study, we collected data from 12 patients who underwent surgery during the last 17 years for symptomatic segmentary tracheomalacia by use of biocompatible aluminum‐oxide ceramic rings. All except one patient had undergone previous tracheostomy, six had a history of long‐term intubation, two had previous trauma, and two patients had previous cancer treatment including radiotherapy. One of the patients still had an existing tracheostoma, which was closed when a ceramic ring was implanted. Tracheal wall collapse with pseudoglottis formation or flattened anterior‐posterior tracheal diameter was documented with fiberoscopy at rest, and both pre‐ and postoperative airway resistance measurements were performed in all 12 patients using a spirometer. After malacic segments were found to be expandable using rigid tracheoscopy while the patient was under general anesthesia, preparation of the trachea was performed using a midline vertical incision in the neck. Subsequently, the malacic trachea was expanded by placing and suturing proper‐sized ceramic ring(s) around it.Results: In all patients, surgical expansion of the malacic segment using ceramic rings was successfully carried out without major complications while inspiratory stridor was resolved. Airway resistance decreased significantly from an average of 0.62 to 0.385 kPascal.Conclusion: Although the results of applying internal tracheal stents are encouraging, complications such as stent migration, granulation tissue and fistula formation, and mucociliary transport arrest are possible. Biocompatible ceramic rings do not cause foreign body reactions, remain stabile, and, with a proper suturing technique, provide a suitable long‐term solution.
Induction of Regional Collateral Sprouting Following Muscle Denervation
Authors: Koob Jason W. , Moradzadeh Arash , Tong Alice , Hayashi Ayato , Myckatyn Terence M. , Tung Thomas H. , Mackinnon Susan E. 
Published: February 2009

AbstractObjectives/Hypothesis: Anecdotal clinical findings suggest that denervated muscle may regain modest functional recovery via spontaneous collateral sprouts from intact adjacent nerve fibers. The current study evaluates the conditions needed for the denervated masseter muscle to induce axonal sprouting from the facial nerve. We hypothesize that epineurial injury is required to induce collateral sprouting toward a neighboring denervated muscle.Study Design: Twelve thy1‐yellow fluorescent protein‐16 (thy1‐YFP‐16) transgenic mice whose axons express yellow fluorescent protein were allocated into six groups, with four degrees of facial nerve injury (intact, crush, transection, removed segment) with or without masseter denervation.Methods: Animals underwent serial in vivo imaging analyses under the fluorescent microscope weekly for 5 or 7 weeks and were subsequently perfused for analysis. Masseter muscle acetylcholine receptors (AChRs) were stained with Alexa Fluor 594 conjugated α‐bungarotoxin, and whole mounts were imaged with confocal microscopy.Results: In groups with intact or crushed facial nerves, no evidence of collateral sprouting was demonstrated. Mice with transected facial nerve branches or removed segments demonstrated sprouting from the proximal stump into the denervated masseter. Staining of the AChRs confirmed that new neuromuscular junctions were established between the facial nerve and the denervated masseter.Conclusions: This study suggests that epineurial injury is required to stimulate axonal sprouting into adjacent denervated muscle. Nerves with compromised epineurium may be useful in promoting neo‐neurotization after muscle denervation.
Contralateral Ear in Chronic Otitis Media: A Histologic Study
Authors: Rosito Letícia Petersen Schmidt , da Costa Sady S. , Schachern Patricia A. , Dornelles Cristina , Cureoglu Sebahatin , Paparella Michael M. 
Published: February 2009

AbstractObjective: The objective of this study is to determine the prevalence of the contralateral ear changes in human temporal bones of donors with chronic otitis media.Study Design: Transversal.Material and Methods: The temporal bones were examined under light microscopy and then described. Chronic otitis media was defined by the presence of irreversible inflammatory alterations in the middle ear cleft. The contralateral ear was defined as the normal or the less affected ear. To compare the qualitative variables, the χ2 test was used. Spearman's nonparametric test was used for correlations. P values less than or equal to .05 were considered significant.Results: We studied 85 pairs of temporal bones. Cholesteatoma was observed in 22.4% of the more damaged ears. The prevalence of contralateral ears with alterations was 91.8%. The main alterations were granulation tissue (81%), effusion (58%), and tympanic membrane retractions (35%). There was a direct and moderately strong correlation between the extent of granulation tissue in the more damaged ear and the contralateral ear (r
s = 0.345, P = .004). A strong correlation was observed between the extent of cholesteatoma in the more damaged ear and in the contralateral ear (r
s = 0.617, P < .001).Conclusion: We observed a high prevalence of changes in the contralateral ear. There was a direct correlation between the extent of both granulation tissue and cholesteatoma between the two ears, demonstrating that the more extensive the manifestation of these pathologies in the more damaged ear, the greater they will be in the contralateral ear.
Gene Expression Changes of Inflammatory Mediators in Posterior Laryngitis Due to Laryngopharyngeal Reflux and Evolution With PPI Treatment: A Preliminary Study
Authors: Thibeault Susan L. , Smith Marshall E. , Peterson Kathryn , Ylitalo‐Moller Riitta 
Published: February 2009

AbstractHypothesis: Standard of care in laryngopharyngeal reflux (LPR) is acid suppression therapy. Its treatment efficacy and mechanism of action are not well documented. No objective study investigating the molecular patterns of inflammation in LPR or in response to proton pump inhibitor (PPI) treatment has been accomplished. We hypothesized that gene expression levels of mediators of inflammation—interleukin 6 (IL6), interleukin 8 (IL8), interleukin 1a (IL1a), interleukin 1b (IL1b), transforming growth factor beta 1 (TGFβ1), vascular endothelial growth factor (VEGF), fibroblast growth factor‐2 (FGF2), and tumor necrosis factor alpha (TNFα)—in posterior larynx tissue would be increased in those with diagnosed LPR and would be then reduced with PPI treatment.Study Design: Prospective uncontrolled trial.Methods: Biopsies from the posterior larynx were taken from 25 participants with LPR before and after a 10‐week period with rabeprazole (40 mg). RNA isolation and real‐time PCR was used to measure gene expression levels.Results: No significant differences were measured for any of the cytokines, either for the entire participant group (n = 25) or for the subset of participants who did not have a previous history of PPI usage (n = 15). In those participants who had a history of PPI usage (n = 10), a significant increase in gene expression levels post medication was measured for TGFβ1 (P = .0396), VEGF (P = .0216), IL8 (P = .0297), after adjusting for compliance, subjective improvement, and reflux severity.Conclusions: Our findings are provocative and speak to the unresolved understanding of the pathophysiology of LPR, its diagnosis, and its differences from gastroesophageal reflux disease.
Comparison Between Mitomycin C and Chitosan for Prevention of Anterior Glottic Steno After CO2 Laser Cordectomy in Dogs
Authors: Fang Rui , Sun Jingwu , Wan Guanglun , Sun Dongdong 
Published: February 2009

AbstractObjective: To compare the effectiveness of an immediate application of topical mitomycin C (MMC) with chitosan for prevention of anterior glottic stenosis (AGS) after microsurgical resecting of both vocal fold with CO2 laser, including the anterior commissure, in a canine model.Design: Prospective randomized experimental study.Method: Twenty‐four canine larynges were injured by a microresecting procedure of both vocal folds with a CO2 laser. The dogs were randomly divided into three groups for treatment, respectively with MMC, chitosan, or isotonic sodium chloride solution (control) for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected, the ultrastructures of the fibroblasts were examined with a transmission electronic microscope, and expression of basic fibroblast growth factor (bFGF) and transforming growth factor beta1 (TGF‐β1) were evaluated by enzyme‐linked immunosorbent assay (ELISA). Three weeks after surgery, the remaining dogs' glottic web were lysed and repeatedly treated with MMC, chitosan, or isotonic sodium chloride solution. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically 6 weeks after the initial surgery.Results: Results included 1) transmission electronic microscope examination of the ultrastructures of the fibroblasts indicated that both MMC and chitosan inhibited the proliferation of fibroblast; 2) the expression of bFGF and TGF‐β1 increased both in the MMC group and the chitosan group, and the expression of bFGF in the chi‐tosan group was higher than in the MMC group (P = .010), while the expression of TGF‐β1 was lower (P = .000);3) the extent of AGS formation was decreased both in the MMC group and the chitosan group, while it was less in the chitosan group than in the MMC group (P = .047); 4) the grade of collagen content between the MMC group and the chitosan group was not significantly different (P = .5).Conclusion: Chitosan is more effective in preventing AGS after CO2 laser cordectomy than MMC.
When to Cut? Using an Objective Structured Clinical Examination to Evaluate Surgical Decision‐Making
Authors: Franzese Christine 
Published: February 2009

AbstractObjectives: To create an objective structured clinical examination (OSCE) tailored to surgical residents that uses surgical case scenarios appropriate for the experience level of the resident to evaluate whether residents understand the indications for a specific surgery, identify when indications are met, and make the appropriate decision to proceed with an operation.Methods: The surgical OSCE consisted of two case scenarios: a junior case created for postgraduate year (PGY) 2 to 3 level residents and a senior case created for PGY 4 to 5 level residents. Four senior residents and four junior residents in the otolaryngology department participated. Residents were instructed to proceed as if they had all the capabilities of the otolaryngology clinic. Recordings were made of each encounter and were reviewed by two separate faculty member with expertise in each case. Faculty evaluated whether surgical indications were elicited by history, whether certain physical examination or radiographic findings were recognized, whether residents made the correct diagnosis, and whether residents not only made the decision to proceed with surgery but also indicated the correct surgery.Results: Seniors (100%) were better at obtaining needed surgical information and indications than juniors (25%). Seniors were more willing to make the decision to proceed with surgery (100%), whereas no juniors actually scheduled surgery. The reasons for this ranged from failure to elicit surgical indications to lack of surety in proceeding with surgery. All seniors recommended the appropriate surgery, but only 75% correctly identified the need for emergent intervention. Results of evaluations were reviewed with each resident individually.Conclusions: The surgical OSCE was successful in evaluating resident surgical decision‐making. Juniors were not as capable as seniors in eliciting surgical indications and in “making the jump” to proceed with surgery. These results were used by our faculty to work with juniors on surgical history‐taking and decision‐making. These results were also useful in identifying seniors who could recognize an emergency situation.
The Old‐Fashioned Politzer Maneuver: A Video Clip Demonstration
Authors: Casale Manuele , Rinaldi Vittorio , Setola Roberto , Salvinelli Fabrizio 
Published: February 2009

AbstractPolitzer maneuver causes retrograde inflation of the middle ear by forcing air through the eustachian tube, and it has been proposed by many authors as the main nonsurgical treatment of middle ear effusion. To our knowledge, this is the first case in the literature in which air entering into a middle ear with effusion through a Politzer maneuver has been captured on video (www.laryngoscope.com).
Actinomycosis of the Temporal Bone With Labyrinthine and Facial Nerve Involvement
Authors: Mehta Deepak , Statham Melissa , Choo Daniel 
Published: February 2009

AbstractObjectives: To demonstrate the clinical, radiologic, and pathologic findings of actinomycosis of the temporal bone.Study Design: Case report and literature review.Methods: Analysis of a case through medical records and literature review.Results: Actinomycosis is a rare cause of subacute‐chronic suppurative infection of the temporal bone. We present an 11‐year‐old male with a history of ciliary dyskinesia presenting with a 6‐week history of right‐sided otorrhea, otalgia, and a 1‐week history of progressive facial weakness. Final histopathology revealed a diagnosis of actinomycosis. A review of the literature showed 25 cases of temporal bone actinomycosis. This is the first reported case of actinomycosis causing facial nerve palsy and labyrinthine invasion. Effective treatment includes aggressive surgical debridement followed by long‐term administration of appropriate antibiotic.Conclusions: Actinomycosis can be a cause for bone erosive lesions of the temporal bone and can result in significant morbidities. Prompt tissue diagnosis with suspicion for nonmalignant causes of bone erosive disease can help in implementing appropriate treatment.
Modulation of MyoD‐ and Ki‐67‐Positive Satellite Cells in the Short‐Term Denervated Rat Thyroarytenoid Muscle
Authors: Kumai Yoshihiko , Ito Takaaki , Miyamaru Satoru , Yumoto Eiji 
Published: February 2009

AbstractObjectives: To evaluate the effects of short‐term denervation on the kinetics of satellite cells (SCs) and myocytes in the rat thyroarytenoid (TA) muscle using immunohistochemistry for a myogenic regulatory factor, MyoD, and a cell proliferation marker, Ki‐67.Study Design: Quantitative immunohistochemical assessment of MyoD and Ki‐67 expression in SCs and myocytes after denervation.Methods: The left recurrent laryngeal nerve (RLN) was transected in 15 adult Wistar rats, which were sacrificed 1, 3, or 7 days after the treatment (n = 5, each group). Fluorescein immunostaining was used to visualize the localization of MyoD+ and Ki‐67+ SCs in combination with M‐cadherin immunostaining for detection of SCs. We examined the temporal changes of the ratios of MyoD+ and Ki‐67+ SCs for all of the counted muscle fibers and M‐cadherin+ cells in both the denervated and the contralateral control TA muscle.Results: On the denervated side, the TA muscle contained 3.8 ± 0.4% MyoD+ SCs and 1.3 ± 0.4% Ki‐67+ SCs. Of the SCs, 22.6 ± 2.2% were MyoD+, and 14.5 ± 4.4% were Ki‐67+, whereas SCs on the control side did not express these markers.Conclusions: In the rat TA muscle, denervation induces SC activation, and some SCs enter the cell cycle, whereas others are involved in the differentiation process. The number of activated SCs is relatively small compared with all M‐cadherin+ SCs. Therefore, SCs might be good targets for a therapy to prevent TA muscle atrophy after RLN paralysis.
Crile's Neck Dissection
Authors: Silver Carl E. , Rinaldo Alessandra , Ferlito Alfio 
Published: February 2009

AbstractGeorge Crile, after a long experience with treatment of head and neck cancer and study of a large number of cases, appreciated that these tumors almost always drained through the lymphatic pathways of the neck, rarely metastasized distantly, and were thus theoretically curable by resection of the primary tumor and its lymphatic draining shed. After evaluation of his early failures, he found that a block resection of all of the lymph node‐bearing tissue of the neck in addition to resection of the primary tumor was the most effective means of obtaining a cure, particularly in patients with clinical evidence of spread of disease to the neck. Such radical surgery, at the time, was fraught with difficulty because of the lack of blood transfusion, antibiotics, and endotracheal anesthesia, but Crile devised several strategies for combating these obstacles. Crile performed 36 such block resections with a determinate 3‐year survival of 75% compared with 19% 3‐year survival in patients who had not undergone block resection. The surgical precepts developed by Crile laid the foundation for the effective modern surgical treatment of head and neck cancer.
Histologic Study of an Autologous Fat Graft in the Larynx of Dogs With Unilateral Vocal Fold Paralysis
Authors: Kruschewsky Leonardo de Souza , de Mello‐Filho Francisco Verissimo , Saggioro Fabiano , Serafini Luciano Neder , Rosen Clark Allan 
Published: February 2009

AbstractObjective: To determine the histologic finds of autologous fat graft (AFG) in 24 paralyzed canine left vocal folds 12 weeks after introduction.Study Design: Animal model. Experimental prospective study.Methods: Twenty‐four mongrel dogs of both genders weighing 15 to 20 kg were divided into three study groups (SGs) of eight dogs each, whose larynges were grafted by vocal fold lipoinjection (VFL‐SGA), vocal fold lipoinjection plus insulin (VFLI‐SGB), and by fat graft medialization laryngoplasty (FGML‐SGC), respectively, and observed for 12 weeks, followed by immediate sacrifice. All 24 dogs were submitted to left vagal and recurrent laryngeal nerve resection. All animals were confirmed to have a left vocal fold paralysis four weeks later, when 2 mL of autologous fat graft were placed inside the left paraglottic space. The larynges were removed at pre‐established times and, after they were studied for remaining fat graft volume by magnetic resonance imaging, they were studied histologically to evaluate the influence of the different techniques on the histologic behavior of the graft.Results: Each of the three study groups had its specific finds for fat graft detection and fat absorption, and its characteristics identified and compared statistically. The groups were not statistically different.Conclusion: The histologic findings for the AFG applied to a vocal fold were similar in groups VFL‐SGA, VFLI‐SGB and FGML‐SGC 12 weeks after grafting, with no statistically significant differences between groups, and revealed an almost total loss of the grafted fat.
Management of the Post‐Tracheostomy Scar
Authors: Grant Nazaneen , Davison Steven P. 
Published: February 2009

AbstractTracheostomy scar management is aimed at filling lost deep tissue bulk, the correction of tracheal skin tug, and a tension‐free closure that falls more naturally into the neck folds. Three cases are used to illustrate the major principles involved in the correction of tracheostomy scars. Those reconstructive principles are 1) re‐approximation of individual layers of the neck for improved contour and release of tracheal skin tug, 2) filling of tissue deficit, using scar de‐epithelialization, muscle flaps, or acellular dermal grafts, 3) excision of hypertrophic scarring or keloids, and 4) horizontal wound closure using simple closure or local skin flaps such as z‐plasty. The goals and techniques outlined can resolve skin adherence to the trachea and can improve scar appearance in this noticeable location.