bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing Loss in Progressive Systemic Sclerosis Patients: A Comparative Study
Authors: Kastanioudakis Ioannis , Ziavra Nausicaa , Politi Eudokia N. , Exarchakos Georgios , Drosos Alexandros A. , Skevas Antonios 
Published: February 2003

OBJECTIVETo investigate the middle and inner ear involvement in patients with progressive systemic sclerosis (PSS).STUDY DESIGN AND SETTINGSWe prospectively evaluated 34 PSS patients. All patients underwent a complete ear‐nose‐throat physical examination and audiological evaluation with pure tone, impedance, and speech audiometry. In addition, systemic manifestations of the disease and drug therapy were recorded. Finally, all patients were tested for the presence of autoantibodies. The results were compared with those of 45 age‐matched healthy subjects.RESULTSWe found a sensorineural hearing loss in 20% and mixed type hearing loss in 3.3% of the patients. There was no correlation of hearing loss with age, systemic manifestations of the disease, presence of autoantibodies, and drug therapy. Ten percent of the patients had patulous eustachian tubes.CONCLUSIONOne fourth of PSS patients had a hearing loss affecting the middle and mainly the high frequencies. This is a lower percentage than that reported by other investigators. A significant prevalence of bilateral patulous eustachian tubes was noticed as well. Further investigation is needed for a better understanding of the mechanism of ear damage in PSS patients.
Portal Venous Ultraviolet B‐Irradiated Donor Alloantigen Prevents Rejection in Circumferential Rat Tracheal Allografts
Authors: Genden Eric M. , Mackinnon Susan E. , Yu Samuel , Hunter Daniel A. , Flye M. Wayne 
Published: February 2003

BACKGROUNDBefore tracheal transplantation can be considered as a method of reconstruction in patients with extensive circumferential tracheal defects, we must achieve a state of nontoxic, donor‐specific tolerance so that the risks of such a transplant do not outweigh the benefits.OBJECTIVEOur objective was to determine whether a single intraportal injection of modified donor alloantigen achieves donor‐specific immunosup‐pression for major histocompatibility complex‐mismatched rat tracheal allografts.STUDY DESIGNBuffalo (recipient) rats were pretreated with either a single portal‐vein administration of ultraviolet B (UVB)‐irradiated donor splenocytes (n = 4) or an intraportal inoculation of nonirradiated donor splenocytes (n = 4). Major histocompatibility complex‐mismatched Lewis (donor) tracheal allograft segments were then grafted into treatment groups 7 days after donor‐cell pretreatment. Tracheal rejection was assessed by histologic analysis, mucosal cilia motility, and in vitro immunologic assessment.RESULTSThe UVB‐treated group demonstrated no acute or chronic rejection as well as complete functional recovery. In vitro immunologic assessment demonstrated a donor‐specific hyporesponsiveness and donor allospecificity. Untreated animals and those receiving nonirradiated donor splenocytes showed acute rejection of their tracheal allografts.CONCLUSIONRecipient pretreatment with intraportally administered UVB‐irradiated donor splenocytes prevents rejection of circumferential rat tracheal allograft segments by inducing a donor‐specific immune hyporesponsiveness.
Injection Snoreplasty: How to Treat Snoring without All the Pain and Expense
Authors: Brietzke Scott E. , Mair Eric A. 
Published: February 2003

OBJECTIVEWe introduce Injection Snoreplasty: an innovative, safe, and effective palatal snoring procedure with minimal cost and discomfort to the patient. A well‐described sclerotherapy agent, Sotradecol, is injected into the soft palate to reduce/eliminate palatal flutter snoring.STUDY DESIGN AND SETTINGTwenty‐seven patients with a diagnosis of palatal flutter snoring (respiratory disturbance index less than 10) by sleep study were enrolled in the protocol. Office treatment sessions were performed 6 to 8 weeks apart. Success was judged by subjective improvement in snoring and objective evidence of palatal stiffening/scarring.RESULTSTwenty‐five (92%) of 27 patients reported significant decrease in snoring. There were no significant postinjection complications. Visual analog pain scale confirmed minimal discomfort. Most patients received more than 1 treatment (average, 1.8) in order to receive optimal palatal stiffening.CONCLUSION/SIGNIFICANCEInjection Snoreplasty is a simple, safe, and effective office treatment for primary snoring. Advantages over current snoring procedures include simplicity, low cost, decreased posttreatment pain levels, and minimal/no convalescence.
T3 Glottic Cancer: Oncologic Results and Prognostic Factors
Authors: Lassaletta Luis , García‐Pallarés Marta , Morera Eduardo , Ricardo Bernáldez , Gavilan Javier 
Published: February 2003

OBJECTIVESTo analyze oncologic results, prognostic factors, and consideration of transglottic tumors as a separate entity in 73 patients with T3 glottic carcinoma treated by surgery ± radiation therapy at La Paz University Hospital from 1984 to 1994.METHODSSixty‐four patients underwent a total laryngectomy; neck dissection was performed in 50 patients; 29 patients received postoperative radiotherapy.RESULTSThe 5‐year overall survival, cause‐specific survival, and relapse‐free survival rates were 58.1%, 66.8%, and 63.7%. Univariate analysis revealed prognostic significance for age, dyspnea, initial tracheostomy, and pathologic lymph node status. No difference was found when comparing survival and relapse rates between transglottic and glottic tumors.CONCLUSIONSurgery provides acceptable rates of cancer control and survival for patients with T3 glottic carcinoma. Older patients, patients with positive neck nodes, and those presenting with dyspnea have worse prognosis. The term transglottic is merely descriptive and has little impact on prognosis.
Value of Flow Cytometry in the Evaluation of Head and Neck Fine‐Needle Lymphoid Aspirates: A 3‐Year Retrospective Review of a Community‐Based Practice
Authors: Cannon C. Ron , Richardson L. Douglas 
Published: February 2003

OBJECTIVETo study the clinical efficacy of flow cytometry in patients suspected of having a lymphoma with head and neck pathology.STUDY DESIGNRetrospective review of 49 patients with lymphoid aspirates having concurrent flow cytometry studies.SETTINGPrivate practice office‐based study.CONCLUSIONFine‐needle aspiration with concurrent flow cytometry is a useful, convenient adjunct to the diagnosis of head and neck non‐Hodgkins lymphomas.SIGNIFICANCEFlow cytometry is a significant improvement over fine‐needle aspiration derived cytologic diagnosis alone. Tissue open biopsy may be avoided altogether in some patients with non‐Hodgkins lymphoma.
Versatility and Donor Site Morbidity of the Lateral Upper Arm Flap in Intraoral Reconstruction
Authors: Gellrich Nils‐Claudius , Schramm Alexander , Hara Iwao , Gutwald Ralf , Jürgen Düker , Schmelzeisen Rainer 
Published: February 2003

OBJECTIVEThe lateral upper arm flap is not widely used yet for intraoral defect reconstruction. Investigation of its morphologic and functional outcome was the objective of this study.STUDY DESIGNThe morphologic and functional results of recipient (swallowing, flap survival, dehiscence of margins, cutaneous fistulas, intraoral hairs) and donor sites (wound healing, scar width and length, sensory and motor disturbance) (n = 44) were checked clinically. Postoperative swallowing was investigated via videofluorography (n = 11).RESULTSThe lateral upper arm flap showed low donor site morbidity, primary closure was achieved in all but one case. Sensory deficit at the proximal forearm (n = 27) occurred without any case of compromise of radial nerve function. Videofluorography allows for objective evaluation of swallowing function.CONCLUSIONSThe lateral upper arm flap is the reconstruction of first choice for intraoral defects due to its low donor site morbidity.
Nasal Irrigation for the Alleviation of Sinonasal Symptoms
Authors: Heatley Diane G. , McConnell Kari E. , Kille Tony L. , Leverson Glen E. 
Published: February 2003

OBJECTIVETo determine the effect of nasal irrigation on sinonasal symptoms.STUDY DESIGN AND SETTINGA total of 150 adult subjects with chronic sinusitis symptoms were recruited from the community and assigned to 1 of 3 treatment groups: nasal irrigation with bulb syringe, nasal irrigation with nasal irrigation pot, or control treatment with reflexology massage. Groups 1 and 2 performed daily hypertonic saline irrigation with 1 device for 2 weeks and then with the other device for 2 weeks. Group 3 performed reflexology massage daily for 2 weeks. Prospective data collected included pretreatment Medical Outcomes Study Short Form, pretreatment and posttreatment Rhinosinusitis Outcomes Measure, daily medication use, subjective treatment efficacy, and preference of irrigation method.RESULTSThere was a significant and equivalent improvement in Rhinosinusitis Outcomes Measure 31 score after 2 weeks of intervention in each treatment group; 35% of subjects reported decreased use of sinus medication.CONCLUSIONDaily nasal irrigation using either a bulb syringe, nasal irrigation pot, and daily reflexology massage were equally efficacious and resulted in improvement in the symptoms of chronic sinusitis in over 70% of subjects. Medication usage was decreased in approximately one third of participants regardless of intervention.
Clinical Anatomy of the Nasal Process of the Frontal Bone (Spina Nasalis Interna)
Authors: Hosemann Werner , Gross Rudolf , Goede Ullrich , Kuehnel Thomas 
Published: February 2003

OBJECTIVESDuring endonasal frontal sinusotomy with the sharp spoon, a solid piece of bone is frequently encountered anterior to the neo‐ostium. This bone may be referred to as the nasal process of the frontal bone or internal nasal spine (spina nasalis interna). A prominent spina may render an extended sinusotomy difficult and may call for use of the drill. A series of anatomic measurements is presented to illustrate the 3‐dimensional anatomy of the spina nasalis and the regional anatomy.METHODSA maximum endonasal frontal sinusotomy (Draf type I‐II procedure, nasofrontal approach type II) was performed on 36 anatomic specimens by means of a sharp spoon. The dimensions of the remaining nasal spine were measured subsequently together with the anterior‐posterior diameter of the inferior frontal sinus, the thickness of the anterior frontal sinus wall, and the distance from the neo‐ostium to the anterior ethmoidal artery.RESULTSThe individual microanatomy of the medial floor of the frontal sinus showed a wide range of variation. The average height of the individual spine was 10 mm, the maximum depth 6 mm. A correlation was found between the nasofrontal angle of the specimen and the anterior‐posterior dimension of the spine: the more acute the angle, the thicker the spine. In three quarters of the cases, the neo‐ostium was separated by just one anterior ethmoidal cell from the anterior ethmoidal artery.CONCLUSIONSThe presented investigations provide the surgeon with quantitative data on the individual anatomy of the nasal spine and offer additional information for selecting the appropriate surgical procedure in the individual patient.
Osseointegrated Implants in Children: Experience from Our First 100 Patients
Authors: Granström Gösta , Bergström Kerstin , Odersjö Marie , Tjellström Anders 
Published: February 2003

This study was undertaken on 100 children aged 16 years or under intended for installation of osseointegrated implants. Of these, 76 had implants installed for bone‐anchored hearing aids or prostheses. The main indication for implant installation was a bilateral ear malformation. Surgery was generally performed as a two‐stage procedure with a healing time of 3 to 4 months in between. Available bone thickness was on average 2.5 mm, and lack of bone necessitated bone augmentation in 12 patients. Thirty‐nine percent of implants were installed in contact with the dura, sigmoid sinus, or an air cell. Implant failures were 5.8% of 170 inserted fixtures. Adverse skin reactions appeared in 9.1% of patients over a 21‐year follow‐up period. Revision surgery was undertaken in 22% of patients because of appositional growth of the temporal bone. Of the 24 children considered but not found suitable for osseointegration surgery, plastic surgery was considered a better option, or growth of the temporal bone was awaited. It is concluded that the rate of implant failure is lower in children; the frequency of skin reactions is the same as in adults, but revision surgery is more common in young patients because of new bone formation. Our clinical experience supported by the data presented in this article suggests that the concept could be used with good functional and aesthetic results in children.
Conservative Management of Infections in Cochlear Implant Recipients
Authors: Yu Kenneth C.Y. , Hegarty Joseph L. , Gantz Bruce J. , Lalwani Anil K. 
Published: February 2003

OBJECTIVEThe goal of this study was to evaluate a conservative management strategy of postoperative infection after cochlear implantation.METHODSA retrospective review of the medical records of 108 cochlear implant patients operated on at the University of California, San Francisco between 1991 and 2000 and 133 cochlear implant patients from the University of Iowa between 1997 and 2000 showed 4 patients with evidence of postoperative infections. The clinical presentation, intervention, laboratory results, and outcome are analyzed in each case.RESULTSMinimal surgical intervention with limited incision and drainage with prolonged postoperative antibiotics was effective in treating postoperative cochlear implant infections without the need for device removal. Implant function remained unaffected after surgery.CONCLUSIONPostoperative cochlear implant infections can be effectively controlled with limited surgical and prolonged medical management. Chronic implant infections may be explained by a primary immunodeficiency. With appropriate treatment leading to infection control, a conservative management strategy is advocated before consideration of device explantation.
Muscle Fiber and Satellite Cell Apoptosis in the Aging Human Thyroarytenoid Muscle: A Stereological Study with Confocal Laser Scanning Microscopy
Authors: Malmgren Leslie T. , Jones Christine E. , Bookman Linda M. 
Published: February 2003

OBJECTIVEThis study determines the role of changes in numerical densities of apoptotic myonuclei and satellite cells in age‐related remodeling of the thyroarytenoid muscle (TA).DESIGNChanges in numerical densities of apoptotic myonuclei and satellite cells were estimated for the entire TA by using stereological techniques.RESULTSThere was an increase in NV apoptotic myonucleus, fiber type (P < 0.05) and in the percentage of apoptotic myonuclei (P < 0.05) in type 1 but not in type 2 muscle fibers. There was also an increase in NV apoptotic satellite cell, fiber type (P < 0.05) and in the percentage of apoptotic satellite cells (P < 0.05) in type 1 fibers but not in type 2 fibers.CONCLUSIONApoptosis may contribute to age‐related fiber loss and atrophy in the TA.SIGNIFICANCETherapeutic techniques based on decreasing the frequency of apoptosis may block age‐related fiber loss and atrophy in the TA.
Free Flap Reconstruction of the Head and Neck: Analysis of 241 Cases
Authors: Haughey Bruce H. , Wilson Ewain , Kluwe Lucia , Piccirillo Jay , Fredrickson John , Sessions Donald , Spector Gershon 
Published: February 2003

OBJECTIVEWe undertook this study of free flap reconstruction of the head and neck to stratify patients and procedures, to determine how donor site preference changed over time, to assess medical and surgical outcomes, and to identify variables associated with complications.METHODSWe analyzed computerized medical records from 236 patients who underwent a total of 241 reconstructions at a tertiary academic medical center in St. Louis between 1989 and 1998. We created a more detailed retrospective database of 141 of those patients by using 48 perioperative variables and 7 adverse outcome measures. Multivariate statistical models were used to analyze associations between variables and outcomes.RESULTSThe fibula became the preferred donor site for mandibular reconstruction, and the radial forearm became the preferred donor site for pharyngoesophageal reconstruction. For the 241 procedures, the mortality rate was 2.1%, the median length of stay was 11 days, and the flap survival rate was 95%. Administration of more than 7 L of crystalloid during surgery and age over 55 were associated with major medical complications. Blood transfusion, prognostic comorbidity, and number of surgeons correlated with length of stay. Cigarette smoking and receipt of more than 7 L of crystalloid during surgery were associated with overall flap complications, and weight loss of more than 10% before surgery, more than one operating surgeon, and cigarette smoking were associated with major flap complications.CONCLUSIONSRisk to patients and transferred tissue is low in free flap head and neck reconstruction. Age, smoking history, and weight loss should be considered during patient selection. Fluid balance should be considered during and after surgery. Division of labor for patient care should be carefully delineated among surgeons in a teaching setting.
Aggressive Endoscopic Resection of Inverted Papilloma: An Update
Authors: Schlosser Rodney J. , Mason John C. , Gross Charles W. 
Published: February 2003

ObjectiveEndoscopic resection has been proposed for sinonasal inverted papilloma (IP). Our objective was to determine the efficacy of aggressive endoscopic resection of IP.MethodsRetrospective analysis was performed on patients undergoing endoscopic resection of IP at the University of Virginia between 1990 and 1996. Total ethmoidectomies, wide maxillary antrostomies, frontal recess explorations, sphenoidotomies, and turbinate resection were performed as required. Once all visible papilloma was removed, residual mucosa was removed by using a diamond burr to polish bone at the site of origin.ResultsTwenty‐one patients were treated with endoscopic resection of IP. Only 1 of 21 patients had an adjunctive external procedure (an osteoplastic flap without obliteration). Average follow‐up was 41.9 months after initial aggressive endoscopic resection at the ureterovesical angle. Recurrences occurred in 19% (4/21) of patients. One of the 4 had two recurrences. Recurrences occurred in 16 months or less, except for one noted at 35 months and another at 56 months.ConclusionsAggressive endoscopic resection of IP by experienced rhinologists is an acceptable treatment.
Fibromatosis of the Head and Neck Region
Authors: K. Tse Gary M. , Chan Kui‐Fat , Ahuja Anil T. , King Ann D. , W. Pang Peter C. , H. To Edward W. 
Published: February 2003

OBJECTIVEFive cases of head and neck fibromatosis were analyzed. The imaging and pathologic findings, surgical management, and clinical outcome were discussed.STUDY DESIGN AND SETTINGA retrospective study of 5 adult head and neck fibromatosis cases, evaluating long‐term follow‐up results of conservative treatment.RESULTSThe 5 patients (2 male and 3 female) ranged in age from 16 to 51 years. The lesion size ranged from 1 to 8 cm. Four cases had limited surgical resection; 1 case was followed only. One of the surgically treated cases had a recurrence that was irradiated. All patients were well for a follow‐up period of 2 to 8 years.CONCLUSIONAggressive excision of head and neck fibromatosis cannot be achieved easily. Vigilant follow‐up with or without conservative surgical excision achieves good disease control. Low dose radiotherapy can be used for inoperable cases.SIGNIFICANCEJudicious conservative treatment should be attempted for head and neck fibromatosis to achieve optimal functional preservation.
Human Papillomavirus Infection and Survival in Oral Squamous Cell Cancer: A Population‐Based Study
Authors: Schwartz Seth R. , Yueh Bevan , McDougall James K. , Daling Janet R. , Schwartz Stephen M. 
Published: February 2003

OBJECTIVETo determine whether human papillomavirus (HPV) type 16 affects survival in oral squamous cell carcinoma.STUDY DESIGNTwo hundred fifty‐four patients diagnosed with primary oral cancer were studied for survival in relation to tumor HPV type 16 status. Kaplan‐Meier analysis and Cox proportional hazard models were used to assess survival and estimate hazard ratios adjusted for potential confounders.RESULTSHPV type 16 DNA was detected in 15.1% of tumors. HPV 16 positive patients had significantly reduced all‐cause mortality (hazard ratio [HR] estimates = 0.34, 95% CI = 0.14, 0.83) and disease‐specific mortality (HR = 0.17, 95% CI = 0.04, 0.76) compared with HPV 16 negative patients after adjustment for age, stage, treatment, smoking, alcohol, education, and comorbid disease.CONCLUSIONSThe presence of HPV type 16 DNA is independently associated with a favorable prognosis in patients with oral squamous cell carcinoma.CLINICAL SIGNIFICANCEAlthough HPV genotyping is currently not widely available, it may provide important prognostic information.
Primary Laryngeal Melanoma
Authors: Lin Shing‐Yu , Hsu Chen‐Yi , Jan Yee‐Hee 
Published: February 2003

Malignant melanoma of the larynx is a rare disease. Only 52 cases have been reported in the literature,1,2mostly among white men.3Of the cases described, only 10 showed “in situ change,”1,3–5which is an important criterion for diagnosis of primary melanoma. We present an Asian woman diagnosed with primary melanoma of the larynx. This patient demonstrated a polypoid tumor and 4 flat patches over the supraglottic region. Microscopically, both “in situ change” and “melanosis” were noted. Primary melanoma of the larynx transformed from mucosal melanosis was strongly suspected. The patient received total laryngectomy and bilateral modified neck dissection. No local recurrence was noted, but lung and liver metastasis were proven 5 months later. The patient finally died of disseminated disease.
Pilomatrixoma of the Head and Neck in Children
Authors: Agarwal Ravi P. , Handler Steven D. , Matthews Mark R. , Carpentieri David 
Published: February 2003

OBJECTIVEPilomatrixomas are benign skin neoplasms of hair follicle origin. They are one of the most common superficial masses of the head and neck excised in children. Although the entity has been well studied in the literature, few studies have been undertaken to evaluate the clinical characteristics of head and neck pilomatrixomas specifically in children. The purpose of this study was to review the clinical characteristics and management of children presenting with pilomatrixomas of the head and neck at a large tertiary care pediatric hospital.STUDY DESIGNA retrospective chart review was performed of all patients with histologically confirmed pilomatrixoma of the head and neck excised during a 6‐year period (1992–1997) at the Children's Hospital of Philadelphia.RESULTSNinety‐one cases of pilomatrixoma were confirmed in 86 patients. The age range was 5 months to 17 years. The median age at time of excision was 6.0 years. The most common sites of occurrence were the cheek (36%), neck (20%), periorbital region (14%), and scalp (9%). The male to female ratio was 1:1.5. Multiple lesions were found in 8.2% of patients. Surgical excision was curative in all cases.CONCLUSIONPilomatrixoma is a cutaneous neoplasm that is one of most common causes of superficial head and neck masses in children. Although the presurgical diagnosis may be difficult in some cases, pilomatrixoma must be kept in the differential of superficial head and neck masses in children. Surgical excision is almost always curative.