bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of Disposable Intraoperative Facial Nerve Stimulators
Authors: Randall David A. , Wester Derin C. , Hunsaker Darrell H. 
Published: November 2003

AbstractFacial nerve injury is one major morbidity of surgery performed along the course of this nerve. Surgeons frequently employ stimulators to identify and protect the nerve. Both disposable devices as well as larger, reusable stimulators are available. Despite their common use, relatively little documentation exists regarding the safety and reliability of these devices. We tested the electrical output of the four disposable, single‐use motor nerve stimulators that are marketed in the United States. We found that each produced consistent stimulus output over time. One stimulator slightly exceeded the manufacturer's listed output while three devices produced significantly less voltage and current than specified by the manufacturer.
Kikuchi's Disease: Report of Three Cases and an Overview
Authors: Nikanne Elina , Ruoppi Pirkko , Vornanen Martine 
Published: November 2003

AbstractWe describe, to our knowledge, the first native Finnish patients with Kikuchi's histiocytic necrotizing lymphadenitis. The diagnosis was based in all cases on histopathological findings in openbiopsy. The disease was first detected in Japan in 1972, but in Scandinavia, until this decade, there had been no cases reported.Our patients were young, otherwise healthy women who had cervical lymphadenopathy, fever, and fatigue as their main symptoms. In two of them, the disease was mild and subsided spontaneously within 2‐6 months. One patient with more fulminant lymphadenopathy was treated with antimicrobial and antiinflammatory drugs. She became symptomless in 3 months.The cause of Kikuchi's disease is unknown. A viral or postviral hyperimmune reaction has been proposed as its etiology. Malignant lymphoma and systemic lupus erythematosus are differential diagnoses. Histopathological findings are pathognomonic and pathologists must be aware of its typical characteristics.
Tenuous Airway in Children With Trisomy 21
Authors: de Jong Andrew L. , Sulek Marcelle , Nihill Michael , Duncan Newton O. , Friedman Ellen M. 
Published: November 2003

AbstractMultiple congenital anomalies are closely linked to Down syndrome(trisomy 21). Cardiac malformations are found in 40% of patients, a large number of whom will require a major surgical procedure. The importance of postextubation stridor in these children is frequently underestimated. A retrospective review of 99 trisomy 21 patients who underwent cardiovascular surgery revealed postextubation stridor in 24 (24.2%). Significant factors for the development of stridor included younger age (P=0.04), lower growth percentile for weight (P=0.03), and increased frequency of reintubation(P=0.04). Subglottic stenosis was found in 6 (6.1%). In 4 of these patients, an endotracheal tube of larger diameter than predicted for age was used. All 6 patients were less than the 10th percentile for weight. We conclude that Down syndrome patients deserve special considerations and modifications of standard intubation techniques for successful airway management.
Ki‐67 As a Prognostic Marker in Adenoid Cystic Carcinoma Assessed With the Monoclonal Antibody MIB1 in Paraffin Sections
Authors: Nordgård Ståle , Franzén Gunnar , Boysen Morten , Halvorsen Tore B. 
Published: November 2003

AbstractThe monoclonal antibody MIB1 recognizing the Ki‐67 antigen in formalin‐fixed, paraffin‐embedded tissue was used to study the proliferative activity in 44 adenoid cystic carcinomas of the salivary glands. The antigen expression was compared with clinical factors, histopathological grading, and prognosis. The Ki‐67 value was significantly higher in tumors from patients suffering from treatment failure than in nonfailures (P < 0.001). The Ki‐67 expression was also higher in tumors exhibiting areas more than 30% of the solid growth pattern and higher in sinonasal tumors than in other locations. By Cox regression analysis, Ki‐67 more than 4% was the strongest prognostic indicator (P
<0.005). Clinical stage and violation of surgical margins were also found to be independent significant prognostic indicators. We conclude that Ki‐67 expression estimated by the use of MIB1 is a powerful tool for predicting the short‐term prognosis for patients with adenoid cystic carcinoma.
Head and Neck Manifestations of Plasma Cell Neoplasms
Authors: Nofsinger Yoon Choi , Mirza Natasha , Rowan Philip T. , Lanza Donald , Weinstein Gregory 
Published: November 2003

AbstractMultiple myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma are plasma cell neoplasms. They represent distinct manifestations of a disease continuum, whereby the clinical findings are critical to diagnosis. Plasma cell neoplasms are histologically similar, and distinguishing one from the other has significant implications for treatment and survival. Plasma cell neoplasms are relatively unusual malignancies of the head and neck region. We present a case series of plasma cell neoplasms involving the skull base, paranasal sinus, larynx, and mandible as an introduction to a complete review of the literature on plasma cell neoplasms of the head and neck area.
Malformation and Stenosis of the Cricoid Cartilage in Association With Larsen's Syndrome
Authors: Hoeve Hans J. , Joosten Koen F.M. , Bogers J.J.C. , Hazebroek Frans W.J. , Pfenninger Jürg , van der Voort Edwin , Leijala Mauri 
Published: November 2003

AbstractThree patients with the typical features of Larsen's syndrome are described. All three developed severe respiratory symptoms caused by a congenital subglottic stenosis. Tracheotomy and treatment of the stenosis by means of laryngotracheoplasty resulted in complete collapse of the cricoid cartilage and the proximal tracheal skeleton. Lack of rigidity of the laryngeal and tracheal cartilages in patients with Larsen's syndrome could well be responsible for this failure. Surgical treatment consisted of resection of the stenotic and collapsed areas and end‐to‐end anastomosis. This therapy was eventually successful in all three patients.
Tracheotomy and the Intensive Care Unit Patient
Authors: Henrich Douglas E. , Blythe William R. , Weissler Mark C. , Pillsbury Harold C. 
Published: November 2003

AbstractTransportation of the intensive care unit (ICU) patient to the operating room for tracheotomy has been implicated as an unnecessary source of complications and has been cited as a relative indication for percutaneous tracheotomy. However, there is very little evidence in the literature to support this claim. We evaluated 100 consecutive patients who were transported from the ICU to the operating room for tracheotomy. There were no complications related to patient transportation. A total of five complications occurred, all unrelated to patient transportation. Two patients receiving pressure control ventilation developed a pneumothorax on postoperative days 7 and 8, respectively. There were three minor complications directly related to the tracheotomy: peristomal cellulitis, tracheitis, and hemorrhage of less than 25 cc on postoperative day 1. The minor complications were treated appropriately and resolved without any adverse sequelae. We provide a detailed review of 100 consecutive ICU patient tracheotomy cases and compare this with 109 tracheotomies in non‐ICU patients. Transportation of the ICU patient does not appear to increase the risk of complications during tracheotomy and should not be cited as a cause of complications in the percutaneous tracheotomy literature. The results with standard surgical tracheotomy in the controlled setting of the operating room should serve as the standard by which other procedures are judged.
Subtotal Parotidectomy: A 10‐Year Review (1985 to 1994)
Authors: Helmus Christian 
Published: November 2003

AbstractA subtotal parotidectomy is a conservative resection in which less than a superficial lobectomy is performed and less than a full facial nerve is dissected. From 1985 to 1994, 146 subtotal parotidectomies were performed for a variety of benign and limited, low‐grade malignant tumors. The procedure is based on the premises that adequate margins are necessary, that the procedure can be terminated when these margins are obtained, and that the true margin is usually the tumor‐to‐nerve margin. For selective neoplasms the subtotal parotidectomy has many advantages with results that equal or surpass the classic superficial lobectomy.
Cochlear Implantation in Common Cavity Malformations Using a Transmastoid Labyrinthotomy Approach
Authors: McElveen John T. , Carrasco Vincent N. , Miyamoto Richard T. , Linthicum Fred H. 
Published: November 2003

AbstractThe transmastoid facial recess approach has become the standard technique for cochlear implantation. Although this approach has been used for implantation in patients with common cavity deformities, it is not without increased risk to the facial nerve. Using a direct approach to the common cavity that circumvents the facial recess, we have successfully implanted four patients with common cavity deformities. An aberrant facial nerve in one patient would have precluded placement of the electrode array using standard cochlear implant techniques. As demonstrated in these four patients, the direct approach to the common cavity is an effective approach for placement of the electrode array, minimizes risk to the facial nerve, and may decrease the likelihood of postoperative cerebrospinal fluid leaks. Intraoperative video footage demonstrates the feasibility and facility of this approach in patients with common cavity deformities.
Individualizing Hearing Preservation in Acoustic Neuroma Surgery
Authors: Arriaga Moisés A. , Chen Douglas A. , Fukushima Takanori 
Published: November 2003

AbstractSurgical series of hearing preservation in acoustic neuroma usually emphasize a team's results with one particular technique. This report reviews acoustic neuroma outcomes of individualizing the surgical approach to patient and tumor characteristics. This study reviews 60 consecutive hearing preservation acoustic neuroma surgeries in a total series of 330 acoustic neuromas. Tumor sizes ranged from 0.3 to 4 cm in patients ranging from 23 to 74 years of age. Middle fossa surgery was performed in 57%, retrosigmoid in 43%. Overall, measurable hearing was preserved in 77%, and useful hearing in 67%. Among middle fossa cases, 85% had measurable and 74% had useful hearing. Among retrosigmoid surgeries, 65% had measurable hearing and 58% had useful hearing. Overall, long‐term facial nerve function was excellent (grade I or II) in 90% and poor (grade V or VI) in 2%. There was one case of bacterial meningitis(2%), and cerebrospinal fluid leaks requiring surgery occurred in four patients (7%). The hearing preservation and other outcome parameters in this series compare favorably with other reports. We believe that individualizing the surgical approach to the patient's tumor characteristics and clinical features contributed to the high rate of hearing preservation.
Laryngeal Evoked Brainstem Responses in Humans: A Preliminary Study
Authors: Yin Shengguang S. , Qiu William W. , Stucker Fred J. , Hoasjoe Denis K. , Aarstad Robert F. , Batchelor Barbara M. 
Published: November 2003

AbstractLaryngeal evoked brainstem responses (LBRs) were recorded in normal human subjects in an attempt to develop a central laryngeal function test and enhance our understanding of neurolaryngologic disorders. The results showed that the human LBR consists of five positive peaks and five negative peaks reproducible within 10 ms after a vibratory stimulation to the superior laryngeal nerve (SLN). The waveform reproducibility was verified by blocking the SLN and topically anesthetizing the hypopharyngeal cavity. The morphology and latency of peak 5 were similar to results obtained in animal LBR experiments. It was concluded that a vibratory stimulation to the SLN was a noninvasive method to elicit far‐field potentials from the central laryngeal pathway. These findings encourage further effort to establish normative data and explore clinical correlations.
Pediatric Functional Endoscopic Sinus Surgery: Is a Second Look Necessary?
Authors: Mitchell Ron B. , Pereira Kevin D. , Younis Ramzi T. , Lazar Rande H. 
Published: November 2003

AbstractFunctional endoscopic sinus surgery (FESS) has become the surgical procedure of choice for the treatment of chronic sinusitis that is refractory to medical treatment. It has become routine to perform endoscopy in children under general anesthesia 2 to 3 weeks after FESS to facilitate examination and cleaning of the operative site. We compared the clinical outcome of 50 children who underwent FESS without a second‐look endoscopy with 50 children who underwent a routine second look. Patients with systemic disease (cystic fibrosis, immotile ciliary syndrome, immunoglobulin deficiency) or undergoing a revision procedure were excluded from the study. The results show that the postoperative improvement in nasal obstruction, nasal drainage, and chronic cough was the same for both groups. We conclude that in the vast majority of children without systemic disease and not undergoing a revision procedure, a second endoscopic procedure may not offer any apparent advantage.
Effect of Immunotherapy on Seasonal Changes in Serum‐Specific IgE and IgG4 in Patients With Pollen Allergic Rhinitis
Authors: Ohashi Yoshihiro , Tanaka Ayaki , Kakinoki Yasushi , Ohno Yoshiharu , Sakamoto Hirokazu , Kato Akifumi , Masamoto Tateo , Washio Yushi , Nakai Yoshiaki 
Published: November 2003

AbstractSerum specific IgE and IgG4 in 70 patients with seasonal rhinitis caused by Japanese cedar pollens were determined before and during the pollen season. Seasonal increase rate in specific IgE was significantly smaller in the immunotherapy patients than the pharmacotherapy patients, and seasonal increase in specific IgG4 was significant in the immunotherapy patients only. Seasonal increase rate in specific IgE was not significantly different between the patients who responded markedly to short‐term immunotherapy and those who did not. On the other hand, seasonal increase rate in specific IgG4 was significantly different between them. In contrast, seasonal increase rate in specific IgE was significantly smaller in the patients who showed marked response to the long‐term immunotherapy than those who did not show marked response to the long‐term immunotherapy, but seasonal increase rate in specific IgG4 was not significantly different between them. In conclusion, our results suggest that modulation of specific IgG4 response and specific IgE response might be involved in the early and late symptom relief during immunotherapy, respectively. However, further studies might be necessary to definitively establish the clinical roles of specific IgE and specific IgG4 in immunotherapy.
Primary Laryngeal Lymphoma
Authors: Ansell Stephen M. , Habermann Thomas M. , Hoyer James D. , Strickler John G. , Chen Michael G. , McDonald Thomas J. 
Published: November 2003

AbstractPrimary laryngeal lymphoma is a very rare entity, with fewer than 50 cases reported in the English literature in the past 60 years. Close scrutiny of some of these case reports reveals that the larynx was not always the only site of involvement, thereby diminishing the total number of patients with primary laryngeal lymphoma to fewer than 35. The authors report a series of six patients, who were seen and evaluated at the Mayo Clinic between 1952 and 1995, with stage IAE non‐Hodgkin's lymphoma of the larynx. Three patients had large‐cell lymphomas according to the REAL (Revised European‐American Lymphoid) classification. The other three had a small lymphocytic lymphoma, follicular small cleaved lymphoma, and follicular mixed lymphoma. All patients received radiation therapy alone as initial therapy for their disease and all patients had a complete remission to initial therapy. Four patients subsequently relapsed and the histology at relapse was the same as the initial histology in all four patients. Five patients have died, three of lymphoma, with a median survival of 67 months (range, 40 to 228 months). In view of the heterogeneity of histologies in this group of lymphomas, the variability in duration of response, and the significant number of patients who died of their disease, it is more likely that primary laryngeal lymphoma is an unusual presentation of non‐Hodgkin's lymphoma than a separate disease entity. Despite the small number of patients in this study, the data would suggest that patients are best treated according to the histology of the lymphoma, rather than the limited stage and location of the disease.
Fibrosing Inflammatory Pseudotumors of the Central Skull Base
Authors: Sung Myung‐Whun , Kim Kwang Hyun , Lee Chang Ho , Moh Jee Hoon , Kim Woo Ho , Han Moon Hee 
Published: November 2003

AbstractThe most important step in the differential diagnosis of mass lesions of the central skull base is to rule out malignant neoplasms. However, nonneoplastic lesions, such as infections or nonspecific inflammatory lesions of the skull base, can mimic malignant processes. In this study, the authors analyzed seven cases of nonneoplastic noninfectious mass‐forming lesions involving the central skull base. In most cases, malignant processes were suspected at the initial phase of diagnostic work‐up, but subsequent histologic examinations revealed that these lesions consisted of inflammatory cells and fibrosis without neoplastic cells. Common manifestations were pain and other neurological symptoms related to the involved anatomical sites. A variety of neurological dysfunctions of the cranial nerves not including the olfactory and spinal accessory nerves were observed. No patient developed separate lesions outside the head and neck region. After the pathologic diagnosis, most of the patients were treated with oral steroid therapy, with initial doses of prednisolone, 60 to 100 mg/d. It was difficult to relate responsiveness to steroid therapy with the histologic degree of sclerosis, fibrosis, or chronicity of the disease in these cases. Otolaryngologists should be aware of this disease when making treatment decisions for their patients with skull base lesions.
Inhibitory Effect of Macrolides on Interleukin‐8 Secretion From Cultured Human Nasal Epithelial Cells
Authors: Suzuki Hideaki , Shimomura Akira , Ikeda Katsuhisa , Furukawa Masayuki , Oshima Takeshi , Takasaka Tomonori 
Published: November 2003

AbstractThe mechanism of macrolide therapy in chronic sinusitis patients is unclear. The authors studied the effect of macrolides on interleukin (IL)‐8 secretion from cultured human nasal epithelial cells. Epithelial cells harvested from the nasal polyps of patients with chronic sinusitis were primary‐cultured, and secreted IL‐8 in culture media was measured by enzyme immunoassay. The cells secreted considerable amounts of IL‐8 constitutively and in response to lipopolysaccharide. The secretion was significantly inhibited by 10−5 M of erythromycin, clarithromycin, roxithromycin, and josamycin. 10−6 M erythromycin still showed the inhibitory effect, whereas the same concentration of josamycin did not. These results indicate that macrolide antibiotics may act as an immunomodulator to reduce IL‐8 in inflammatory sites and, at least partially, account for the clinically discrepant effects between 14‐ and 16‐membered ring macrolides in long‐term low‐dose therapy for chronic sinusitis.
Reconstruction of the Soft Palate by Uvulopalatal Flap
Authors: Zohar Yuval , Buler Nora , Shvilli Ytshak , Sabo Reni 
Published: November 2003

AbstractSurgical removal of the soft palate in cases of neoplastic disease has a functionally detrimental effect on the patient, resulting in rhinolalia and nasal regurgitation. The authors describe their original surgical technique for repairing the lateral soft palate defect using a uvulopalatal flap. The flap is readily available and the procedure is single staged and without sequela. The aim of this reconstructive procedure is to obtain a diminished soft palate defect by primary surgery. In five patients who underwent a partial excision of the soft palate, the surgical defect was corrected at the time of initial surgery by a uvulopalatal flap. In this technique, the surface of the defect was diminished, postoperative rhinolalia and regurgitation were unremarkable, and sometimes an obturator was obviated. Using a local myomucosal flap, the procedure is simple, safe, and effective.
Nonsyndromic Autosomal Dominant Progressive Sensorineural Hearing Loss: Audiologic Analysis of a Pedigree Linked to DFNA2
Authors: Kunst Henricus , Marres Henri , Huygen Patrick , Ensink Robert , Van Camp Guy , Van Hauwe Peter , Coucke Paul , Willems Patrick , Cremers Cor 
Published: November 2003

AbstractAn analysis was performed of the regression of the individual hearing threshold on age in the affected persons in a six‐generation Dutch family with nonsyndromic autosomal dominant sensorineural hearing loss, which showed linkage to the DFNA2(1p34) region, similar to at least four previously reported nonrelated families. The offset threshold was significantly higher at the high frequencies (around 30 dB at 2 to 8 kHz) than at the lower ones(approximately 0 dB at 0.25 to 1 kHz). Hearing impairment at the higher frequencies may therefore have been present already at birth or in early childhood. The regression coefficient, or the ‘annual threshold increase,’ expressed in dB/y, was about 1 dB/y on average, but the higher frequencies (1 to 8 kHz) showed significantly more rapid progression than the lower frequencies (0.25 to 0.5 kHz).
Tube Placement: A Prospective, Randomized Double‐Blind Study
Authors: Derkay Craig S. , Wadsworth J. Trad , Darrow David H. , Strasnick Barry , Thompson G. Kevin , O'Master Jennifer 
Published: November 2003

AbstractBilateral myringotomy with tympanostomy tube placement is the second most frequently performed pediatric surgical procedure, next to circumcision. Postoperative pain relief for children undergoing this procedure has been an ongoing concern. The authors undertook a prospective, randomized, double‐blind, placebo‐controlled clinical study in 200 consecutive children to investigate the efficacy of oral acetaminophen, acetaminophen with codeine, ibuprofen, and placebo administered preoperatively in relieving postoperative pain in children undergoing this procedure. All children received topical analgesia consisting of antibiotic eardrops mixed with 4% lidocaine intraoperatively. There was no significant difference in postoperative pain score between the four groups (
P
> 0.4447). Thus it is likely that the intraoperative administration of antibiotic eardrops mixed with 4% lidocaine is all that is required to alleviate postoperative pain in children undergoing myringotomy with tympanostomy tube placement. Preoperative oral analgesics are apparently of little added benefit.
Lateralized and Bilateral Olfactory Function in Patients With Chronic Sinusitis Compared With Healthy Control Subjects
Authors: Klimek Ludger , Hummel Thomas , Moll Bertram , Kobal Gerd , Mann Wolf J. 
Published: November 2003

AbstractResults of this study demonstrated that a new olfactory test, the “Sniffin' Sticks,” can be used to distinguish hyposmic patients with chronic sinusitis (n = 63) from control subjects. Dirhinic testing yielded improved olfactory sensitivity compared with monorhinic testing. However, dirhinic results were not significantly different from results obtained for the best nostril.