bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of angiogenic factors: Coexpression of interleukin‐8 and vascular endothelial growth factor in patients with head and neck squamous carcinoma
Authors: Eisma Roselle J. , Spiro Jeffrey D. , Kreutzer Donald L. 
Published: November 2003

AbstractObjective/Hypothesis: Angiogenesis has been used as a prognostic indicator in a variety of cancers and is believed to be controlled by angiogenic factors, including the cytokines interleukin‐8 (IL‐8) and vascular endothelial growth factor (VEGF). We hypothesized that the in vivo coexpression of both IL‐8 and VEGF in head and neck tumors contributes to perpetuating tumor growth and metastasis by enhancing angiogenesis. Methods: Immunohistochemical analysis for IL‐8 and VEGF was performed using specimens from 33 cancer patients and 6 control patients. We quantitatively evaluated levels of IL‐8 and VEGF in tumor tissue homogenates from those same patients using enzyme‐linked immunosorbent assay and radioimmunoassay. Comprehensive histories of each patient were taken and later analyzed for clinical correlations with IL‐8 or VEGF levels. Results: IL‐8 and VEGF were found to be colocalized within the head and neck squamous cell carcinoma (HNSCCA) tumor cells. In the head and neck tumor specimens, IL‐8 levels ([38,152 ± 1.8] × 105 pg/mg total protein [TP]) were 22‐fold greater than controls (1,721 ± 2,122 pg/mg TP). The tumor levels of VEGF (1,304 ± 6,037 pg/mg TP) were nearly fourfold higher than the controls (317 ± 400 pg/mg TP. Interleukin‐8 and VEGF levels were found to have a positive correlation (P ⩽ .0001). Patients exhibiting high levels in picograms per milligram of TP and/or number of moles of IL‐8 and VEGF were found to clinically have more aggressive disease manifested by higher TNM stage, more recurrences, and shorter disease‐free intervals (P ⩽ .03) Conclusions: Marked increase in HNSCCA of IL‐8 and VEGF underscores the importance of these angiogenic factors in this disease. Understanding the roles and interplay of angiogenic factors such as IL‐8 and VEGF may have value in the treatment of HNSCCA.
Paroxysmal laryngospasm after laryngeal nerve injury
Authors: Wani Manish K. , Woodson Gayle E. 
Published: November 2003

AbstractObjective: Describe a clinical syndrome of laryngeal hypersensitivity following laryngeal nerve injury. Study Design: Retrospective review of six patients with laryngeal paralysis sustained during neck surgery who presented with paroxysms of coughing and stridor, progressing to brief episodes of complete airway occlusion. Methods: Chart review. Results: Superior laryngeal nerve blockade temporarily improved symptoms in four of five patients. Botulinum toxin relieved spasm in two of three patients and reduced symptoms in the third. Symptoms gradually diminished or resolved in four patients from 1 to 2.5 years later. One patient underwent arytenoidectomy and one patient has a tracheostomy. Conclusions: Patients with laryngeal injury may present with stridor and acute airway obstruction secondary to paroxysmal laryngospasm. The authors have found that superior laryngeal nerve blockade or botulinum toxin may be effective in temporary relief of symptoms.
Evidence for recurrent laryngeal nerve contribution in motor innervation of the human cricopharyngeal muscle
Authors: Brok Heidy A. J. , Copper Marcel P. , Stroeve Rutger J. , de Visser Bram W. Ongerboer , Venker‐van Haagen Anjob J. , Schouwenburg Paul F. 
Published: November 2003

AbstractObjective: To study the functional motor nerve supply of the upper esophageal sphincter in humans.Study Design: Intraoperative electromyographic study.Methods: The contribution of the recurrent laryngeal nerve and the pharyngeal plexus in the motor nerve innervation of the cricopharyngeal muscle and the inferior pharyngeal constrictor muscle was examined intraoperatively.Results: Electromyography showed that there is a considerable overlap in the innervation of the cricopharyngeal muscle and the inferior pharyngeal constrictor muscle. The recurrent laryngeal nerve functionally contributes to the motor innervation of the cricopharyngeal muscle in all patients and contributes to the motor innervation of the inferior pharyngeal constrictor muscle in most patients. The pharyngeal plexus functionally contributes to the motor innervation of the inferior pharyngeal constrictor muscle but does not always contribute to the motor innervation of the cricopharyngeal muscle.Conclusions: This is the first report which provides evidence that the recurrent laryngeal nerve functionally contributes to the motor innervation of the cricopharyngeal and inferior pharyngeal constrictor muscle. Furthermore, this study shows that intraoperative electromyography in humans is a feasible method to analyze the physiology of the motor innervation of the upper esophageal sphincter.
Functional results of plastipore prostheses for middle ear ossicular chain reconstruction
Authors: Bayazit Yildirim , Göksu Nebil , Beder Levent 
Published: November 2003

AbstractObjective: Assessment of plastipore prostheses for middle ear ossicular chain reconstruction. Hearing results with total and partial Plastipore ossicular replacement prostheses (TORP and PORP) were evaluated in open‐ and closed‐cavity operations. Study Design: A retrospective review of 237 patients who underwent operation for chronic ear disease as well as ossiculoplasty with plastipore prostheses. In order to assess the functional results, only 156 of 237 patients were included in the study. Follow‐up ranged from 6 to 46 months. Methods: Canal wall up and canal wall down operations were performed. Either TORP or PORP ossiculoplasty was performed in each operation. An air‐bone gap closure to within 20 dB was considered successful. Results: With TORPs, the air‐bone gap closure to within 20 dB was achieved in 43.1%, and similar results were obtained with PORPs in 63.3%. In canal wall down and canal wall up operations, the success rates were 55.8% and 55.7%, respectively. The best results were obtained with PORPs in canal wall down operations, with a success rate of 82%. The extrusion rate of the prostheses was 4.2%. Conclusion: Hearing results of PORPs are better than TORPs. In canal wall up and canal wall down operations similar hearing results are obtained. PORP ossiculoplasty in a canal wall down operation yields the most favorable hearing result.
Nerve cell adhesion molecule expression in squamous cell carcinoma of the head and neck: A predictor of propensity toward perineural spread
Authors: McLaughlin Robert B. , Montone Kathleen T. , Wall Stephen J. , Chalian Ara A. , Weinstein Gregory S. , Roberts Shelley A. , Wolf Patricia F. , Weber Randal S. 
Published: November 2003

AbstractObjective: To evaluate head and neck squamous cell carcinomas (SCCAs) for the expression of nerve cell adhesion molecule (N‐CAM). We propose that expression of N‐CAM by tumor cells may be associated with perineural invasion in SCCA of the head and neck. Methods: Seventy‐six archived specimens of histologically proven SCCA were analyzed by immuno‐histochemistry for the expression of N‐CAM. Positive and negative controls were used to assess staining. Two sections of each specimen were reviewed for the presence of perineural invasion. A retrospective chart review was performed for each patient that corresponded to the above specimens. Results: Perineural invasion was present in 28 (37%) of the 76 patients evaluated for the expression of N‐CAM. N‐CAM expression was demonstrated in 38 (50%) of the 76 specimens. The incidence of N‐CAM expression was significantly associated with perineural invasion (P = .002). There was no significant association between the presence of staining or the presence of perineural invasion and the incidence of locoregional recurrence, distant metastasis, or survival status; however, the mean follow‐up was only 13.6 months (range, 1–49 mo). Conclusion: There is a positive correlation between the presence of N‐CAM expression and perineural invasion in SCCA of the head and neck. The expression of this adhesion molecule by tumor cells may facilitate both homophilic cell‐to‐cell and heterophilic cell‐to‐substrate adhesion, thereby enabling the tumor cells to use the perineural tissues or neural cells, or both as a conduit for perineural spread.
Success of the modified epley maneuver in treating benign paroxysmal positional vertigo
Authors: Wolf Jeffrey S. , Boyev Kestutis P. , Manokey Brenda J. , Mattox Douglas E. 
Published: November 2003

AbstractObjective: Benign paroxysmal positional vertigo (BPFV) is a common condition seen by otolaryngologists. The purpose of this study is to determine the ability of the modified Epley maneuver to treat BPPV. Study Design: Retrospective review. Methods: A retrospective chart review of 107 patients diagnosed with BPPV at our institution between March of 1993 and June of 1995. Each patient was diagnosed with isolated BPPV by history and Hallpike‐Dix maneuver. There were no other vestibular symptoms or electronystagmogram abnormalities. Patients diagnosed with BPPV received modified Epley maneuvers, were instructed to remain upright for 48 hours, and wore a soft collar for a week. Patients were followed up with repeat Hallpike‐Dix maneuvers at 1 to 2 weeks. If symptoms persisted, the maneuver was repeated for up to a maximum of three times, at which point patients were considered to have failed treatment. Results: The average age of patients was 57.8 years old. Thirty percent were male and the right ear was affected in 54%. The posterior semicircular canal was affected in 105 ears. The average patient received 1.23 Epley maneuvers, with a success rate of 93.4%. No successfully treated patients received mastoid vibration. Seven out of 107 patients failed after three Epley maneuvers. Two failure patients had a history of temporal bone fracture. Two failure patients were treated with posterior semicircular canal block surgery. Conclusion: The modified Epley maneuver is an excellent treatment for BPPV. Key Words: Vertigo, benign paroxysmal positional vertigo (BPPV), Epley maneuver, semicircular canal.
Intraoperative electromyography for predicting facial function in vestibular schwannoma surgery
Authors: Axon Patrick R. , Ramsden Richard T. 
Published: November 2003

AbstractObjective: To assess the validity of intraoperative minimal stimulation threshold (MST) for predicting long‐term facial function after vestibular schwannoma surgery. Study Design: Prospective blinded study. Methods: MST after tumor dissection and postoperative clinical facial function, assessed using the House Brackmann grading system (HB), were used to predict long‐term clinical facial function, recorded at least 6 months after surgery. Results: Two hundred and nine consecutive patients fulfilled selection criteria and 184 had successful intraoperative electrophysiologic monitoring and were eligible for further study. MST of 0.05 mA had moderate accuracy for predicting good long‐term facial function, with 94% sensitivity, 91% positive predictive value (PPV), 60% specificity, and 70% negative predictive value (NPV). A more relevant group of 77 patients with poor postoperative facial function (HB III‐VI) were assessed for predicting good long‐term function. Applying this criteria, test accuracy fell, with 83% sensitivity, 64% PPV, 60% specificity, and 75% NPV. Postoperative clinical facial function had a greater accuracy for predicting good long‐term function, with 83% sensitivity, 79% PPV, 75% specificity, and 79% NPV. A model of predicted probabilities of good outcome (HB I and II) was derived from a logistic regression with two additive predictors (postoperative HB and MST). This demonstrated that for patients with postoperative HB grade V, MST aided prediction. Conclusions: Intraoperative stimulation thresholds, when assessed against a relevant group of patients with poor postoperative facial function, had poor predictive accuracy. The severity of immediate postoperative clinical facial function was the most accurate predictor of long‐term outcome. MST aided long‐term prediction in a small but relevant group of patients with postoperative HB grade V facial function. Key Words: Facial nerve, vestibular schwannoma, electromyography, EMG.
Roles of Cytokines and Cell Cycle Regulating Substances in Proliferation of Cholesteatoma Epithelium
Authors: Tanaka Yasuhiro , Kojima Hiromi , Miyazaki Hidemi , Koga Tomohiko , Moriyama Hiroshi 
Published: November 2003

AbstractObjectives: It can be surmised that the cell cycle must be involved in cell proliferation of the epithelium of middle ear cholesteatoma. Thus a comparative study was conducted of the levels of expression of cyclin‐dependent kinase 2 (cdk2) and cyclin‐dependent kinase 4 (cdk4)—substances known to be involved in the cell cycle—in cholesteatoma epithelium and the normal epithelium of the bony region of the external ear canal. In addition, it has been reported that the expression of cytokines in the epithelium is accelerated in response to subepithelial inflammation. This suggests that an interaction between the epithelium and subepithelium, which is subject to paracrine regulation, is deeply involved in epithelial proliferation. Accordingly, attention was focused on interleukin−1α (IL‐1α) and keratinocyte growth factor (KGF), cytokines which are found in the subepithelium, and experiments were conducted to elucidate their effects on the expression of the substances known to be involved in the cell cycle. Methods: The expressions of cdk2 and cdk4 in the cholesteatoma epithelium and external ear canal epithelium were investigated by an immunohistochemical technique. In addition, cultured human keratinocytes were grown in medium containing IL‐1α or KGF at concentrations of 0, 20, and 100 ng/mL, and the differences in the expression of cdk2 and cdk4 were investigated and compared by Western blot analysis. Results: In the cholesteatoma epithelium specimens, cdk2 and cdk4 were observed to be expressed in the basal and parabasal layers and in the upper layer (prickle layer and granular layer). Their expression tended to be increased compared with their expression in the normal external ear canal epithelium, and this tendency was marked in subepithelial sites showing severe inflammation. In addition, exposure of cultured human keratinocytes to IL‐1α or KGF resulted in accelerated expression of both cdk2 and cdk4, and this was especially striking in the case of addition of KGF. Conclusion: It can be surmised that, in cholesteatoma, accelerated expression of IL‐1α and KGF by inflammatory cells at subepithelial sites of inflammation leads to upregulation of cdk2 and cdk4 in epithelial cells and to cell proliferation. It was concluded that this is at least one sequence of events involved in the mechanism causing epithelial proliferation in cholesteatoma.
The Posterior Thyroplasty Window: Anatomical Considerations
Authors: Maragos Nicolas E. 
Published: November 2003

AbstractObjectives: Explain surgical technique of performing a posterior thyroplasty window.1 Describe the internal laryngeal anatomy and structures available through the posterior window approach. Describe posterior window approach.Study Design: Review of lateral laryngeal anatomy and retrospective review of 125 cases involving a posterior thyroplasty window approach. Review mechanics of stress and stress concentration inherent with partial removal of rigid substance. Describe anatomical considerations and surgical complications.Methods: Charts were reviewed and tabulated for surgical complications, efficacy and safety of surgical approach, specific anatomical variations, and variety of surgery available through the posterior window.Results: Performance of 125 posterior thyroplasty windows revealed no evidence of entry into the piriform sinus. Three thyroid ala fractures ensued, two of the body and one of the inferior cornu. Operations available included arytenoid adduction,1 arytenoid fixation,2 lysis of joint adhesions, and access to the posterior cricoarytenoid muscle for botulinum toxin injections.Conclusions: The posterior thyroplasty window affords easy, direct access to the internal, posterolateral larynx while preserving the cricothyroid joint, the action of the cricothyroid muscle, and the internal division of the recurrent laryngeal nerve.
Surgical Removal of Subglottic Hemangiomas in Children
Authors: Van Den Abbeele Thierry , Triglia Jean‐Michel , Lescanne Emmanuel , Roger Gilles , Nicollas Richard , Ployet Marie‐Josèphe , Garabédian Eréa‐Noël , Narcy Philippe 
Published: November 2003

AbstractObjective: To examine the indications and the results of surgical excision of severe subglottic hemangiomas.Design: Retrospective study and case series.Setting: Four academic tertiary care centers of pediatric otolaryngology.Patients: Twenty children were included from 1991 to 1997. All presented with severe subglottic hemangiomas resistant to classical treatments such as corticosteroids and/or CO2 laser.Intervention: Six children were operated on using laryngotracheal reconstruction and prolonged stenting by a reinforced Silastic roll and 14 children were operated on by a single‐stage laryngotracheoplasty and post‐operative intubation in a pediatric intensive care unit.Results: All patients were successfully decannulated or extubated and have been free from recurrent hemangiomas.Conclusion: The surgery of severe subglottic hemangiomas is a reliable technique in selected patients and should be considered in corticoresistant or corticodependent, circular, or bilateral hemangiomas.
Systematic Management of Osteoradionecrosis in the Head and Neck
Authors: Hao Sheng‐Po , Chen Hung Chi , Wei Fu‐Chan , Chen Chao‐Yu , Yeh Albert Re‐Ming , Su Jen‐Liang 
Published: November 2003

AbstractObjectives: Osteoradionecrosis is one of the most serious and devastating complications of radiotherapy. The proper management of osteoradionecrosis is currently undetermined. The objective of this study is to evaluate the treatment results of a systematic approach to osteoradionecrosis.Study Design: A prospective study of a systematic approach to osteoradionecrosis in the head and neck area was undertaken.Methods: From July 1993 to June 1998, 33 cases of osteoradionecrosis in the head and neck area were treated using a systematic approach that combined sequestrectomy and hyperbaric oxygen therapy.Results: Seven (21%) had recurrent cancer. The control rate of the other 26 osteoradionecrosis cases was 77% (20/26).Conclusions: Persistent osteoradionecrosis, despite diligent radical treatment, raises the suspicion of recurrent cancer. Extensive osteoradionecrosis with a multiple discharging fistula, a large area of exposed necrotic bone, or a coexistent fracture should be treated primarily with radical sequestrectomy and microvascular free flap reconstruction. Surgery still plays a major role in controlling osteoradionecrosis, and hyperbaric oxygen therapy is adjuvant.
Otolaryngology Care Unit: A Safe and Cost‐Reducing Way to Deliver Quality Care
Authors: Strauss Melvin , Bellian Kenneth 
Published: November 2003

AbstractObjectives: Patients undergoing treatment for head and neck cancer, obstructive sleep apnea, and potential airway obstruction are often unnecessarily admitted to an intensive care unit (ICU). This study determined the efficacy of an intermediate care unit (OtoCare Unit) for their management.Methods: A mail survey was conducted of 110 academic institutions' experience with intermediate care units; a retrospective study was performed of our ICU use with analysis of the use of invasive monitoring, length of stay, and cost; and a retrospective study of our first 168 OtoCare Unit patients and their outcomes, complications, and charges was performed.Results: There were 56 responses to 110 survey inquiries. Thirty institutions used some form of intermediate care, while five had a separate otolaryngology unit. Analysis of our 1‐year ICU experience showed that of 54 patients who underwent head and neck surgery, 36 patients were admitted to the ICU. Of these 36 admissions, only 9 patients required invasive monitoring and the majority had stable clinical courses. Guidelines were established for an OtoCare Unit: patients use non‐ICU beds, mobile noninvasive monitoring units are provided, and a 1:4 nurse‐to‐patient ratio is used. Phase I included 35 patients who required a mandatory post‐anesthesia care unit (PACU) stay of 4 hours. Three minor complications occurred in this group. Phase II included 133 patients who were permitted to enter the OtoCare Unit as soon as they recovered from anesthesia. There were nine minor complications and three major complications in this group. The charge savings compared with ICU usage for such patients was $35,762.00.Conclusions: An OtoCare Unit is a safe and cost‐effective means of caring for this select group of patients.
Microneurovascular Allotransplantation of the Canine Tongue
Authors: Haughey Bruce H. , Beggs James C. , Bong Jeongpyo , Genden Eric M. , Buckner Allyson 
Published: November 2003

AbstractIntroduction: Reconstruction of the tongue with existing methods of tissue transfer often leaves glossectomy patients with significant deficits in speech and swallowing. The critical role of the tongue is implied by its unique structure and function. This paper reports the development of an animal model of hemitongue allotransplantation and documents functional and anatomic outcomes of this procedure.Methods: Ten pairs of unmatched dogs underwent reciprocal exchange of the left hemitongue with microneurovascular replantation. The unoperated hemitongue acted as the control. Under cyclosporine immunosuppression, animals surviving long term underwent clinical observation, before electromyography, force transduction studies, and histological evaluation being euthanized.Results: Five animals survived between 6 and 13 months for long‐term evaluation. The remaining group were euthanized because of or died of overwhelming infection or uncontrollable transplant rejection. The latter sometimes resulted from difficulty in the delivery of the cyclosporine. Clinical recovery of tongue function was observed, as well as resumption of motor unit potential activity on electromyography. Contractile force recovery of the transplanted tongue averaged 68% of control (range, 47%‐97%), and histological study of the hypoglossal and lingual nerves demonstrated anatomic evidence of reinnervation. Preservation of muscle, mucosal, and stromal ultrastructure was seen with light microscopy of the transplanted tongue.Conclusions: Allotransplantation of the hemitongue and associated neurovascular apparatus is possible in a large mammalian model, with long‐term survival of tissue being accompanied by partial recovery of contractile properties. Anatomical and clinical evidence also points to sensory recovery. These data support the future possibility of employing a similar technique in glossectomy patients.