bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital Middle Ear Cholesteatomas in Children: Our Experience in 34 Cases
Authors: Darrouzet Vincent , Duclos Jean‐Yves , Portmann Didier , Bebear Jean‐Pierre 
Published: February 2003

OBJECTIVESTo evaluate clinical data, extensions, residual disease rate, and functional results in cases of congenital cholesteatoma in pediatric patients compared with cases of acquired forms.STUDY DESIGN AND SETTINGIn a retrospective study conducted at a single tertiary care center over a decade, 34 congenital cholesteatomas (mean patient age, 6.6 years) isolated from a series of 215 cholesteatomas in children were treated surgically and followed up for an average of 83 months. Surgical treatment consisted of the closed technique (CT), open technique tympanoplasty in CT [TOT], radical mastoidectomy (RM), or Rambo's technique. The main outcome measures were surgical findings, residual lesion rate, and hearing assessment.RESULTSThe first surgical procedure was CT in 85.3%, TOT in 8.8%, RM in 2.9%, and Rambo's technique in 2.9% of patients. Two, 3, and 4 operations were necessary in 76.5%, 11.4%, and 11.4% of children, respectively. Residual lesions were observed in 34.6% of those multi‐operated patients (7 CT and 2 TOT), 24.1% in those treated with CT, and 29.2% in those treated with CT with a planned second look. Mean postoperative pure tone average and air‐bone gap were 26 and 21 dB, respectively. A speech reception threshold of less than 30 dB HL was achieved in 66% of patients. A total of 26 ossiculoplasties had to be performed (8 partial and 18 total); the mean postoperative air‐bone gap was lower after the former (15 dB) than after the latter (22 dB). A high‐frequency pure‐tone hearing loss of more than 10 dB was uncommon (5.8%). Unsurprisingly, the residual lesion rate seems to be higher for congenital than for acquired cholesteatomas, but hearing results are significantly better.CONCLUSIONIn most cases, staged CT appears to be the best technique to treat these lesions, which often develop in a well‐pneumatized mastoid.
Outcome Predictors for Endoscopic Sinus Surgery
Authors: Wang Pa‐Chun , Chu Chia‐Chen , Liang Shu‐Cheng , Tai Chih‐Jaan 
Published: February 2003

OBJECTIVEThe outcomes management of endoscopic sinus surgery (ESS) is a major effort to improve the quality of chronic sinusitis treatment. The objective of this study was to investigate the factors that may predict a variety of outcomes of ESS.STUDY DESIGN AND SETTINGTwo hundred and thirty consecutive patients who underwent ESS were prospectively evaluated by computerized axial tomography scan of the sinus and a validated chronic sinusitis survey (CSS) before surgery. The effects of prognostic factors were then investigated.RESULTSExtent of disease was a consistent predictor (P < 0.05) for bleeding, complication occurrence, medical resource utilization, subjective sinus‐specific health status, and physicians' objective evaluation of surgical outcomes. The preoperative CSS total score and extent of disease significantly (P < 0.05) predicted the postoperative CSS total score. Subjective and objective outcomes were significantly correlated (r = 0.58, P = 0.0001). These findings suggested the necessity of disease severity stratification when reporting ESS outcomes.CONCLUSIONOperation‐related events, medical resource utilization, physician evaluation, and sinus‐specific health status of patients are all integral parts of reporting outcomes of ESS. We have concluded that computerized axial tomography scan of the sinuses and CSS are efficient ways of providing reliable baseline information before ESS.
Tuberculous and Nontuberculous Cervical Lymphadenitis: A Clinical Review
Authors: Chao Siew Shuen , Loh Kwok Seng , Tan Kun Kiang , Chong Siew Meng 
Published: February 2003

OBJECTIVESThe aim of the present study was to identify differences in clinical characteristics between patients with tuberculous cervical lymphadenitis and those with nontuberculous cervical lymphadenitis and to determine the diagnostic accuracy of fine needle aspiration (FNA) cytology.STUDY DESIGN AND SETTINGSeventy‐two patients with inflammatory cervical lymphadenitis were studied retrospectively. They were divided into 2 groups: group 1 consisted of those with tuberculous lymphadenitis and group 2 consisted of those with non‐tuberculous lymphadenitis. The demographic characteristics, clinical parameters, and hematological and cytological results of the 2 groups were compared.RESULTSOther than there being a significantly higher proportion of foreign‐born patients in group 1, there were no differences in clinical characteristics between the 2 groups. The sensitivity and specificity of FNA cytology in the diagnosis of tuberculous lymphadenitis were 88% and 96%, respectively.CONCLUSIONIt is difficult to clinically differentiate tuberculous from nontuberculous lymphadenitis. FNA cytology is useful in the diagnosis of tuberculous lymphadenitis.SIGNIFICANCEIn regions where tuberculosis is endemic, treatment can be instituted without the need for excisional biopsy if the FNA results show characteristic caseating granuloma.
Aspirin‐Sensitive versus Non‐Aspirin‐Sensitive Nasal Polyp Patients: Analysis of Leukotrienes/fas and Fas‐Ligand Expression
Authors: Ziroli Nancy E. , Na Hanjo , Chow James M. , Stankiewicz James A. , Samter Max , Young M. Rita I. 
Published: February 2003

OBJECTIVEThe goal of the present study was to identify levels of leukotrienes released by leukocytes and nasal polyps from aspirin‐sensitive patients (ASPs) and non‐aspirin‐sensitive patients (NASPs) after exposure to various concentrations of aspirin. Eosinophil expressions of apoptosis regulators were also compared.STUDY DESIGN AND SETTINGLeukotriene release from nasal polyps and leukocytes of ASPs and NASPs was measured after exposure to differing concentrations of aspirin. Eosinophils were analyzed for Fas and Fas ligand receptors using flow cytometry.RESULTSNASPs showed increased leukotriene release from nasal polyps on increased aspirin exposure. Polyps from ASPs did not show any change. ASPs showed greater leukotriene release from blood on increasing aspirin exposure compared with NASPs. Flow cytometric analysis showed eosinophils in the peripheral blood of ASPs have decreased Fas expression compared with those of NASPs.CONCLUSIONSThis study showed differences in leukotriene release and eosinophil apoptosis between ASPs and NASPs.
Management of Sphenoid Sinus Cerebrospinal Fluid Rhinorrhea: Making Use of an Extended Approach to the Sphenoid Sinus
Authors: Mehendale Neelesh H. , Marple Bradley F. , Nussenbaum Brian 
Published: February 2003

OBJECTIVESSpecific information addressing the management of cerebrospinal fluid (CSF) fistulas that originate from within the sphenoid sinus remains scant. The objective of this study was to review the cause and management of CSF rhinorrhea arising from the sphenoid sinus.STUDY DESIGN AND SETTINGThis is a retrospective chart review of 12 cases of CSF rhinorrhea arising from the sphenoid sinus that occurred in 11 patients. All patients were treated at a single institution between 1994 and 1999.RESULTSAll patients were managed surgically with sphenoid sinus fat obliteration using an endoscopic sublabial, transseptal approach. This approach was successful for all 12 cases, with median duration of follow‐up of 18 months.CONCLUSIONSEndoscopically assisted transseptal repair of CSF fistulas that originate within the sphenoid sinus offers an alternate approach to previously described methods of repair in this region. Advantages include wide access to the entire sphenoid sinus, improved access to laterally pneumatized regions within the sphenoid sinus, and rostral mucosal closure over the repair within the sinus.
Lung Volume Dependence of Pharyngeal Cross‐Sectional Area by Acoustic Pharyngometry
Authors: Kamal Ibrahim 
Published: February 2003

Pharyngeal size and the dynamic behavior of the pharynx may be important factors in the modulation of pharyngeal airflow. There are two measures of pharyngeal function: changes in pharyngeal area with lung volume and changes in pharyngeal area in response to externally applied positive pressure. Both measurements have been used for the assessment of pharyngeal function, and both reflect pharyngeal “floppiness.” The aim of the present study was to examine the relationship between pharyngeal cross‐sectional area, using acoustic reflection technique, and different lung volumes (tidal volume, inspiratory reserve volume, and expiratory reserve volume), to determine whether there are differences in mechanical properties of the pharynx of normal volunteers in response to changes in intrapharyngeal pressure. The acoustic technique was used to assess the pharyngeal cross‐sectional area of 40 healthy volunteers (29 men and 11 women) at tidal volume, inspiratory reserve volume, and expiratory reserve volume. In men, the mean pharyngeal area at tidal volume was 3.191 cm2, the mean pharyngeal area at inspiratory reserve volume was 2.976 cm2, and the mean pharyngeal area at expiratory reserve volume was 2.975 cm2. In women, the corresponding pharyngeal area measurements were 2.832, 2.484, and 2.492 cm2. statistical analysis of results showed that men have a larger pharyngeal cross‐sectional area and the pharyngeal airways of men and women act in a similar manner in response to changes in intrapharyngeal pressure, with men having a greater change. Examination of the pharyngeal compliance by acoustic pharyngometry adds to the potential of this technique as a tool for the evaluation of the pharyngeal airway in terms of area and dynamic behavior assessment. This may be of relevance in promotion of the development of upper airway assessment in patients with obstructive sleep apnea.
The Otologic Consequences of the Omagh Bomb Disaster
Authors: Miller Ian S. M. , McGahey David , Law Kathleen 
Published: February 2003

OBJECTIVESThe goal of the study was to compare the spontaneous healing rate for traumatic perforation of the tympanic membrane sustained in the Omagh bomb disaster with that of previous reports in the literature.DESIGN AND SETTINGA retrospective study was conducted at Tyrone County Hospital, Northern Ireland, 2 years after the incident.PARTICIPANTSOne hundred thirty‐eight patients who sustained otologic injuries from the bomb blast were included in the study.RESULTSOnly 47 of the 124 perforations healed spontaneously. The previously reported spontaneous healing rate for traumatic perforations of the tympanic membrane is 80% to 90%; in our study, the healing rate was unexpectedly low at 38%.CONCLUSIONThe massive explosion in a narrow street with hundreds of persons in close proximity to the bomb may account for the poor healing rate.
The Effects of an External Nasal Dilator and Nasal Dimensions in Asians
Authors: Ochi Kentaro , Ohashi Toru 
Published: February 2003

OBJECTIVESWe examined the potential correlation between the effectiveness of an external nasal dilator for Asians and nasal dimensions.STUDY DESIGN AND SETTINGSThe length, width, and height of the subjects' nose were measured. From these parameters, a nasal index (nasal width/nasal length) and a basal view index (columella height/nasal width) were calculated. Nasal airway resistances with and without an external nasal dilator were measured.RESULTSThere was a significant correlation between both nasal index and basal view index and the changes in nasal resistance that resulted from wearing an external nasal dilator, whereas no significant correlation was detected between each of the 3 nasal dimensions and changes in nasal resistance.CONCLUSIONSNoses with a smaller nasal index or a larger basal view index receive greater benefits from the wearing of an external nasal dilator. The effects of external nasal dilators are influenced by nasal shape rather than by individual nasal dimensions in Asians.
Reassessment of CD62L as a Marker of Pre‐Effector T Cells in the Tumor Draining Lymph Nodes of Head and Neck Cancer Patients
Authors: Strome Scott E. , Martin Elizabeth , Flies Dallas , Khurana Dianne , Salomao Diva , Tamada Koji , Chapoval Andrei I. , Kasperbauer Jan L. , Olsen Kerry D. , Chen Lieping 
Published: February 2003

OBJECTIVESCD62L was evaluated as a determinant of human pre‐effector T cells.STUDY DESIGN AND SETTINGPhenotype and cytokine secretion profiles of CD62L cells were determined based on activation status.RESULTSCD62LLow T cells demonstrated significantly higher secretion of interleukin (IL)‐10 and interferon (IFN)‐Γ than did CD62LHigh T cells. After activation, the majority of cells expressed high levels of the CD62L surface marker. Postactivation levels of IL‐10 production remained elevated or unchanged. In a murine B16 melanoma model, freshly isolated CD62LLow tumor draining lymph nodes (TDLN) T cells showed increased secretion of IL‐2 and IL‐4 but not of IL‐10 or IFN‐γ. The surface expression of CD62L and cytokine secretion patterns were maintained after activation with concomitant increases in IL‐10.CONCLUSIONOur results provide evidence that CD62LLow T cells in TDLNs of progressively growing squamous cell carcinoma of the head and neck differ phenotypically and functionally from those of mouse origin.SIGNIFICANCECharacterization of this human CD62LLow T cell population provides initial insight regarding novel surface markers in TDLN T cells that might correlate with antitumor reactivity.
The Temporal Course of Adenovirus‐Mediated Gene Transfer in the Rat Larynx
Authors: Ian N. Jacobs , Ralph P. Tufano , Danielle S. Walsh , Timothy Crombleholme 
Published: February 2003

OBJECTIVEPolypeptide growth factors have important influences on wound‐healing and scar tissue formation. Specific growth factors or their inhibitors may potentially decrease scar tissue formation and prevent subglottic stenosis. Gene transfer using recombinant adenovirus may be an ideal method to mediate endogenous production of growth factors to inhibit fibrosis.STUDY DESIGNThe study incorporated adenovirus‐mediated transduction of normal and stenotic rat larynges and histologic analysis of the sequential expression of a β‐galactosidase marker gene over time.SETTINGThe study was conducted at the animal care facility of an academic children's hospital.RESULTSWe report successful transduction in normal and injured rat larynx with peak expression of β‐galactosidase at 2 days after transduction and almost complete disappearance by 7 days. There appeared to be an early inflammatory response to the viral injection, but at 7 and 14 days after injection (transduction) the uninjured rat larynges resumed a normal histologic appearance. All distant sites stained negative for β‐galactosidase.CONCLUSIONRecombinant adenovirus‐mediated gene transfer is feasible in the rat larynx with transient duration and limited toxicity.SIGNIFICANCEAdenovirus‐mediated gene transfer has the potential to deliver growth factors that modulate wound healing and inflammation in the larynx by inhibiting fibrosis.
Final Validation of the Pediatric Tracheotomy Health Status Instrument (PTHSI)
Authors: Hartnick Christopher J. , Giambra Barbara K. , Bissell Cynthia , Fitton Cynthia M. , Cotton Robin T. , Parsons Susan K. 
Published: February 2003

OBJECTIVEWe sought to describe the development and final testing of an instrument designed to evaluate the impact of tracheotomy on the health‐related quality of life of affected families in whom a child has had a tracheotomy (the Pediatric Tracheotomy Health Status Instrument [PTHSI]).STUDY DESIGNThis cross‐sectional study designed to analyze a disease‐specific health status instrument to establish validity and reliability.RESULTSThe PTHSI was initially pilot tested in 130 families during a 3‐month period from September through November 2000. After initial analysis and revision, from January 2001 through July 2001, 154 different families completed the revised instrument. The overall Cronbach's α coefficient for the instrument was 0.91, with domain‐specific coefficients ranging from 0.66 for physical symptoms to 0.87 for caregiver stress and coping. Specific criterion validity analysis produced a Pearson correlation coefficient of 0.8 (P < 0.0001). Construct validity testing via Wilcoxon matched sum testing suggested statistically significant differences between subpopulations (P < 0.001).CONCLUSIONAfter initial testing and revision of the PTHSI, final instrument administration and analysis reveal the instrument to be valid and reliable. Future studies are planned to evaluate its responsiveness in longitudinal application.
Does Dexamethasone with Preemptive Analgesia Improve Pediatric Tonsillectomy Pain?
Authors: Giannoni Carla , White Sno , Enneking F. Kayser 
Published: February 2003

OBJECTIVEThe study goal was to determine whether the combination of dexamethasone with preemptive analgesia has an additive effect in further improving recovery.STUDY DESIGNWe conducted a prospective, randomized, double‐blinded trial of 50 children undergoing tonsillectomy at a university ambulatory surgery center. One study group received 1 intravenous dose of dexamethasone, and another group received 1 dose of saline solution. All patients received tonsillar fossa injections of ropivacaine plus clonidine before tonsil excision.RESULTSThe 2 study groups were similar in main outcome measurements. Pain intensity and quality of life were not statistically different between the groups. There was a small trend to less trismus and less cumulative codeine use in the steroid group. Overall, there was a very low incidence of nausea and vomiting in both groups, which may have been due to the preemptive analgesia.CONCLUSIONDexamethasone does not significantly improve the morbidity of pediatric tonsillectomy when preemptive analgesia with ropivacaine and clonidine is used concurrently.
Speech Recognition in Background Noise of Cochlear Implant Patients
Authors: Fetterman Bruce L. , Domico Elizabeth H. 
Published: February 2003

OBJECTIVESThe performances of adult patients using Spectral peak (Nucleus 22 or Nucleus 24 patients) or Continuous Interleaved Sampling or Advanced Combination Encoder (Clarion patients) were evaluated in their ability to perform in quiet and in 2 levels of background noise.PATIENTS AND METHODSNinety‐six patients were tested with the City University of New York Sentences presented at 70 dB in quiet and at signal‐to‐noise ratios (SNR) of +10 and +5 dB. Patients were scored on the number of words perceived correctly.RESULTSScores were different at each condition (P < 0.05): 88% words correct in quiet, 73% correct at an SNR of +10 dB, and 47% correct at an SNR of +5 dB. Linear regression analysis found no significant correlation between test score and age at implantation or time using the implant. A weak negative correlation was found between years of hearing loss and score.CONCLUSIONCompeting noise interferes with comprehension of connected speech for most cochlear implant patients.
Microsatellite Analyses of Loci at 7q31.3‐q36 Reveal a Minimum of Two Common Regions of Deletion in Nasopharyngeal Carcinoma
Authors: Tan Guolin , Xiao Jianyun , Tian Yongqian , Dong Longnwen , Jiang Nin , Zhan Fenfang , Li Guiyuan 
Published: February 2003

OBJECTIVEOur goal was to better define the extent and specificity of deletion in the 7q32‐qter chromosomal region in nasopharyngeal carcinoma (NPC).DESIGN AND SETTINGPolymerase chain reaction‐based deletion analysis was performed on DNA samples from 24 paired NPCs and corresponding germlines using 13 microsatellite markers mapped to chromosome subbands 7q31.3‐q36.RESULTSLoss of heterozygosity of at least 1 marker in this interval was found in 18 (75%) of 24 tumor specimens. Particularly frequent allelic losses were identified at 5 loci: D7S495 (46%), D7S509 (42%), D7S500 (45%), D7S631 (30%), and D7S514 (35%). Two shortest regions of overlap could be identified in this interval, although the most common shortest region of overlap appeared to lie around D7S500 between but not including D7S631 and D7S495, on chromosome subband 7q32.CONCLUSIONThese results suggest that at least 2 putative tumor suppressor genes important in the pathogenesis of NPC are present in the examined interval, an interval that has also been found to harbor deletions in breast and prostate carcinomas.
Expression of the Proto‐Oncogene eIF4E in Inflammation of the Oral Cavity
Authors: Chandy Binoy , Abreo Fleurette , Nassar Raja , Stucker Fred J. , Nathan Cherie‐Ann 
Published: February 2003

OBJECTIVEeIF4E (4E) is elevated in 100% of head and neck squamous cell carcinoma (HNSCC) and in premalignant lesions of the larynx. However, it is not elevated in normal mucosa. In this study, we hypothesize that 4E is not significantly elevated in inflammation unlike its expression in premalignant lesions of the oral cavity.STUDY DESIGNBiopsies from the oral cavity were divided into 5 groups: (1) normal mucosa, (2) chronic inflammation, (3) mild dysplasia from leukoplakic lesions, (4) mild dysplasia in surgical margins of patients with HNSCC, and (5) HNSCC. Immunohistochemical qualitative analysis was then performed.RESULTSNone of the 15 specimens in group 1 and 100% of the 15 specimens in group 5 expressed 4E. Of the 29 specimens in group 2 only 4/29 (13%) overexpressed 4E compared with 10/31 (32%) in group 3 and 9/21 (42%) in group 4. There was a significant difference between groups 2 and 3 and groups 2 and 4 (P < 0.0001 and P < 0.003 respectively) but no significant difference between groups 1 and 2 (P = 0.13) and between groups 3 and 4 (P = 0.30).CONCLUSION4E is not significantly elevated in inflammation of the oral cavity thus fulfilling one of the criteria that biomarkers require to be useful in a clinical setting.
Middle meatal vs antral lavage cultures in intensive care unit patients
Authors: Kountakis Stilianos E. , Skoulas Ioannis G. 
Published: February 2003

OBJECTIVEThe study goal was to compare endoscopically guided middle meatal cultures with cultures of antral lavage aspirate in intensive care unit (ICU) patients with sinusitis.METHODSProspective study of febrile ICU patients seen for sinusitis at a tertiary medical center.RESULTSOf 31 antral lavages performed in 18 patients, 19 lavages yielded purulent or mucopurulent aspirate. Endoscopically guided middle meatal cultures yielded the same pathogen, as did cultures of the lavage aspirate in 4 (21%) of these 19 cases. The antral lavage was negative (absence of purulent/mucopurulent aspirate) in 12 cases, and of those, 5 (42%) of the 12 middle meatal cultures showed no growth (sensitivity = 21%, specificity = 58%, χ2‐1.52, P = 0.218).CONCLUSIONEndoscopically guided middle meatal cultures did not correlate well with cultures from the antral lavage aspirate in febrile ICU patients evaluated for sinusitis.
Management of common voice problems: Committee report
Authors: Zeitels Steven M. , Casiano Roy R. , Gardner Glendon M. , Hogikyan Norman D. , Koufman James A. , Rosen Clark A. 
Published: February 2003

OBJECTIVEThis report provides the reader with a state‐of‐the‐art update on a number of common voice problems that require phonosurgical intervention.STUDY DESIGN AND SETTINGThis multiauthor review is not a position statement of the American Academy of Otolaryngology–Head and Neck Surgery (AAOHNS) and may reflect institutional preference and/or bias. It arose from a panel discussion at the AAOHNS meeting in 2000.RESULTSWe provide a review of the genesis and management of papillomatosis, dysplastic glottal epithelium, arytenoid granulomas, Reinke's edema, and vocal‐fold paralysis.CONCLUSIONS AND SIGNIFICANCEIn the past decade, there has been a dramatic expansion of knowledge regarding a variety of voice disorders and associated treatment. There has been a convergence of basic science investigations in anatomy, physiology, and pathology with clinical trials of treatment, both surgical and nonsurgical. This information should provide the reader with current insight into critical management issues of the aforementioned disorders.