bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Utility of Cephalometry With the Muller Maneuver in Evaluating the Upper Airway and Its Surrounding Structures in Chinese Patients With Sleep‐Disordered Breathing
Authors: Liao Yu‐Fang , Huang Chiung‐Shing , Chuang Ming‐Lung 
Published: November 2003

AbstractObjective The objective was to simultaneously measure the size and collapsibility of the upper airway in Chinese patients with sleep‐disordered breathing using cephalometry with the Muller maneuver.Study Design Prospective study of 100 consecutive Chinese patients evaluated for sleep‐disordered breathing at a sleep center.Methods Each patient received overnight polysomnography and two lateral cephalograms (at the end‐expiration phase and the Muller maneuver, respectively) to evaluate the upper airway and its surrounding structures (soft palate, tongue, and hyoid bone). After excluding 15 subjects from this study because of unclear cephalograms, 85 patients with sleep‐disordered breathing were enrolled, including 32 with snoring or mild obstructive sleep apnea and 53 with moderate to severe obstructive sleep apnea.Results Patients with varying degrees of severity of sleep‐disordered breathing significantly differed in terms of the structure and function of the upper airway and the surrounding structures. The Muller maneuver may result in dynamic changes in the retropalatal airway and pharyngeal length, and the levels of dynamic changes were related to the severity of sleep‐disordered breathing. Pearson correlation analysis revealed that the decrease in the minimum retropalatal dimension during the Muller maneuver in patients with snoring or with mild obstructive sleep apnea was related to the thickening of the soft palate and posterior displacement of tongue. Meanwhile, the decrease in the minimum retropalatal dimension in patients with moderate to severe obstructive sleep apnea was related to lengthening of the soft palate, increased tongue height, and downward displacement of the tongue and hyoid bone.Conclusion Cephalometry with the Muller maneuver may provide further insight into the pathogenesis of various levels of severity of sleep‐disordered breathing.
Difference in Facial Canal Anatomy in Terms of Severity of Microtia and Deformity of Middle Ear in Patients With Microtia
Authors: Takegoshi Hideki , Kaga Kimitaka 
Published: November 2003

AbstractObjectiveTo study the difference in the facial canal anatomy in terms of the severity of microtia and deformity of the middle ear in patients with microtia using high‐resolution computed tomography (HRCT).Study DesignForty‐six ears with microtia were examined by HRCT. These ears were graded based on two systems of classification and scoring, respectively. The HRCT findings of each group were compared with those of other groups by multiple comparison using the Tukey honestly significant difference test.MethodsForty‐six ears with microtia (unilateral microtia, n = 12; bilateral microtia, n = 34) were examined by HRCT. These ears were graded based on two systems of classification and scoring, respectively. The HRCT findings and age distribution of each group were compared with those of other groups by multiple comparison using the Tukey honestly significant difference test.ResultsThe mastoid portion of the facial nerve was 3 mm more anteriorly displaced in patients with grades II and III microtia than in those with grade I microtia (P<.01). From the scoring system that was used, the course of the facial nerve was not significantly different between patients with a score of 5 points or less and those with a score of 6 points or more.ConclusionThe mastoid portion of the facial nerve in patients with grades II and III microtia would be more anteriorly displaced because of hypoplasia of the second genu.
Acute Vertigo Following Cervical Manipulation
Authors: Young Yi‐Ho , Chen Chia‐Hung 
Published: November 2003

AbstractObjective/Hypothesis Either licensed American chiropractors or traditional Chinese herbalists may produce vertiginous attack in a patient after cervical manipulation. The purpose of the study was to present our experience in treating these patients to determine the risk of this procedure.Study Design A retrospective study from May 1999 to April 2002.Methods Nine patients (one man and eight women) with acute vertigo after cervical manipulation were admitted and underwent a battery of audiometric and vestibular tests, accompanied by magnetic resonance imaging and magnetic resonance angiography examination.Results The mean interval for the onset of acute vertigo after cervical manipulation was within 1 day (17 h). Electronystagmography revealed multiple central signs. Magnetic resonance angiography scan also disclosed abnormality in the vertebral artery such as occlusion, stenosis, or slow blood flow in three patients. After treatment with dextran, relief of vertigo without neurological deficits was experienced in all nine patients.Conclusions When there are multiple central signs in electronystagmography results or slow blood flow of the vertebral artery is displayed in neck on Doppler sonography or magnetic resonance angiography scan, the therapeutic benefits of cervical manipulation cannot be expected to outweigh its potential risk for the morbidity of cervical vessels.
Radiofrequency for the Treatment of Allergic Rhinitis Refractory to Medical Therapy
Authors: Lin Hsin‐Ching , Lin Pei‐Wen , Su Chih‐Ying , Chang Hsueh‐Wen 
Published: November 2003

AbstractObjectives/Hypothesis The ideal treatment for allergic rhinitis refractory to medical therapy is still lacking. The aim of the study is to evaluate the efficacy of turbinate surgery with radiofrequency for the treatment of allergic rhinitis that is unresponsive to medical therapy.Study Design A prospective, nonrandomized clinical study.Methods From February 2000 to April 2002, 108 consecutive patients (45 men and 63 women [mean age, 29.5 y]) with allergic rhinitis refractory to medical therapy who underwent radiofrequency turbinate surgery were enrolled in the study. Postoperative follow‐up ranged from 12 to 26 months. A standard 0‐to‐10 visual analogue scale with an anchor was used to assess the pain and the allergic symptoms, including nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes, preoperatively and postoperatively at the end of weeks 1 and 2 and months 1, 3, 6, and 12 after surgery. Statistical analysis was determined by repeated measures of ANOVA.Results None of the 108 patients had obvious discomfort other than mild numbness over the premaxillary area (24 of 108 [22.2%]) during operation. Also, no adverse reactions including bleeding, infection, adhesion, or a worsening of allergic symptoms were encountered. One hundred one patients were included in the final statistical analysis. Only nine patients reported no improvement at all after treatment. The response rate of radiofrequency turbinate surgery for allergic rhinitis refractory to medical therapy was 91.1% (92 of 101). At 1 year after the treatment, the degree of nasal obstruction had changed on the visual analogue scale (mean ± SD) from 6.84 ± 2.09 to 2.47 ± 1.60, an improvement of 63.9%. The degree of rhinorrhea had changed from 5.74 ± 2.75 to 2.57 ± 2.31, an improvement of 55.2%. The degree of sneezing had changed from 5.30 ± 2.80 to 2.59 ± 2.13, an improvement of 51.1%. The degree of itchy nose had changed from 3.74 ± 3.16 to 1.82 ± 2.27, an improvement of 51.3%. The degree of itchy eyes had changed from 3.17 ± 3.09 to 1.68 ± 2.38, an improvement of 47.0%. The visual analogue scale scores for nasal obstruction, rhinorrhea, sneezing, itchy nose, and itchy eyes decreased significantly with time, from preoperative scores to scores at 1 year after surgery. Other additional effects and improvements, including headache, lumpy throat, night cough, and tinnitus, were also reported by the patients. Most of the patients stated that they would consider repeating this procedure if necessary and would recommend the new method to their friends with the same problems.Conclusions The study demonstrates that radiofrequency appears to be an effective and safe tool for treating allergic rhinitis with poor response to medical therapy. In the future, radiofrequency has the potential to be one of the most popular surgical modalities for the treatment of allergic rhinitis refractory to medical therapy.
Preoperative Diagnosis of Allergic Fungal Sinusitis
Authors: Dhiwakar Muthuswamy , Thakar Alok , Bahadur Sudhir , Sarkar Chitra , Banerji Uma , Handa Kumut Kumar , Chhabra Sunil Kumar 
Published: November 2003

AbstractObjectives/Hypothesis Although the diagnosis of allergic fungal sinusitis is mainly based on characteristic histopathological findings, certain preoperative diagnostic criteria have been proposed. However, their usefulness in differentiating allergic fungal sinusitis from other sinus diseases is unknown. The objective of the study was to identify accurate preoperative diagnostic parameters for allergic fungal sinusitis.Study Design Prospective, comparative study.Methods Twenty consecutive cases of allergic fungal sinusitis were evaluated prospectively and compared with 16 cases of ethmoidal polyposis and 5 cases of invasive sinus aspergillosis, with regard to various clinical, radiological, and immunological parameters. All patients were categorized based on histopathological findings.Results Nasal polyps were seen in all 20 cases of allergic fungal sinusitis, all 16 cases of ethmoidal polyposis, and 2 of 5 cases of invasive sinus aspergillosis. Computed tomography (CT) scan hyper‐attenuation was seen in all 20 cases of allergic fungal sinusitis but also in 2 (13%) cases of ethmoidal polyposis and 2 (40%) cases of invasive sinus aspergillosis. Serum levels of specific anti‐Aspergillus immunoglobulin E were elevated in 14 (70%) cases of allergic fungal sinusitis, 2 (13%) cases of ethmoidal polyposis, and 3 (60%) cases of invasive sinus aspergillosis. The combination of all three (ie, nasal polyps, CT scan hyper‐attenuation, and elevated titers of anti‐Aspergillus immunoglobulin) was not found in any case of ethmoidal polyposis or invasive sinus aspergillosis. This triad demonstrated a sensitivity of 70% and a specificity of 100% for the preoperative diagnosis of allergic fungal sinusitis.Conclusions Nasal polyps, CT scan, and specific immunoglobulin E titers, when considered in combination, have a high preoperative diagnostic value in allergic fungal sinusitis. However, they should not be considered in isolation because considerable overlap occurs with invasive sinus aspergillosis and ethmoidal polyposis.
Professor Nicolas Taptas (1871–1955): A Pioneer of Post‐Laryngectomy Voice Rehabilitation
Authors: Lascaratos John G. , Trompoukis Constantinos , Segas John V. , Assimakopoulos Dimitrios A. 
Published: November 2003

AbstractObjective To report on the career of Professor Nicolas Taptas of Constantinople (1871–1955) and his contribution to the development of an artificial larynx.Study Design Historical review.Methods The unpublished documents of Taptas's family archives and one of his papers, describing his own original technique for voice rehabilitation after total laryngectomies, were studied.Results In his texts, Taptas described the application of external laryngeal prostheses in one of his patients who underwent total laryngectomy. Taptas meticulously recorded his own first successful attempt in a woman with cancer of the larynx. He was one of the first scientists who, at the end of the 19th century, devised an external laryngeal prosthesis, which had the advantage of rehabilitating a sufficiently strong whispering voice; by using a prototype valve, he avoided problems of aspiration of liquids and food to the bronchi.Conclusion Nicolas Taptas's contribution to the development of the artificial larynx was vital because he devised and applied one of the first external laryngeal artificial prostheses with satisfactory functional results.
Intraoperative Parathyroid Hormone Testing: What Have We Learned?
Authors: Proctor Matthew D. , Sofferman Robert A. 
Published: November 2003

AbstractObjectives/Hypothesis The development of rapid, sensitive assays for measuring the intact parathyroid hormone (iPTH) molecule has the potential to allow the surgeon to determine the success of parathyroid surgery intraoperatively. The purpose of the study was to review our results in the context of currently held beliefs regarding the ability of the intraoperative iPTH to predict resolution of hyperparathyroidism.Study Design Retrospective review.Methods The study series is a retrospective review of 107 consecutive parathyroidectomies performed by a single surgeon. Patients with primary, secondary, and tertiary hyperparathyroidism were included.Results The intraoperative assay allowed an overall success rate of 93.4% across all patient categories. The success rate in patients with primary hyperparathyroidism was 95.7%. Measuring the iPTH level at 10 versus 15 minutes after the removal of tissue did not significantly affect the predictive value of the test. A decrease of 50% in the iPTH level after the resection of hyperfunctioning tissue was prognostic of successful treatment of the hyperparathyroid state. By contrast, a postexcision iPTH level that was within the normal range was not always predictive of cure.Conclusions The intraoperative iPTH assay is particularly useful in the treatment of primary hyperparathyroidism. The assay eliminates the need for intraoperative frozen‐section analysis in most cases and allows the surgeon to perform limited resections with confidence. This is especially true in complicated parathyroid surgeries, such as revision surgeries or those requiring concomitant thyroid surgery. The assay is also useful in secondary hyperparathyroidism, although it appears that the inability to identify small nonfunctional or hypofunctional supernumerary parathyroid glands means that long‐term normocalcemia may not be assured.
State of Mastication Affects Quality of Life in Patients With Maxillary Sinus Cancer
Authors: Terada Nobuhisa , Numata Tsutomu , Kobayashi Noriko , Gorai Shigeki , Kobayashi Tadashi , Ono Ken‐ichi , Konno Akiyoshi 
Published: November 2003

AbstractObjectives/Hypothesis The quality of life of head and neck cancer patients after treatment is poor compared with a typical population sample. However, little is known about patients with maxillary sinus cancer. The identification of symptoms that are most troublesome for these patients and the development of strategies to minimize these negative sequelae should be matters of high priority.Study Design A restrospective study of patients with maxillary sinus cancer who underwent maxillary bone resection.Methods Thirty patients with maxillary sinus squamous cell carcinoma participated in the study. The relationships among the degree of masticatory ability, the extent of the surgically resected area, and quality of life after combined treatment of maxillary cancer were evaluated.Results Scores of all physical and mental factors as assessed by the Short Form–36 questionnaire decreased as the masticatory ability of patients worsened. In edentulous cases, the masticatory ability was higher in the reduced operation group than in the extensive operation group.Conclusion Maintaining adaptability to a denture is essential to preserve quality of life, particularly in patients with anodontia.
Voice, Speech, and Swallowing Outcomes in Laser‐Treated Laryngeal Cancer
Authors: Jepsen Matthew C. , Gurushanthaiah Deepak , Roy Nelson , Smith Marshall E. , Gray Steven D. , Davis R. Kim 
Published: November 2003

AbstractObjective To describe preliminary voice, speech, and swallowing outcomes in patients treated by endoscopic laser excision of laryngeal cancer with or without adjuvant radiation therapy.Study Design Retrospective review.Methods Seventeen surgically treated patients (five T2 glottic and 12 clinically staged T2 supraglottic squamous cell carcinomas) participated in the study. Self‐ratings of voice (Voice Handicap Index) and swallowing (M. D. Anderson Dysphagia Inventory) were completed, as well as independent auditory‐perceptual ratings of voice and speech recordings.Results Although no significant difference between Voice Handicap Index, M. D. Anderson Dysphagia Inventory, and listener ratings was identified based on tumor site and irradiation status, there was a trend toward poorer outcomes in patients who received adjuvant radiation therapy. Whereas the patients having supraglottic cancer tended to report better voice but poorer swallowing outcomes, the glottic cancer group displayed the opposite pattern. Severity on Voice Handicap Index correlated significantly with listener severity ratings of speech, suggesting that the patients' perception of their voice handicap was similar to the listeners' judgments of their speech severity.Conclusions The results suggest the following trends: 1) Adjuvant radiation therapy was associated with poorer outcomes for voice, speech, and swallowing and may be associated with more impairment than surgery alone and 2) poorer outcomes on voice and swallowing were observed for the glottic and supraglottic cancer groups, respectively. To bolster these preliminary findings, additional outcomes studies in patients treated with conservation therapy are needed.
Adenocarcinoma Ex‐Pleomorphic Adenoma of the Lacrimal Sac and Nasolacrimal Duct: A Case Report
Authors: Baredes Soly , Ludwin Danielle B. , Troublefield Yolanda L. , Langer Paul D. , Mirani Neena 
Published: November 2003

AbstractObjectives To present the clinical presentation, workup, surgical approach, and pathological findings of the first case report of a patient with adenocarcinoma ex‐pleomorphic adenoma of the lacrimal sac and nasolacrimal duct.Study Design Retrospective review of the records of a case of adenocarcinoma ex‐pleomorphic adenoma of the lacrimal sac and nasolacrimal duct.Methods The clinical presentation, workup, surgical approach, and pathological findings were reviewed.Results A 51‐year‐old man presented with a 10‐year history of recurrent epiphora of the right eye. At dacryocystorhinostomy a small lesion was visualized within the lumen of the lacrimal sac. A biopsy specimen was consistent with adenocarcinoma. En bloc resection was accomplished using a lateral rhinotomy and medial maxillectomy. The final specimen showed adenocarcinoma ex‐pleomorphic adenoma. The patient was given postoperative radiation therapy. He was free of disease 16 months after treatment.Conclusions Lacrimal sac tumors should be considered in the differential diagnosis of chronic epiphora. Management of nasolacrimal adenocarcinoma requires complete surgical resection. Radiation treatment in and of itself is not curative but may be useful as adjuvant therapy. Carcinoma ex‐pleomorphic adenoma can develop in the lacrimal sac and nasolacrimal duct.
Postural Cephalometric Analysis and Nasal Resistance in Sleep‐Disordered Breathing
Authors: Virkkula Paula , Hurmerinta Kirsti , Löytönen Markku , Salmi Tapani , Malmberg Henrik , Maasilta Paula 
Published: November 2003

AbstractObjectives The study was designed to compare upright and supine cephalometric measurements in snorers and to evaluate the effects of mandibular position and nasal resistance on pharyngeal dimensions. Anthropometric, rhinomanometric, and cephalometric measurements were used to investigate predictors of apnea‐hypopnea index.Study Design Prospective, cross‐sectional.Methods Forty consecutive habitually snoring men waiting for nasal surgery (mean age, 44 y; mean body mass index, 28 kg/m2) underwent an overnight polysomnographic, anterior rhinomanometric, and cephalometric analysis in upright and supine positions.Results Nasal resistance correlated positively with minimal pharyngeal airspace at the level of tongue. The opening of jaws after voluntary relaxation of the mandibular position on lying down correlated with decrease in pharyngeal airway measurements at both velopharyngeal and tongue‐base levels. In stepwise multiple regression analysis the overall patient model explained 68% of the variation in apnea‐hypopnea index with body mass index as the largest predictor. In the nonobese patients, the model explained 86% of variation in apnea‐hypopnea index with change in anteroposterior position of the lower jaw in upright and supine measurements and combined nasal resistance after mucosal decongestion as independent determinants. In selected skeletal subtypes the models predicted 83%, 79%, 61%, and 90% of the variation in apnea‐hypopnea index.Conclusions In the nonobese patients nasal resistance and change in mandibular position on lying down were found to be independent contributing factors to the apnea‐hypopnea index. Further research on supine cephalometry and relaxed mandibular position may improve prediction of sleep‐disordered breathing in snorers.
Intrapharyngeal Distribution of Gastric Acid Refluxate
Authors: Shaker Reza , Bardan Eytan , Gu Chengming , Kern Mark , Torrico Laura , Toohill Robert 
Published: November 2003

AbstractObjectives/Hypothesis Determination of intrapharyngeal distribution of gastric acid refluxate is needed to better understand the pathogenesis of reflux‐attributed aerodigestive tract disorders. The aims of the study were to determine intrapharyngeal distribution of gastric acid refluxate and to determine whether this distribution can better differentiate patients from control subjects compared with data obtained from a single hypopharyngeal site.Methods We prospectively studied 10 healthy volunteers, 12 patients with reflux laryngitis, and 15 patients with vasomotor rhinitis using a concurrent dual pharyngeal/dual esophageal pH recording technique. We determined the hypopharyngeal and oropharyngeal pH profile, including number, duration, and distribution of reflux events irrespective of and in correlation with intraesophageal pH profile using four different pH thresholds.Results Few drops in pharyngeal pH were found to be true reflux events based on their correlation with esophageal pH events. For the pharyngeal pH threshold criterion of a drop to 4.0 or less, 6 of 12 patients with reflux laryngitis, 5 of 15 patients with vasomotor rhinitis, and 2 of 10 normal control subjects exhibited a total of 25 (range, 1–5) distal pharyngeal acid reflux events. Overall, 34% of these events reached the oropharyngeal pH recording site. Between‐group comparison for all levels of pH threshold criteria did not show any significant difference of reflux parameters in the hypopharyngeal or in the oropharyngeal sites among the studied groups.Conclusions Reflux of gastric acid into the pharynx may extend to the region of the oropharynx in both patients and control subjects. Overall distribution of acid refluxate to the oropharynx is low but as groups is similar between healthy individuals and patients with reflux laryngitis and those with vasomotor rhinitis. Parameters of oropharyngeal acid reflux such as number and duration do not differentiate patients from control subjects.