bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post‐Tonsillectomy Bleeding: A Meta‐Analysis
Authors: Krishna Priya , Lee Dennis 
Published: November 2003

AbstractObjective/Hypothesis To reconcile conflicting reports and opinions of the value of preoperative coagulation studies for patients undergoing tonsillectomy.Study Design Meta‐analysis: Articles were identified by MEDLINE search, references from review articles, textbook chapter, and retrieved reports. Independent observers selected prospective trials of patients undergoing tonsillectomy or adenoidectomy and tonsillectomy. Retrospective studies meeting other inclusion and exclusion criteria were included for sensitivity analyses of results.Methods Data were abstracted from studies for an end point of bleeding with normal and abnormal coagulation tests. Four prospective studies met all inclusion and exclusion criteria. These four studies were used in the data synthesis. An additional eight retrospective studies met all other criteria and were used in the sensitivity analysis.Results Pooled analysis of 3384 patients revealed a rate of 3.3% (95% confidence interval [CI], 2.5%–4.1%) for post‐tonsillectomy bleeding in patients with normal coagulation studies. A rate of 8.7% (95% CI, 1.5%–15.9%) was obtained for bleeding in patients with abnormal coagulation studies. No significant rate difference in post‐tonsillectomy bleeding was demonstrated.Conclusion There is no difference in the rate of post‐tonsillectomy bleeding in patients with abnormal coagulation studies as compared with patients with normal coagulation studies obtained preoperatively.
Complementary and Alternative Medicine in Otolaryngology
Authors: Asher Benjamin F. , Seidman Michael , Snyderman Carl 
Published: November 2003

AbstractThe widespread interest in and use of complementary and alternative medicine (CAM) by patients in the United States has been established by multiple surveys. One‐third of the U.S. population uses some form of CAM, and an estimated 23 billion dollars is spent annually on these therapies. Because of prevalent usage of CAM among patients, it is important that physicians have some knowledge of this subject. With this purpose in mind, this report reviews the current research on CAM as it relates to common disorders of the head and neck: rhinitis, sinusitis, tinnitus, vertigo, and head and neck oncology.
Tonsillectomy With Argon Plasma Coagulation (APC): Evaluation of Pain and Hemorrhage
Authors: Bergler Wolfgang , Huber Kerstin , Hammerschmitt Nicolas , Hörmann Karl 
Published: November 2003

AbstractObjective Argon plasma coagulation (APC) offers a new possibility for tonsillectomy (TE) because of its effective hemostasis and limited penetration depth of the coagulation zone. The APC dissector allows dissection and hemostasis in a one‐step procedure. The aim of this prospective, randomized, single‐blinded study was the evaluation of pain and hemorrhage of the “hot” argon‐plasma‐coagulation tonsillectomy (TEAPC) compared with a conventional “cold” non‐electrosurgery tonsillectomy (TEConv).Methods Two hundred one consecutive patients undergoing tonsillectomy were included in a single‐blinded, randomized, prospective study with stratification in two age groups.Results There was no statistical significant difference between TEAPC and TEConv in the intensity of postoperative pain and primary or secondary hemorrhage in both age groups. In the TEAPC group, the mean duration of tonsillectomy was significantly reduced by more than 50% in both age groups (P <.01). The blood loss was 90% decreased in the TEAPC compared with the TEConv in both age groups (P <.01).Conclusions The APC technique does not face the general problem of electrosurgery or thermal coagulation techniques in which the postoperative pain is often increased compared with conventional cold techniques. It offers an innovative new tonsillectomy method with significant reduced blood loss and surgical time.
Spectral Karyotyping Analysis of Head and Neck Squamous Cell Carcinoma
Authors: Singh Bhuvanesh , Gogineni Swarana , Goberdhan Andy , Sacks Peter , Shaha Ashok , Shah Jatin , Rao Pulivarti 
Published: November 2003

AbstractObjectives/Hypothesis The genetic content of head and neck squamous cell carcinomas is ill defined. Spectral karyotyping (SKY) is a new technique that allows the simultaneous detection of all chromosomal translocations by labeling each individual chromosome with different fluorescent agents. In the current study we used SKY to analyze cell lines and a primary tumor derived from head and neck squamous cell carcinomas (HNSCC) to delineate recurrent translocations and breakpoints.Study Design Spectral karyotyping analysis of head and neck cancer.Methods Two cell lines (MDA886 and MSK922) and one primary tumor in short‐term culture were subjected to metaphase growth arrest with colcemide in their exponential growth phase and fixed onto glass slides. Painting probes for each of the autosomes and the sex chromosomes were generated from flow‐sorted human chromosomes using sequence‐independent DNA amplification. The probes were labeled using a polymerase chain reaction–based reaction and hybridized to metaphase preparations for 2 days at 37°C. Biotinylated probes were detected using avidin Cy5 and digoxigenin‐labeled probes with an anti‐mouse digoxigenin antibody followed by goat anti‐mouse antibody conjugated to Cy5.5. Chromosomes were counterstained with 4,6‐diamino‐2‐phenyliodole (DAPI), and a minimum of five metaphases were captured and analyzed for each case. Breakpoints on the SKY‐painted chromosomes were determined by comparison of corresponding DAPI banding.Results Spectral karyotyping analysis revealed a complex pattern of chromosomal abnormalities. A total of 66 translocations were identified in the three cases, with one new recurrent translocation at (der(4)t(4;20)(q35;?)). Nine complex translocations, involving three or more chromosomes, were identified in these cases. Overall, 96 breakpoints were assigned to metaphase chromosomes and another 74 breakpoints could not be assigned. Breakpoints most commonly involved chromosomes in genetic rearrangements were 1, 3, 5, 8, 13, 16, and 17.Conclusions Spectral karyotyping analysis reveals the true complexity of chromosomal aberrations in cell lines derived from head and neck squamous cell carcinomas. The use of SKY, in combination with other techniques, may allow for a more complete assessment of the genetic abnormalities of head and neck cancers and serve as a starting point for gene identification.
Tetracaine Topical Anesthesia for Myringotomy
Authors: Hoffman Ronald A. , Li Chun‐Lun J. 
Published: November 2003

AbstractObjectives/Hypothesis To study the efficacy and safety of topical tetracaine anesthesia for office myringotomy and myringotomy with a tube.Study Design Retrospective review of patients undergoing office myringotomy, with or without tube insertion, performed over a 4‐year period.Methods A topical solution of 8% tetracaine base in 70% isopropyl alcohol was used in 381 ears. Five to 10 drops of the solution were applied to the tympanic membrane for 10 to 15 minutes and aspirated. Myringotomy was performed either with a myringotomy knife or with a CO2 laser (OtoLAM).Results Topical tetracaine was used in all 231 ears (100%) undergoing myringotomy without a tube and 150 of 212 ears (71%) undergoing myringotomy with a tube. Tetracaine alone was effective in providing tympanic membrane anesthesia in 95% of myringotomy without a tube (220 ears) and in 93% of myringotomy with a tube (139 ears). There were six complications, including five cases of severe vertigo and one unusual prolonged, transient facial nerve weakness.Conclusion Topical tetracaine is efficacious and safe for use in office myringotomy.
Cervicofacial Rhytidectomy After Head and Neck Tumor Removal
Authors: Lee Jonathan H. , Sherris David A. 
Published: November 2003

AbstractObjective To compare intraoperative and postoperative complication rates of cervicofacial rhytidectomy after head and neck tumor removal with complication rates of rhytidectomy in the normal patient population.Study Design Retrospective chart review and literature review.Methods A sample of 11 patients treated by a single surgeon (D.A.S.) at an academic referral center who met the inclusion criteria was reviewed for previous head and neck surgical history, medical history, and surgical results and subsequent complications of the facial esthetic procedure. These rates were compared with the complication rates for cervicofacial rhytidectomy in normal patients as quoted in the general medical literature.Results Patients ranged in age from 48 to 75 years (mean age, 58 y). Of the 11, no patient experienced a major complication of rhytidectomy, and two experienced a minor postoperative complication. Both patients had received postoperative radiation for the treatment of their previous tumor, and both noted a small (<1.5 cm) area of wound dehiscence before postoperative day 10, which required no revision and healed without sequelae. No other intraoperative or postoperative complications were found.Conclusion Cervicofacial rhytidectomy may be safely and effectively performed on postoperative patients with head and neck tumors without increased incidence of major complications when compared with patients without a surgical tumor history. The increased incidence of minor wound dehiscence experienced by 2 of the 3 patients who received postoperative radiation in this study may indicate that small areas of skin incision dehiscence are more likely in patients who have been radiated. Surgeons performing rhytidectomy on patients with head and neck tumors who were previously radiated should consider more meticulous subdermal closure to avoid such dehiscence. Patients should be informed of the slightly higher risk of dehiscence before surgery.
Parathyroid Cysts: A Case Report and Review of the Literature
Authors: Fortson James K. , Patel Vijaykumar G. , Henderson Vernon J. 
Published: November 2003

AbstractObjectives/Hypothesis Parathyroid cysts are rare clinical entities. They frequently present as a clinical diagnostic problem. They may mimic solitary thyroid nodules. The purpose of the study was to review the literature and present a case of a 22‐year‐old euthyroid woman presenting with recurrent swelling in the neck. Her complaints included choking and dysphagia. Fine‐needle aspiration of the mass revealed clear, watery fluid with an extremely high level of calcium and c‐terminal midmolecule parathyroid hormone assay in excess of 8000 pg/mL. Treatment consisted of neck exploration and removal of a 6 × 5‐cm cystic encapsulated mass. Pathological diagnosis revealed a benign parathyroid cyst. The role of needle aspiration in diagnosing thyroid masses and the importance of parathyroid hormone assay in diagnosing parathyroid cyst are emphasized.
Phonoscopy—A Valuable Tool for Otolaryngologists and Speech‐Language Pathologists in the Management of Dysphonic Patients
Authors: Leonard Rebecca , Kendall Katherine 
Published: November 2003

AbstractObjectives To describe the phonoscopic evaluation, present a rationale for its use, and demonstrate its use in identifying laryngeal and vocal pathology.Study Design Retrospective review.Methods One hundred consecutive cases of new patients referred to our voice clinic team were reviewed. Findings on laryngeal examination as reported by the referring otolaryngologist were compared with our findings on “phonoscopic” examination. The phonoscopic examination combines the traditional voice evaluation performed by speech‐language pathologists with endoscopy, which is relatively new to the voice clinician, to visualize the larynx during a broad sample of phonatory tasks. Patients with spasmodic dysphonia or tremor were excluded from the study.Results In 26 cases of the 100 reviewed, our observations were consistent with those of the referring otolaryngologist. In 32 cases, we agreed with the referral diagnosis, but found additional factor(s) related to pathology. In 42 cases, our findings differed from those of the referring physician.Conclusions Results support our contention that phonoscopic evaluation can be of value to both the otolaryngologist and speech‐language pathologist. It is particularly recommended in those patients whose dysphonia is unexplained following diagnostic laryngeal examination by the otolaryngologist, in cases in which voice use is a suspected factor in the pathology, and when voice therapy is a recommended treatment for a dysphonic patient.
Bilateral Lateral Rhinotomy Incisions for Medial Maxillectomies in the Management of Pediatric Invasive Fungal Sinusitis
Authors: Malhotra Pramit S. , Danahey Daniel , Sidman James 
Published: November 2003

AbstractObjective To determine if simultaneous, bilateral lateral rhinotomies for medial maxillectomies would result in central skin or bone loss in pediatric patients with invasive fungal disease.Study Design Retrospective chart review.Setting Tertiary care children's hospital.Patients Three children underwent surgery between April 1996 and June 1998. Ages at treatment ranged from 11 to 14 years. All had bilateral, biopsy‐proven invasive fungal disease of the lateral walls of the nose. All were undergoing chemotherapy for acute lymphocytic leukemia (ALL) or acute myelocytic leukemia (AML).Intervention Bilateral lateral rhinotomies for medial maxillectomy. Two of 3 also had simultaneous total septectomy.Main Outcome Measure Skin survival and patient survival.Results All three patients had bilateral simultaneous medial maxillectomy for invasive fungal disease in the presence of profound pancytopenia secondary to treatment of leukemia. One patient had minor nasal edema postoperatively, but none showed any loss of the central nasal skin or facial skeleton. All patients survived the invasive fungal disease with follow‐up of at least 24 months. All patients underwent multiple debridements after the original surgery, and 3 of 6 eyes had permanent epiphora requiring dacryocystorhinostomies.Conclusions Bilateral simultaneous lateral rhinotomies are safe in children and did not result in any central skin loss. Aggressive bilateral surgery for invasive fungal disease is compatible with a good esthetic outcome and long‐term survival.
Effects of Interferon‐α‐2b and Octreotide on Healing of Esophageal Corrosive Burns
Authors: Kaygusuz Įrfan , Çelįk Onur , Özkaya Özay , Yalçin Şinasi , Keleş Erol , Çetįnkaya Tufan 
Published: November 2003

AbstractObjective The aim of this study was to investigate the effect of interferon‐α to 2b and octreotide on the treatment of esophagus corrosive burns.Method The experimental study was performed on 63 rabbits. Burn was obtained by treating a segment, isolated in cervical esophagus, with NAOH. The rabbits were allocated into three groups (control, interferon, and octreotide). On the fourth, eighth, and 20th days, 7 rabbits randomly selected from each group were killed. Comparisons among the groups were made by taking histopathologic findings, stenosis index, and hydroxyproline production into consideration. Cross‐tabulation and analysis of variance tests were used for statistical analysis.Results There were no statistically significant differences among the groups in terms of epithelial changes, extension of inflammation, and severity of fibrosis. In terms of severity of inflammation, there was a statistically significant difference between the control and the other two groups. Also, a significant difference was found between the control group and the other two groups in terms of extension of fibrosis on the 20th day. The difference between the control and the two treatment groups was significant on the eighth day and the 20th day measurements. Comparison of the hydroxyproline values showed a statistically significant difference between the octreotide group and the other two groups on the eighth and 20th days.Conclusion Histopathologic and biochemical findings indicate that, by hindering fibrosis progress, octreotide (and interferon) might be new and promising alternatives in the treatment of corrosive burns of the esophagus.
Endoscopic Management of 108 Sinus Mucoceles
Authors: Har‐El Gady 
Published: November 2003

AbstractObjectives/Background Traditional teaching has emphasized the need for complete removal of sinus mucoceles to achieve a cure. However, with the introduction of endoscopic sinus surgical instruments and techniques, there has been a trend toward transnasal endoscopic management of sinus mucoceles. The aim of this study is to establish the efficacy of endoscopic management of sinus mucoceles.Study Design Retrospective review.Patients and Methods Between 1988 and 2000, 103 patients with 108 paranasal sinus mucoceles were treated endoscopically. This series includes 66 frontal and frontoethmoid, 17 ethmoid, 7 sphenoethmoid, 12 sphenoid, and 6 maxillary mucoceles. Ninety patients (83.3%) had intraorbital extension and 85 of them presented with some degree of proptosis or eye displacement. Sixty patients (55.5%) had erosion of the skull base with varying degrees of intracranial extension of the mucocele. Follow‐ up ranged from 1 to 131/2 years with a median of 4.6 years.Intervention All patients underwent endoscopic‐wide marsupialization of the mucocele cavity. Stents were used in frontal mucoceles only.Results Recurrence of a frontal mucocele was seen in 1 patient (0.9%). In 5 patients, out of 23 patients who presented with massive pansinus polyposis in addition to the mucocele, recurrent polyposis required revision surgery. However, the mucoceles did not recur in those patients.Conclusions There is increasing evidence in the literature that endoscopic management of sinus mucoceles results in long‐term control with recurrence rates at or close to 0%. Rhinologic surgeons should consider the endoscopic technique as the surgical treatment of choice.
Evaluation of Omeprazole in the Treatment of Reflux Laryngitis: A Prospective, Placebo‐Controlled, Randomized, Double‐Blind Study
Authors: Noordzij J. Pieter , Khidr Aliaa , Evans Brent A. , Desper Ellen , Mittal Ravinder K. , Reibel James F. , Levine Paul A. 
Published: November 2003

AbstractObjectives Proton‐pump inhibitors are often recommended in the treatment of laryngitis secondary to gastric reflux. Despite prospective treatment studies reporting high efficacy, only one previous report has been placebo‐controlled and blinded. The objective of this study was to determine the efficacy of omeprazole in treating proven reflux laryngitis.Study Design Prospective, placebo‐controlled, randomized, double‐blind clinical trial.Methods Fifty‐three patients with one or more reflux laryngitis symptoms were recruited to undergo 24‐hour dual‐channel pH probe testing. Thirty patients with more than four episodes of laryngopharyngeal reflux were enrolled. By random assignment, 15 patients received 40 mg omeprazole twice a day and the other 15 received placebo for a period of 2 months. Symptoms (hoarseness, throat pain, lump in throat sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn) and endoscopic laryngeal signs (erythema, edema, and mucus accumulation) were recorded initially, at 1 month, and 2 months.Results In general, most symptom scores improved over time for both the omeprazole and placebo groups. Hoarseness, when patients begin with low hoarseness symptom scores, and throat clearing improved significantly more in patients on omeprazole than in those on placebo during the 2‐month study. Throat pain, lump in throat sensation, excessive phlegm, difficulty swallowing, pain with swallowing, and heartburn showed improvement in both treatment arms, signifying the possibility of a placebo effect. Endoscopic laryngeal signs did not change significantly over the course of the study for either treatment group.Conclusions A placebo effect appears to exist in the treatment of reflux laryngitis. However, hoarseness, when initially scored low, and throat clearing resulting from reflux laryngitis are effectively treated by omeprazole.
A Cost–Benefit Analysis and Method of Creating High‐Quality Posters for a Low Cost
Authors: Karamzadeh Amir M. , Wong Brian J. F. , Crumley Roger L. 
Published: November 2003

AbstractObjective To introduce the results of a cost–benefit analysis comparing an office‐based low‐cost technique for producing research posters versus conventional methods.Study Design Cost–benefit analysis.Methods The average cost for manufacturing a 4′ × 6′ poster using university‐based and commercial reprographic centers (from 10 different institutions and cities) was determined through a phone survey. The total number of posters (1248) presented at the American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting from 1995 through 1999 was used to calculate and subsequently compare the total cost of generating posters using conventional versus our low‐cost method. A detailed description of this technique (low‐cost) is also offered.Results The total printing costs for this meeting using the commercial or university‐based services was $294,000 and $268,000 versus approximately $11,000 with our method. Esthetically, our technique is satisfactory and difficult to distinguish from standard methods from the typical poster‐viewing distance.Conclusions Given the current medical economic environment, the cost disparity between conventional and “low‐cost” poster production, the esthetic acceptability of both, and the relative (compared with oral presentations) lack of scientific impact, we propose that the present technique is an extremely pragmatic option for poster production.
The Intracranial Complications of Rhinosinusitis: Can They Be Prevented?
Authors: Jones N. S. , Walker J. L. , Bassi S. , Jones T. , Punt J. 
Published: November 2003

AbstractObjectives/Hypothesis Reference textbooks on the intracranial complications of rhinosinusitis imply that many of the intracranial complications of rhinosinusitis can be prevented. We sought to examine whether or not this is true.Study Design A retrospective case series.Methods The study included 47 consecutive patients presenting with intracranial complications secondary to rhinosinusitis between 1992 to 1999 with a mean follow‐up of 5 years and 1 month.Results The most common presenting symptoms of intracranial involvement were an altered mental state, headache, fever, seizure, vomiting, a unilateral weakness or hemiparesis, or a cranial nerve sign. These justify an urgent magnetic resonance imaging or computed tomography scan. The importance of imaging before a lumbar puncture cannot be overemphasized. Of particular note was the finding that 21 patients (45%) presented with a periorbital cellulitis or frontal swelling. Therefore, it does not follow that because a collection of pus presents anteriorly it precludes any intracranial involvement. More than half of our patients (55%) had visited their primary care physician with an upper respiratory tract infection and had been treated appropriately. Once any central symptoms or signs developed, there was little evidence of any significant delay in referral to our unit. Only six patients had a history of nasal disease, three having had recent sinus surgery and three having had nasal polyps. Nine patients had significant long‐term morbidity, seven patients had epilepsy, one patient had dysphasia, and one patient had right arm weakness. The single death in our series was associated with a cavernous sinus thrombosis.Conclusions The report emphasizes the need for surgeons to be alert to the diagnosis, particularly in patients with a periorbital abscess or frontal swelling. Sinus surgery has a role in obtaining pus for culture, as well as draining the sinus if it is in continuity with an intracranial collection. Intracranial infections secondary to rhinosinusitis occur sporadically and, although it appears that this cannot be prevented, early recognition and treatment are essential to reduce any subsequent morbidity or mortality.