bluuebunny/crossref_metadata_2025_split huggingface dataset:
A meta‐analysis of dexamethasone use with tonsillectomy
Authors: Goldman Andrew C. , Govindaraj Satish , Rosenfeld Richard M. 
Published: February 2003

OBJECTIVE:To determine the quantitative impact of intravenous dexamethasone on recovery after ton‐sillectomy using established principles for meta‐analysis.STUDY DESIGN/SETTING:Double‐blind randomized‐control trials in which subjects were treated identically except for the presence or absence of peri‐operative intravenous dexamethasone. Six articles met inclusion criteria. Two investigators extracted data regarding postoperative emesis and return to a soft/regular diet.RESULTS:Pooled analysis using a random effects model revealed a 27% decrease (P < 0.00001) in postoperative emesis attributable to dexamethasone (95% CI, 12% to 42%). Dexamethasone increased the tolerance of a soft/regular diet at 24 hours by 22% (P < 0.001), but studies were heterogenous with low precision (95% CI, 1% to 44%).CONCLUSION:To prevent emesis in 1 child after tonsillectomy, approximately 4 children must receive perioperative dexamethasone. An additional benefit is earlier tolerance of a soft/regular diet, but low precision and heterogeneity among studies preclude definitive conclusions.SIGNIFICANCE:Perioperative dexamethasone administration had a positive impact on recovery from tonsillectomy.
Management of Bilateral Vocal Fold Paralysis: Experience at the University of Athens
Authors: Segas John , Stavroulakis Pelagia , Manolopoulos Leonidas , Yiotakis John , Adamopoulos George 
Published: February 2003

The treatment of patients with vocal fold paralysis presents a challenge to the otolaryngologist‐head and neck surgeon. Many techniques have been proposed to manage individuals with unilateral or bilateral vocal fold paralysis. We herein describe the experience of our department in dealing with bilateral vocal fold paralysis. At the University of Athens, patients presenting with symptomatic bilateral paralysis are treated with a posterior cordectomy by using the CO2 or KTP‐532 laser. During the last 5 years, we have treated 20 patients (8 men and 12 women) presenting with symptomatic bilateral vocal fold paralysis. For augmentation of the glottic airway, a modification of Kashima's cordotomy was used, completing a partial posterior cordectomy of one or both true and false vocal folds with the CO2 laser (15 patients) and the KTP‐532 laser (5 patients). An elective tracheotomy was done before the cordotomy. Complications, such as infection, stridor, or dyspnea, were minimal. Although no objective voice analysis was performed, all patients were able to communicate without any phonation device and were satisfied with the result of the surgery. When compared with other techniques, the advantages offered by the posterior cordectomy included rapidity and simplicity in concept, reliability of outcome, short hospitalization, low risk of complications, and the possibility for revision when necessary (posterior cordectomy). From the successful postsurgical results of this study, it can be concluded that the posterior cordectomy is a reliable treatment option for the management of patients with bilateral vocal fold paralysis. (Otolaryngol Head Neck Surg 2001; 124:68–71.)
Efficacy of Evaluation of Audiometric Results After Stapes Surgery in Otosclerosis. I. The Effects of Using Different Audiologic Parameters and Criteria on Success Rates
Authors: De Bruijn Arthur J. G. , Tange Rinze A. , Dreschler Wouter A. 
Published: February 2003

The Committee on Hearing and Equilibrium of the American Academy of Otolaryngology‐Head and Neck Surgery proposed guidelines to provide more uniformity in reporting hearing results after middle ear surgery. One of the proposals was to include the hearing thresholds at 0.5, 1, 2, and 3 kHz in a 4‐frequency pure‐tone average (PTA) and to use postoperative bone‐conduction (BC) levels rather than preoperative BC levels in describing postoperative air‐bone gaps (ABGs). The hearing results of 451 stapes operations were evaluated to analyze to what extent the choice of different audiologic criteria affects success rates. It appeared that choice of PTA significantly affects postoperative gain in air‐conduction thresholds and ABG levels. If one takes the improvements in speech‐reception thresholds as the gold standard, the gain in air‐conduction correlates best with a gain in speech‐reception threshold if a higher frequency, such as 3 or 4 kHz, is included in a 4‐frequency PTA. Also, choice of preoperative or postoperative BC in computing postoperative ABGs had a significant effect on the mean postoperative ABG levels, showing more favorable results with the use of preoperative BC thresholds. (Otolaryngol Head Neck Surg 2001; 124:76–83.)
Allergy Testing and Immunotherapy in an Academic Otolaryngology Practice: A 20‐year Review
Authors: Lane Andrew P. , Pine Harold S. , Pillsbury Harold C. 
Published: February 2003

OBJECTIVEAllergic disease plays a central role in the clinical practice of otolaryngology. The purpose of this study was to review the 20‐year experience of an allergy clinic integrated within an otolaryngology practice at a major academic institution. STUDY DESIGN: We performed a retrospective database review of over 3300 otolaryngology patients referred for allergy skin testing between 1979 and 1999.RESULTSApproximately 80% of patients referred for allergy testing in our clinic had positive test results, of which 75.7% went on to undergo desensitization. The most common allergen was house dust, with allergies to mites, ragweed, and grass also prevalent. Among current allergy immunotherapy patients, 30.8% have undergone nasal septal, turbinate, and/or endoscopic sinus procedures in addition to allergy management. Nasal obstruction was the symptom most frequently persistent despite immunotherapy and the one most frequently reported to be improved by surgery.CONCLUSIONSThe otolaryngologist‐head and neck surgeon is uniquely qualified to perform comprehensive medical and surgical management for patients with complex disease processes involving a component of allergy. We believe that an integrated approach to allergy within an otolaryngology practice optimizes the treatment of such patients. (Otolaryngol Head Neck Surg 2001;124:9‐15.)
Academic Otolaryngology in the New Millennium: Are We Falling Behind?
Authors: Bhattacharyya Neil , Shapiro Nina L. 
Published: February 2003

OBJECTIVETo determine if differences in publication rates have evolved over the past 3 decades for academic otolaryngologists.METHODSThree random samples with 50 academic otolaryngologists each were studied. These otolaryngologists completed training in 1 of the 3 time periods (1970‐74, 1980‐84, 1990‐94) studied. Articles published within the first 5 years after graduation were tabulated and statistically analyzed.RESULTSAcademic otolaryngologists graduating in the 1970s, 1980s, and 1990s averaged 8.7, 8.9, and 6.4 publications during their first 5 years of academic practice, respectively. The first 2 cohorts averaged 5.4 and 5.7 publications in the 4 major otolaryngology journals, versus 3.3 for 1990s graduates. Basic science publications increased for 1990s graduates over those of the 1970s and 1980s graduates. The percentage of first author articles remained stable. Despite these trends, only the drop in case reports was statistically significant (P = 0.023, ANOVA).CONCLUSIONTrends may be developing that predict decreasing publication rates for newly trained otolaryngologists entering academic practice. (Otolaryngol Head Neck Surg 2001;124:4‐8.)
Outcomes of Acid Suppressive Therapy in Patients with Posterior Laryngitis
Authors: Ulualp Seckin O. , Toohill Robert J. , Shaker Reza 
Published: February 2003

OBJECTIVETo evaluate the results of acid suppressive therapy (AST) in posterior laryngitis (PL) patients with and without documented pharyngeal acid reflux (PAR).METHODSThe charts of all patients with PL who received AST and who had undergone pharyngeal pH monitoring were reviewed. Results of AST in patients with PL with and without documented PAR were evaluated by laryngeal examination, symptom scores, and self‐reported overall benefit.RESULTSThirty‐nine patients with PL had received AST and undergone pharyngeal pH monitoring. Follow‐up ranged from 2 to 27 months. Laryngeal findings were improved in patients with and without PAR. Pretreatment total symptom scores were significantly greater than that of posttreatment in patients with and without documented PAR. Overall benefit from AST was reported by the majority of PL patients with and without documented PAR.CONCLUSIONThese findings support the use of AST to reduce or eliminate signs and symptoms in PL regardless of documentation of PAR. (Otolaryngol Head Neck Surg 2001;124:16‐22.)
Management of Cancer of the Supraglottis
Authors: Scola Bartolomé , FernÁNdez‐Vega Manuel , MartÍNez Tomás , FernÁNdez‐Vega Susana , Ramirez Carlos 
Published: February 2003

We present the results of a retrospective study of 903 patients treated with conservation surgery for carcinoma of the supraglottic larynx so we can evaluate our management of supraglottic cancer with different types of surgery. In 301 patients, an extended supraglottic laryngectomy was performed. The recent selective use of transoral laser resection appears to be a rational approach. The 5‐year uncorrected survival was 84%, 81%, 76%, and 55% for stages I, II, III, and IV, respectively. The most common site for local‐regional failure was the cervical lymphatics. The percentage of occult disease in the N0 neck was 21% and epilaryngeal supraglottic location, locally advanced and GIII tumors have a higher frequency of lymph node involvement. There were no differences between comprehensive and anterolateral elective neck dissections. A bilateral elective neck dissection is recommended. In histologically positive neck disease, the survival rates were better with postoperative radiotherapy only in cases of extracapsular spread.
Laser‐Assisted Uvulopalatoplasty: Short‐Term and Long‐Term Results
Authors: Neruntarat Chairat 
Published: February 2003

OBJECTIVESnoring causes many problems for both snorers and family members. Significant improvement has been reported in subjective measures of snoring after laser‐assisted uvulopalatoplasty (LAUP). However, there were few studies of the long‐term results of LAUP from a large number of patients. The purpose of this study was to compare the short‐term versus long‐term results in patients undergoing this procedure.METHODSLAUP has been performed on 340 snorers. The majority of the patients were male with simple snoring by history and confirmed by polysomnographic study. Data on patients were compared from preoperative to the short‐term (6 months) and longterm (more than 3 years) postoperative assessment points. Statistic analysis was performed to assess the significance of differences between groups.RESULTSSignificant improvement was observed in snoring scale at 6 months and long‐term. The mean follow‐up was 40.5 months with a range of 36 to 50 months. There were significant differences between short‐term and long‐term results (P < 0.05). The change in body mass index was significantly different in the patients with and without recurrence (1.9 vs 0.5 kg/m2, P < 0.01). Two hundred fifty‐five (75%) patients had long‐term clinical success, and 34 (12%) patients with short‐term success failed long‐term.CONCLUSIONLAUP in the treatment of simple snoring results in long‐term success. However, patients are at risk of recurrence if they gain weight. (Otolaryngol Head Neck Surg 2001;124:90‐3.)
Tongue Lesions in the Pediatric Population
Authors: Horn Corinne , Thaker Harshwardhan M. , Tampakopoulou Dimitra A. , Serres Lianne M. De , Keller Jeffrey L. , Haddad Joseph 
Published: February 2003

OBJECTIVETo describe the spectrum of pediatric tongue lesions treated surgically at Columbia‐Presbyterian Medical Center from January 1990 to December 1999.STUDY DESIGN AND SETTINGRetrospective case‐series at the pediatric hospital of a tertiary care, academic medical center.RESULTSSeventeen patients were identified. Their ages ranged from 1 to 132 months (median, 7 months). Eight lesions were located anteriorly: mucous cyst (1), polyp (1), chronic inflammatory mass (1), hamartoma (1), squamous papilloma (2), cavernous hemangioma (1), and vascular malformation (1). Four lesions were located posteriorly: teratoma (1), glial choristoma (1), osseous choristoma (1), and benign epithelial cyst (1). Finally, there were 5 diffuse lesions including macroglossia (4) and massively infiltrating congenital lymphatic malformation (1). Symptoms included respiratory distress (3) and dysarthria (3); all other children were asymptomatic.CONCLUSIONSThis series revealed an interesting spectrum of rare solid tumors; compared with other large series, fewer lymphatic and vascular malformations were seen. Presenting symptoms, differential diagnosis, and surgical approach were differentiated according to lesion location.
Facial Translocation Approach to the Skull Base: The Viability of Translocated Facial Bone Graft
Authors: Hao Sheng‐Po 
Published: February 2003

OBJECTIVESA retrospective review of 56 patients who were operated through a facial translocation approach was carried out to assess the viability of the translocated facial bone segment.METHODSEleven patients had preoperative radiotherapy, and 26 had postoperative radiotherapy. In 14 patients the translocated bone segment was kept attached to the anterior cheek, and in 42 patients the bone segment was detached and then implanted. A vascularized flap was used to obliterate the defect in the paranasal sinuses in 15 patients.RESULTSTwelve (21.4%) patients had devitalized bone segment and required sequestrectomy. The incidence of devitalized bone segment was higher in the patients who received postoperative radiotherapy (P = 0.04) and lower in the patients in whom the defect in the paranasal sinuses was reconstructed with a vascularized flap (P = 0.006).CONCLUSIONSThe translocated facial bone segment should be kept attached to the cheek soft tissue when possible, or the defect in the paranasal sinuses should be reconstructed with a vascularized flap.
Transmastoid Decompression As a Treatment of Bell Palsy
Authors: Yanagihara Naoaki , Hato Naohito , Murakami Shingo , Honda Nobumitsu 
Published: February 2003

OBJECTIVEWe sought to assess the efficacy of transmastoid decompression after steroid treatment.STUDY DESIGNOne hundred one adults with Bell palsy having denervation exceeding 95% after steroid treatment were divided into 2 groups. In 58 patients decompression from the labyrinthine segment to the stylomastoid foramen was performed, and the remaining 43 patients were only followed up. Using the Yanagihara score and House Brackmann grading system, the recovery from the palsy was assessed.RESULTSThere was a statistically significant difference in the final facial score of the 2 groups. Within 60 days after the onset, the chance of better recovery from the palsy was higher in the patients with decompression.CONCLUSIONIn the era of steroid treatment, we cannot discard the transmastoid decompression of the facial nerve in the treatment of severe Bell palsy with profound denervation, although further effort is needed to obtain definitive evidence to show the benefit of the operation.
Auricular Pseudocysts: A Treatment with the Chulalongkorn University Vacuum Device
Authors: Supiyaphun Pakpoom , Decha Wittaya , Kerekhanjanarong Virachai , Hirunwiwatkul Prakobkiat 
Published: February 2003

Auricular pseudocysts are rare lesions that present as an asymptomatic cystic swelling of the anterior surface of the auricle, particularly the antihelix. Typically, the pseudocysts contain viscous straw‐yellow fluid similar in appearance to olive oil; however, a clear pale yellow serous transudate may also be encountered. Various therapeutic approaches have been used with variable success. We describe a simple small vacuum device called the Chulalongkorn University vacuum device, which was developed in our center. The device can be easily made anywhere by any surgeon. We report the outcome in 17 patients treated by means of needle aspiration plus application of the Chulalongkorn University vacuum device for 5 days. A complete resolution of the lesion was obtained in 15 (88.2%) patients. Because the procedure is safe and effective and does not require an operating room setting, it may be accepted as an option in the treatment of auricular pseudocysts.
Intracranial Metastases in Patients with Squamous Cell Carcinoma of the Head and Neck
Authors: Bree Remco De , Mehta Dinesh M. , Snow Gordon B. , Quak Jasper J. 
Published: February 2003

BACKGROUNDIntracranial metastases are rarely clinically diagnosed in patients with head and neck squamous cell carcinoma. Only 7 patients with metastases to the cavernous sinus from head and neck squamous cell carcinomas have been reported.METHODSA retrospective study revealed 13 patients with intracranial metastases of head and neck squamous cell carcinoma. In a 53‐year‐old woman a cavernous sinus metastasis of a laryngeal carcinoma was histologically diagnosed by using a CT‐guided surgical navigation system and was treated with stereotactic radiotherapy.RESULTSThe mean survival was 4.3 months. Predictive factors for longer survival were absence of extracranial disease, age younger than 60 years, and treatment with radiotherapy.CONCLUSIONSThe prognosis for patients with intracranial disease is poor. The current development of computer‐assisted stereotactic navigation and stereotactic radiotherapy may facilitate surgical diagnostic exploration and improve treatment, especially in patients without extracranial disease.
Relationship between the Size of Neopharynx after Laryngectomy and Long‐Term Swallowing Function: An Assessment by Scintigraphy
Authors: Hui Yau , Ma Kwok‐Man , Wei William I. , Ho Wai‐Kuen , Yuen Po‐Wing , Lam Lai‐Kun , Chow Chun‐Man 
Published: February 2003

OBJECTIVESTo study the relationship between the size of neopharynx after total laryngectomy and long‐term swallowing function by means of scintigraphy.STUDY DESIGNThe width of pharyngeal remnant was measured during surgery in 11 patients. Their swallowing function was assessed by scintigraphy 8 to 10 years after surgery.METHODSThe width of pharyngeal remnant at its narrowest point in both relaxed and stretched state was measured during surgery. Postoperative scintigraphy data on swallowing were obtained and computed along 3 lines, (1) transit time through neopharynx, (2) percentage of bolus transferred, and (3) swallowing efficiency. The relationship between the 2 sets of data was analyzed by linear regression analysis.RESULTS(1) No statistically significant relationship was found between the size of neopharynx and swallowing function. (2) All patients are clinically asymptomatic.CONCLUSIONSThe swallowing function is not affected by the size of the neopharynx in 11 patients with pharyngeal remnant width ranging from 3 to 8 cm (stretched).
Adductor Muscle Activity Abnormalities in Abductor Spasmodic Dysphonia
Authors: Cyrus Carlos B. , Bielamowicz Steven , Evans Frank J. , Ludlow Christy L. 
Published: February 2003

OBJECTIVETo determine laryngeal muscle activation abnormalities associated with speech symptoms in abductor spasmodic dysphonia (ABSD).STUDY DESIGNBilateral laryngeal muscle recordings from the posterior cricoarytenoid, thyroarytenoid, and cricothyroid muscles were conducted in 12 ABSD patients. Patients' measures were compared during speech breaks and during speech without breaks and with 10 normal controls.RESULTSSignificant group differences were found in the thyroarytenoid muscle; the patients had significantly greater activity on the right side both during speech breaks and nonbreaks in comparison with the controls. Cricothyroid muscle levels were also increased on the right in the patients.CONCLUSIONAn asymmetry in adductor muscle tone between the 2 sides in ABSD may account for difficulties with maintaining phonation and voice onset after volceless consonants.SIGNIFICANCEThese abnormalities may indicate why PCA BOTOX Injections have not been as effective in ABSD as thyroarytenoid injections have been in adductor spasmodic dysphonia. (Otolaryngol Head Neck Surg 2001;124:23‐30)
Characteristics of Bony Erosion in Allergic Fungal Rhinosinusitis
Authors: Nussenbaum Brian , Marple Bradley F. , Schwade Nathan D. 
Published: February 2003

OBJECTIVESErosion of bone with or without extension of disease into adjacent anatomic spaces is observed among some patients with allergic fungal rhinosinusitis (AFRS). The objective of this report is to further define these findings as they relate to this disease.STUDY DESIGNRetrospective chart review of 142 patients with AFRS diagnosed using the Bent‐Kuhn criteria. All patients were treated at a single institution.RESULTSApproximately 20% of patients with AFRS demonstrated bone erosion on CT scan. The ethmoid sinus was the most commonly eroded site. The orbit and anterior cranial fossa were the most common adjacent anatomic spaces to exhibit disease extension. Sinus expansion, not the specific organism identified, was associated with the presence of bone erosion. Surgical management with endoscopic techniques was successful for all patients without any major perioperative complications.CONCLUSIONBone erosion can be related to AFR. Recognition of this possibility is important because bone erosion can be interpreted as an indication of invasive pathosis. In the presence of bone erosion or disease extension, endoscopic techniques can be used to surgically manage this disease.
Effect of Interleukin‐2 and Selenium on the Growth of Squamous Cell Carcinoma Cells
Authors: Thikkurissy Sarath , Pavone Anthony , Rega Anthony , Bae Richard , Roy Martin , Wishe Harvey I. , Kiremidjian‐Schumacher Lidia 
Published: February 2003

OBJECTIVESThe objectives of this study were to determine whether the expression of the interleukin‐2 (IL‐2) receptors on squamous cell carcinoma cells can be enhanced in the presence of selenium (Se) and contribute to a greater retardation of tumor growth after locoregional therapy with IL‐2.STUDY DESIGNThe growth of the cells was studied after in vitro or dietary supplementation with Se in a murine model.RESULTSTreatment of established tumors in hosts supplemented with Se with peritumoral injections of IL‐2 resulted in 50% reduction of tumor size, whereas treatment of early tumors resulted in 72.4% reduction. The effect was most likely related to a combination of enhanced immune responsiveness and enhanced IL‐2 receptor expression on the tumor cells.CONCLUSIONS AND SIGNIFICANCEThe data suggested that local immunotherapy with IL‐2 in hosts supplemented with Se may represent an effective modality of treatment for the prevention of recurrences at the site of conventionally treated primary tumors, including tumors that do not express IL‐2 receptors.