bluuebunny/crossref_metadata_2025_split huggingface dataset:
Head and Neck Computed Tomography Virtual Endoscopy: Evaluation of a New Imaging Technique
Authors: Gallivan Ryan P. , Nguyen Thong H. , Armstrong William B. 
Published: November 2003

AbstractObjective: To evaluate a new radiographic imaging technique: computed tomography virtual endoscopy (CTVE) for head and neck tumors.Study Design: Twenty‐one patients presenting with head and neck masses who underwent axial computed tomography (CT) scan with contrast were evaluated by CTVE. Comparisons were made with video‐recorded images and operative records to evaluate the potential utility of this new imaging technique.Methods: Twenty‐one patients with aerodigestive head and neck tumors were evaluated by CTVE. One patient had a nasal cylindrical cell papilloma; the remainder, squamous cell carcinomas distributed throughout the upper aerodigestive tract. Patients underwent complete head and neck examination, flexible laryngoscopy, axial CT with contrast, CTVE, and in most cases, operative endoscopy. Available clinical and radiographic evaluations were compared and correlated to CTVE findings.Results: CTVE accurately demonstrated abnormalities caused by intraluminal tumor, but where there was apposition of normal tissue against tumor, inaccurate depictions of surface contour occurred. Contour resolution was limited, and mucosal irregularity could not be defined. There was very good overall correlation between virtual images, flexible laryngoscopic findings, rigid endoscopy, and operative evaluation in cases where oncological resections were performed. CTVE appears to be most accurate in evaluation of subglottic and nasopharyngeal anatomy in our series of patients.Conclusion: CTVE is a new radiographic technique that provides surface‐contour details. The technique is undergoing rapid technical evolution, and although the image quality is limited in situations where there is apposition of tissue folds, there are a number of potential applications for this new imaging technique.
Can Topical Mitomycin Prevent Laryngotracheal Stenosis?
Authors: Eliashar Ron , Eliachar Isaac , Esclamado Ramon , Gramlich Terry , Strome Marshal 
Published: November 2003

AbstractObjectives/Hypothesis:Early topical application of mitomycin to a laryngotracheal lesion may prevent or reduce laryngotracheal stenosis (LTS).Study Design:Prospective controlled animal study.Methods:LTS was induced in 60 dogs randomly assigned to four groups. Controls received an immediate topical application of normal saline. The suction‐control group received an immediate application of normal saline followed by suction of secretions on day 2. The mitomycin group received immediate application of 0.7 mL mitomycin (0.2 mg/mL). The repeat‐mitomycin group received an immediate application of mitomycin and a second application on day 2, after secretions were suctioned. The laryngeal lumens were measured endoscopically at baseline, day 12, and day 21. Animals were euthanatized if stenosis approximated 95% or at day 21.Results:All dogs in the mitomycin groups survived to day 21, compared with 12 in the suction group and only 2 controls. No side effects of mitomycin were observed. At day 21, surviving controls had 85% and 95% stenosis. In the mitomycin group, median stenosis was 27% (interquartile range, 29% to 42%); in the repeat‐mitomycin group, 30% (22% to 40%); and in the suction‐control group, 84.5% (72.5% to 93.5%). The mitomycin group differed significantly from controls on day 12 (median difference = 85%, 95% CI = 80%‐94%,P< .0001) and day 21 (difference = 63.9%, 95% CI = 58%‐85%,P= .031).Conclusion:A single topical application of mitomycin significantly reduces the severity of LTS in dogs. Reapplication after 2 days does not improve results. Prospective clinical studies are warranted to assess the efficacy in humans.
Surgical Management of Obstructive Sleep Apnea in Children With Cerebral Palsy
Authors: Magardino Thomas M. , Tom Lawrence W.C. 
Published: November 2003

AbstractObjectives: To evaluate the surgical management of obstructive sleep apnea in children with cerebral palsy.Study Design: Retrospective review of 27 children with cerebral palsy who underwent surgical treatment for obstructive sleep apnea.Methods: Charts were reviewed. Data gathered included primary complaint, coexisting illnesses, initial procedure performed, age at initial surgery, number of days the child was monitored postoperatively in the intensive care unit, notation of postoperative respiratory distress and management, and outcome.Results: Nineteen children underwent adenotonsillectomy for initial treatment of obstructive sleep apnea. Three of these children also had a uvulectomy. Six children had an adenoidectomy alone as their initial procedure. Neither uvulopalatopharyngoplasty nor tracheostomy was performed as an initial procedure. Mean follow‐up was 34 months. Seventy‐six percent of these children have not required any further surgery. Of the six children who have undergone further surgery, one has required a revision adenoidectomy, and another underwent a tonsillectomy and uvulectomy 2 months after the initial adenoidectomy. Four children ultimately required a tracheotomy.Conclusions: Eighty‐four percent of these children were successfully managed without a tracheotomy. We recommend tonsillectomy and/or adenoidectomy for initial surgical treatment of obstructive sleep apnea in children with cerebral palsy.
Diagnosis and Management of Intralabyrinthine Schwannomas
Authors: Green J. Douglas , McKenzie John D. 
Published: November 2003

AbstractObjectives/Hypothesis: Describe the symptoms, signs, radiographic findings, and treatment results for four patients with intralabyrinthine schwannoma beginning either primarily within the labyrinth or extending secondarily into the labyrinth from the internal auditory canal.Study Design: Retrospective review.Methods: Review of clinic records, operative records, imaging studies with follow‐up telephone interview, and when possible, repeat examination.Results: Four patients with intralabyrinthine schwannoma treated by the first author were identified. Episodic vertigo, indistinguishable from Meniere's disease, was present in all but one of the patients in this study. A progressive unilateral hearing loss was also found in all of the patients. Magnetic resonance imaging revealed tumor isolated to the vestibule in two patients with the cochlea primarily involved in the other two patients. Intracochlear tumor extending into the internal auditory canal had been missed on preoperative imaging in one patient and was found during a translabyrinthine vestibular nerve section. In another patient with an intracanalicular schwannoma, tumor extending into the basal turn of the cochlea was not removed during a translabyrinthine approach to the internal auditory canal. The tumor subsequently recurred, necessitating a transotic approach for removal. A transmastoid/translabyrinthine approach was used to successfully remove tumor in one patient. Another patient with good hearing and no vestibular symptoms at time of this writing is being followed with serial imaging studies. As expected, the three patients who underwent surgery have anacusis in the operated ear and are free of vertigo at follow‐up intervals of 12, 26, and 65 months.Conclusions: Intralabyrinthine schwannomas are rare tumors with optimal treatment being determined by the symptoms, tumor location, and hearing. Findings of an intralabyrinthine schwannoma on magnetic resonance imaging may be easily over‐looked and attributed to inflammatory changes.
A Review of Objective Methods of Evaluating Auditory Neural Pathways
Authors: Hood Linda J. 
Published: November 2003

AbstractObjectives: Review physiological methods of evaluating function of the auditory neural pathways in infants, children, and adults. Present two case studies to demonstrate the usefulness of physiological measures in assessing abnormalities of the auditory neural pathways.Study Design: Review of applications of physiological measures of auditory neural function.Methods: Review otoacoustic emissions, auditory evoked potentials, and efferent reflexes, and discuss their use in identifying disorders of the auditory neural pathways from the cochlea to the cortex.Results: Auditory disorders occur from peripheral to central areas of the neural system. Patients with disorders of the peripheral nerve and/or the input from the cochlear inner hair cells, such as the patients presently described as having auditory neuropathy, demonstrate abnormal efferent reflexes, including middle ear muscle reflexes and efferent suppression of otoacoustic emissions, as well as grossly abnormal brainstem evoked potentials. In contrast, patients with more central disorders can be differentiated by normal results on tests of the neural periphery and abnormal findings on cortical evoked potentials and other measures of central function.Conclusions: Physiological measures are sensitive, objective, and less variable in assessing neural disorders than traditional behavioral measures such as pure‐tone or speech audiometry.
Computer‐Aided Surgery in the Petrous Bone
Authors: Gunkel Andreas R. , Vogele Michael , Martin Arno , Bale Reto J. , Thumfart Walter F. , Freysinger Wolfgang 
Published: November 2003

AbstractObjectives: We demonstrate that computer‐assisted frameless stereotactic navigation with the ISG/ELEKTA Viewing Wand system in the petrous bone is routinely possible with sufficient application accuracy.Methods: High‐resolution computed tomography imaging is done with a dedicated structure attached to the mouthpiece of the Vogele‐Bale‐Hohner (VBH) head holder, an integral part of our intraoperative patient fixation. The patient image registration can be reliably performed before surgery in an unsterile environment with the registration structure of the mouthpiece. For intraoperative navigation either the position‐sensitive articulated arm or the optical three‐dimensional digitizer of the ISG/ELEKTA system is used.Results: In the operations of the petrous bone performed so far, i.e., mastoidectomy, cholesteatoma surgery, and lateral skull base revision surgery, the clinical value of three‐dimensional navigation was clearly demonstrated with an application accuracy, constant throughout surgery, mostly limited only by the resolution of the computed tomography.
Ototoxic Impact of Cisplatin in Pediatric Oncology Patients
Authors: Berg Abbey L. , Spitzer Jaclyn B. , Garvin James H. 
Published: November 2003

AbstractObjective: To describe hearing changes in a group of 28 children (age range, 8‐180 mo) undergoing protocol‐based cisplatin therapy.Methods: Conventional, play audiometry, visual reinforcement audiometry (VRA), immittance audiometry, transient click evoked otoacoustic emissions (OAEs), and auditory brainstem response (ABR) evoked potentials were used to assess peripheral sensitivity and for threshold determination.Results: Bilateral symmetrical high‐frequency sensorineural hearing loss was noted in 9 of the 28 children (26%). Hearing loss was evident as early as 1 month after chemotherapy and as late as 50 months and was not dependent on individual or cumulative dosage of cisplatin.Conclusions: 1) Presence of sensorineural hearing loss was independent of individual and/or cumulative dosage of cisplatin; 2) audiologic assessment should be incorporated into a child's periodic medical evaluations after chemotherapy treatment, as onset of sensorineural hearing loss cannot be predicted; 3) personal hearing aids may be indicated for those children with hearing loss affecting the low‐ to mid‐frequencies; a personal assistive listening device (frequency modulated system) may be more appropriate for losses above 3000 Hz; and 4) evaluation and intervention by a speech‐language pathologist may be indicated to address possible articulation or language development problems consequent to hearing loss.
Endotoxin and Tumor Necrosis Factor‐α in Middle Ear Effusions in Relation to Upper Airway Infection
Authors: Nell Marja J. , Grote Jan J. 
Published: November 2003

AbstractObjectives/Hypothesis: This study was performed to elucidate the role of endotoxin and tumor necrosis factor‐α (TNF‐α) in the middle ear effusions (MEEs) of children with otitis media with effusion (OME) in relation to the chronicity of the disease and the presence of upper respiratory tract infection (URTI).Study Design: In a retrospective study 140 MEEs were collected from 101 children between 2 and 12 years of age, and evaluated for the cytokine TNF‐α and the lipopolysaccharide endotoxin. The amounts were quantified and correlated with the type of MEE, OME duration, and the presence of URTI.Methods: Endotoxin levels were measured using a limulus amebocyte lysate assay and TNF‐α levels were measured with an enzyme‐linked immunosorbent assay (ELISA). Means of the different variables were compared using the one‐way ANOVA least significance difference test with P < .05Results: In MEEs classified as mucopurulent (22.8%) both endotoxin and TNF‐α levels (11.9 ± 3 ng/mg total protein and 61.1 ± 21 pg/mg total protein, respectively) were significantly higher compared with serous‐ (23.6%) or mucoid‐ (53.6%) type effusions. Fifty‐five percent of the children who were classified as having chronic OME also had significantly higher amounts of endotoxin and TNF‐α. The majority of the children (61%) had no URTI, although children with URTI (36%) did also have significantly higher levels of endotoxin and TNF‐α in their middle ears.Conclusions: These results indicate that there is a strong correlation between the endotoxin and the TNF‐α concentration in the middle ear and the type of MEE, the presence of URTI, and the chronicity of the disease.
A Safe, Alternative Technique for Inferior Turbinate Reduction
Authors: Friedman Michael , Tanyeri Hasan , Lim Jessica , Landsberg Roy , Caldarelli David 
Published: November 2003

AbstractObjective: Submucous resection of the inferior turbinates is a conventional technique for reducing their size to achieve patent nasal airways in situations where an enlarged turbinate contributes to airway obstruction. Many techniques and complications have been described in the past. We describe a new inferior turbinate reduction technique performed with powered instrumentation and assess its success and complication rates.Study Design: A prospective study of 120 consecutive patients who underwent submucous resection of the inferior turbinates with a microdebrider.Methods: Patient questionnaires were used for subjective assessment of symptoms before and after the procedure. We graded each patient's inferior turbinates for size from I to III before and 6 weeks after surgery for objective analysis.Results: The common complications of standard submucous resection of inferior turbinates include excessive resection, postoperative bleeding, and crusting. The advantage of the microdebrider technique is the precise control of the amount of tissue and location of tissue that is removed on a submucosal plane. The complications encountered with this technique are limited to postoperative bleeding that occurred in 1.6% of patients. There was no crusting or excessive removal of tissue.Conclusion: The results show that submucous resection of inferior turbinates with a microdebrider is a safe method of achieving turbinate size reduction with minimal morbidity.
Videostrobokymography: A New Method for the Quantitative Analysis of Vocal Fold Vibration
Authors: Sung Myung‐Whun , Kim Kwang Hyun , Koh Tae‐Yong , Kwon Tae‐Young , Mo Ji‐Hun , Choi Seung‐Ho , Lee Jae Sung , Park Kwang Seok , Kim Eom Joon , Sung Mee Young 
Published: November 2003

AbstractObjectives: To develop a new analysis method for the quantitative assessment of vibration of the vocal folds, using conventional videostroboscopic image data.Methods: We used prerecorded videostroboscopic images to evaluate quantitatively the vibration of the vocal folds. Successive images were converted as digital images by means of an image‐grabbing board, processed for analysis, and reconstructed as kymograms by rearranging the same lines of all processed images along the time axis.Results: We developed a new technique for evaluating the vibration of the vocal folds. The vibrations of multiple vocal fold regions were easily and objectively evaluated by this technique. The objective parameters, such as open quotient and asymmetry index, could be obtained easily using this technique.Conclusions: Videostrobokymography demonstrated objectively the vibrations of several vocal fold regions at the same time. This technique has the potential to be a new tool to analyze and monitor the pathological changes and treatment results of vocal fold movement in a more refined quantitative fashion, using videostroboscopic images.
Clinical Predictors of Obstructive Sleep Apnea
Authors: Friedman Michael , Tanyeri Hasan , La Rosa Manuel , Landsberg Roy , Vaidyanathan Krishna , Pieri Sara , Caldarelli David 
Published: November 2003

AbstractObjective: To identify physical findings that can be standardized to predict the presence and the severity of obstructive sleep apnea (OSA).Study Design: One hundred seventy‐two patients who answered questionnaires with responses that suggested they might have OSA were included in this prospective study.Methods: All patients underwent a physical examination and polysomnography. The physical examination included the measurement of four parameters used by anesthesiologists to identify patients likely to have difficult intubation to determine if these same parameters predict OSA. We recorded modified Mallampati grade (MMP), tonsil size, and body mass index (BMI) and measured thyroid‐mental distance (TMD) and hyoid‐mental distance (HMD) in the study population.Results: When the physical findings were correlated singly with the respiratory disturbance index (RDI), we found that MMP (P < .001), tonsil size grading (P = .008), and BMI (P = .003) were reliable predictors of OSA. A greater correlation with OSA emerged when an “OSA score” was formulated by factoring the MMP, tonsil grade, and BMI grade (RDI = 7.816 × MMP + 3.988 × Tonsil Size + 4.675 × BMI − 7.544). A high score was not only predictive of OSA but also correlated well with OSA severity. Neither HMD nor TMD correlated with the severity of RDI.Conclusions: An OSA score may help identify those patients who should have a full sleep evaluation.
Advantages of a New Miniature Hearing Aid for Mild to Moderate Hearing Loss
Authors: Goode Richard L. , Krusemark Jodi 
Published: November 2003

AbstractObjectives/Hypothesis: To evaluate the performance of a new, miniature, behind‐the‐ear hearing aid designed for individuals with mild to moderate high‐frequency hearing loss who need an aid but are reluctant to try one. The aid is essentially invisible, leaves the ear canal open, and can be fit in less than 30 minutes without an ear impression. The cost is less than $500.Study Design: A 4‐week trial of the aid in 63 ears (62 subjects) with mild to moderate bilateral hearing loss.Methods: A questionnaire was completed at the end of the study by each subject asking them to evaluate several features of the aid (cosmesis, comfort, understanding speech, amplification, and so forth) and to compare their unaided performance in quiet and in noise with the test hearing aid. A rating scale of 1 to 10 was used, with 10 being excellent and 1 poor.Results: Subjective improvement in understanding speech in both quiet (5.8→7.3) and noise (4.6→5.9) occurred with the aid. Cosmesis, comfort, and appearance were highly rated (mean scores, > 8).Conclusions: This aid appears to have several features (comfort, cost, performance, and cosmesis) that make it ideal as a first aid for patients with mild to moderate losses.
Role of Aerating Mastoidectomy in Noncholesteatomatous Chronic Otitis Media
Authors: Ruhl Charles M. , Pensak Myles L. 
Published: November 2003

AbstractObjective: To assess the success rate of revision tympanoplasty with aerating mastoidectomy in patients with noncholesteatomatous chronic otitis media who had failed at least one prior tympanoplasty.Study Design: Retrospective chart review.Methods: Data were analyzed from 135 patients available for clinical and audiometric studies with a minimum of 18 months' follow‐up. All patients had failed at least one prior tympanoplasty and presented with: 1) a persistent tympanic membrane perforation with intermittent drainage, or 2) a wet draining ear, unresponsive to systemic antibiotic and topical management. All patients underwent 1.5‐mm, high‐density, bone window computed tomography (CT) scanning to assess middle ear, epitympanic, and mastoid air cell pneumatization. All patients underwent revision tympanoplasty with aerating mastoidectomy via a post‐auricular approach. Patient charts were reviewed for information regarding preoperative radiographic findings, mucosal and ossicular findings at the time of surgery, and success or failure of revision tympanomastoidectomy.Results: The tympanic membrane graft take rate for the entire group of 135 patients was 90.4% (13 grafts failed). A majority of the patients were found to have radiographic and intraoperative evidence of middle ear/mastoid disease.Conclusion: For patients with noncholesteatomatous chronic otitis media who have failed prior tympanoplastic reconstruction, an aerating mastoidectomy may be indicated and may improve the success rate of the surgery.
A Comparison of Asian and White Patients With Obstructive Sleep Apnea Syndrome
Authors: Li Kasey K. , Powell Nelson B. , Kushida Clete , Riley Robert W. , Adornato Bruce , Guilleminault Christian 
Published: November 2003

AbstractObjective: To evaluate the possible differences between Asian and white patients with obstructive sleep apnea syndrome.Methods: A retrospective review of Asian and white patients during a 12‐month period was conducted. Patients with respiratory disturbance index (RDI) ≥ 15 based on polysomnography were included in the study. Variables examined include age, sex, body mass index (BMI), RDI, lowest oxygen saturation (LSAT), and cephalometric analysis data.Results: Fifty‐eight Asian patients (53 men) and 293 white patients (260 men) were studied. The Asians were younger (44.1 ± 9.8 vs. 47.5 ± 11.6 y, P = .02), and the mean BMI (kg/m2) was 26.6 ± 3.7 in the Asians and 30.7 ± 5.9 in the whites (P < .001). The mean RDI was similar (56.6 ± 34.9 vs. 55.6 ± 26.9, P = NS), but the mean LSAT was lower in the whites (77.7 ± 9.9% vs. 70.0 ± 15.6%, P < .001). Based on the cephalometric data, the Asians have maxillomandibular protrusion, narrower cranial base angle, larger posterior airway space, and more superiorly positioned hyoid bone compared with the whites.Conclusions: Although male gender was found to be an important risk factor for obstructive sleep apnea syndrome in both Asian and white patients, obesity may be a less significant risk factor in the Asians because the majority of our Asian patients were nonobese. There was also variability in the craniomandibular factors that contributed to obstructive sleep apnea syndrome in the two groups.