bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Resorbable Plates in Head and Neck Reconstruction
Authors: Bhanot Sumeet , Alex James C. , Lowlicht Roger A. , Ross Douglas A. , Sasaki Clarence T. 
Published: November 2003

AbstractObjective/Hypothesis The advent of malleable macroporous resorbable plates has allowed the surgeon a greater range of reconstructive options and has decreased the morbidity of conventional plating procedures. Completely malleable after warming to 55°C, resorbable plates can readily conform to most morphologic appearances of fractures or defects and provide rigid fixation when cooled. The plating systems used in head and neck reconstruction are described.Study Design Nine patients were selected for reconstruction using a resorbable plating system. The resorbable system was tested under a variety of clinical situations including frontal sinus fractures (three patients), midface fractures (two patients), mandibular defects (two patients), and laryngeal fractures (two patients).Methods Each case was evaluated for rigidity of fixation, and ease of plate contouring and application. Furthermore, the postoperative functional and cosmetic results and complications were contrasted between the resorbable plating systems and each surgeon's vast experience with traditional plating systems.Results The resorbable plating system was found to be as effective as traditional plating systems with respect to rigidity of fixation, functional results, and complications. In addition, the resorbable system was far easier to contour and, consequently, to apply, while producing higher cosmetic satisfaction after plate resorption than traditional plating.Conclusions Based on our experience, resorbable plates appear to be safe, easy to contour and apply, as well as effective for a wide range of head and neck reconstructive applications. In addition, the shortcomings of permanently retained plates such as plate migration, bone growth restriction, and imaging artifact are avoided.
Defining Tympanostomy Tube Plugs
Authors: Westine John G. , Giannoni Carla M. , Antonelli Patrick J. 
Published: November 2003

AbstractObjectives To define the composition of tympanostomy tube plugs because selecting or developing effective solvents depends on such knowledge.Study Design Prospective, in vitro laboratory study.Methods Luminal contents of 105 plugged, microscopically removed tympanostomy tubes were expressed, pooled, acid hydrolyzed, and passed through a high‐performance liquid chromatography column. Retention times were compared with high‐performance liquid chromatography standards to develop free amino acid and monosaccharide profiles. Cerumen, blood, and chronic mucoid effusion (collected during myringotomy) were pooled and subjected to the same analysis. The elution profiles of each substance were compared to determine which substance most closely matched the plugs.Results High‐performance liquid chromatography amino acid and monosaccharide analysis demonstrated greatest similarity between tympanostomy tube plugs and mucoid effusion.Conclusions Tympanostomy tube plug composition is more similar to mucoid effusion than to blood or cerumen. Solvents to open plugged tympanostomy tubes should be directed against the components of mucoid effusion.
Gastroesophageal Reflux and Eustachian Tube Dysfunction in an Animal Model
Authors: White David R. , Heavner S. Brett , Hardy Stuart M. , Prazma Jiri 
Published: November 2003

AbstractObjective To explore the possible relationship between gastroesophageal reflux and eustachian tube dysfunction in an animal model.Study Design Randomized trial.Methods Twenty Sprague‐Dawley rats were randomly assigned into two groups, the control (phosphate‐buffered saline, n = 10) and experimental (hydrochloric acid [HCl]/pepsin, n = 10) groups. All rats underwent an operation to implant a polyethylene tube into the posterior nasopharynx, through which phosphate‐buffered solution or simulated gastric juice (0.5 mg/mL pepsin in 0.01 HCl) was infused at a rate of 0.1 mL/h for 20 minutes three times a day for 7 days. Passive opening pressure (POP), passive closing pressure (PCP), active clearance of positive pressure (ACPP) and active clearance of negative pressure (ACNP) were measured before catheter implantation, on postoperative day 5, and after days 1, 3, 5, and 7 of infusion. Mucociliary clearance time (MCCT) was measured after day 7 of infusion. Statistical analysis used a two‐way analysis of variance (POP, PCP, ACPP, and ACNP) and Mann‐Whitney rank sum test (MCCT).Results Significant increases in POP (P = .004), PCP (P <.001), ACPP (P <.001), ACNP (P <.001), and MCCT (P <.001) were demonstrated in the HCL/pepsin group compared with the control group. No significant difference was seen between preoperative and postoperative values.Conclusions Nasopharyngeal exposure to simulated gastric juice causes eustachian tube dysfunction in rats. Specifically, middle ear pressure regulation and mucociliary clearance of middle ear contents were disabled. These results support recent reports in the literature linking nasopharyngeal reflux to eustachian tube dysfunction and secondary development of otitis media.
Obstructive Supraglottic Schwannoma: A Case Report and Review of the Literature
Authors: Rosen Frederick S. , Pou Anna M. , Quinn Francis B. 
Published: November 2003

AbstractObjective At the conclusion of the current presentation, the participants should be able to describe the etiology, presentation, histopathologic identification, and treatment options for schwannoma of the larynx.Objectives Nerve sheath tumors rarely occur within the larynx. The goal of the current report is to acquaint the clinician with the presentation and treatment options for this disease.Study Design Retrospective case report and review of the literature.Methods We report one case of schwannoma of the supraglottic larynx at the Department of Otolaryngology, University of Texas Medical Branch (Galveston, TX). In addition, we review English‐language publications regarding laryngeal nerve sheath tumors.Results Laryngeal nerve sheath tumors have an insidious course, commonly involve the supraglottic larynx, and can lead to upper airway obstruction. Cure is achieved by complete surgical excision.Conclusions Median thyrotomy has proven to be safe and successful in the treatment of supraglottic schwannoma.
Dedifferentiated Chondrosarcomas of the Larynx: A Report of Two Cases and Review of the Literature
Authors: Garcia Roberto E. , Gannon Francis H. , Thompson Lester D. R. 
Published: November 2003

AbstractObjective To analyze the long‐term clinical outcome of dedifferentiated chondrosarcoma or chondrosarcoma with additional malignant mesenchymal component (CAMMC) of the larynx and compare the results with those of axial chondrosarcomas.Study Design/Methods Two patients with CAMMC of the larynx (0.03%) were retrospectively identified within the archives of the Armed Forces Institute of Pathology between 1970 and 2001. We compared the clinical and histologic features of these two cases with those reported in the English literature (Medline 1966–2001) (Table I).Results Patient no. 1 was a 67‐year‐old man who presented with a 12‐month history of hoarseness and was found to have a 4‐cm mass involving the cricoid cartilage. Enucleation was performed and histologically demonstrated a dedifferentiated chondrosarcoma. Without additional intervention, the patient died after 136 months without evidence of disease. Patient no. 2 was a 41‐year‐old man who also presented with a 12‐month history of hoarseness and dysphagia and was found to have a 5‐cm mass involving the cricoid cartilage. A total laryngectomy was performed for the dedifferentiated chondrosarcoma. He is alive without evidence of disease at last contact (91 mo).Conclusion CAMMC of the larynx are rare tumors but have a better prognosis than their axial counterparts (mean, 6 mo). Initial voice‐sparing surgery can be followed with more aggressive surgery if recurrences develop.
Patterns of Cartilage Structural Protein Loss in Human Tracheal Stenosis
Authors: Mankarious Leila A. , Adams Allison B. , Pires Valerie L. 
Published: November 2003

AbstractObjectives The study sought to identify which of the major structural proteins in tracheal cartilage are lost in the inflammatory process, and to determine whether damaged cartilage shows signs of regeneration and whether this is an age‐dependent phenomenon.Study Design Immunohistochemical analysis.Methods Archival human tracheal and subglottic stenosis segments removed for the treatment of airway compromise were investigated by means of immunohistochemical analysis for differential loss of collagen type I or type II or aggrecan.Results Specimens were found to have preferentially lost collagen I and aggrecan in areas of severe disruption of the cartilage ring. Collagen II was preserved. In addition, areas of apparent cartilage regeneration were identified based on increased collagen II and aggrecan relative to baseline levels in uninjured sections of the rings. Regenerative capacity was present in most of the specimens investigated and was not age specific.Conclusions Collagen I and aggrecan are lost in areas of severe ring compromise, indicating that at least one of these two molecules is responsible for structural integrity. The remaining cartilage has some regenerative capacity, but it is small relative to the degree of cartilage damage. No new collagen I was identified in the cartilage ring, indicating that, although an intense inflammatory reaction occurred, fibroblasts did not deposit new collagen I as seen in other scar tissues.
Velopharyngeal Function After Microsurgical Reconstruction of Lateral and Superior Oropharyngeal Defects
Authors: Kimata Yoshihiro , Uchiyama Kiyotaka , Sakuraba Minoru , Ebihara Satoshi , Hayashi Ryuichi , Haneda Tatsumasa , Onitsuka Testuro , Asakage Takahiro , Nakatsuka Takashi , Harii Kiyonori 
Published: November 2003

AbstractObjectives/Hypothesis Defects of the lateral and superior oropharyngeal wall are difficult to reconstruct because of their complicated anatomy and the possibility of causing velopharyngeal incompetence. The objective was to investigate problems of reconstruction and postoperative velopharyngeal function.Study Design Defects were classified into three types (I, II, and III) according to their extent. Four operative procedures were performed: the Patch, Jump, Denude, and Gehanno methods, which include a lateral–posterior pharyngeal advancement flap. Speech intelligibility, velopharyngeal function, and wound dehiscence between the flap and the remaining soft palate were evaluated.Methods Forty patients who had undergone resection of the lateral and superior oropharyngeal walls and subsequent reconstruction were reviewed.Results Most patients with type I or II defects had satisfactory velopharyngeal function. However, in patients with type III defects, speech function was worse and severe velopharyngeal incompetence was more common. The type of defect and the presence of wound dehiscence were related to postoperative function. The rates of wound dehiscence were lower with the Patch and Gehanno methods.Conclusions Postoperative function in patients with type III defects can be affected by various factors. We suggest that the Gehanno method be the treatment of choice for reconstruction of extensive defects of the oropharynx. However, patients in whom more than two‐thirds of the superior and posterior oropharyngeal walls has been resected are poor candidates for reconstruction because of the difficulty of maintaining both nasal airway patency and velopharyngeal function.
Otolaryngologic Aspects of the Lewis & Clark Expedition, 1803–1806
Authors: Eisen Marc D. , Lustig Lawrence R. 
Published: November 2003

AbstractMedical difficulties related to otolaryngology that occurred during the Lewis & Clark Expedition (1803–1806) are highlighted. These difficulties included ear and face frostbite, upper respiratory infections, temporal vessel laceration from an air gun accident, neck scrofula, and a pediatric neck mass. The custom of Clatsop Indian head flattening is also described. These descriptions also aim to illustrate the state of otolaryngology during the early 19th century in America.
Endoscopic‐Assisted Transcolumellar Approach to the Clivus: An Anatomical Study
Authors: Puxeddu Roberto , Lui Matt W.M. , Chandrasekar Kalavakonda , Nicolai Piero , Sekhar Laligam N. 
Published: November 2003

AbstractObjective Surgical exposure of the clivus and retroclival region is a challenging problem. Several extracranial and intracranial approaches using microsurgical techniques have been proposed in the search to optimize the exposure of the clival region. The objective of the present study was to develop an endoscopic‐assisted transcolumellar approach to the anterior clivus.Study Design Experimental anatomic study.Methods The approach was studied in 10 consecutive cadaveric preparations. It included a preliminary external rhinoplasty technique with a septal displacement procedure, which gives a wide intranasal route to the posterior wall of the nasopharynx. By use of a drill system and instruments specially designed for endoscopic sinus surgery, the clivus and retroclival region were appropriately managed. Direct morphometric measurements were obtained during all steps of the procedure.Results The endoscopic‐assisted transcolumellar approach developed in the present experimental study allowed a good exposure of the clivus area and anterior cranial‐cervical junction. By performing a preliminary septoplasty, the nostrils were turned into a single passage with adequate space for endoscopic insertion and manipulation of one or two instruments. The authors were able to completely expose the posterior wall of the sphenoid sinus and clival dura after the thick bone of the vomer, the floor of the sphenoid, and the clivus were removed by a drill. Angled endoscopes provided a comprehensive view of the retrosellar area.Conclusions The endoscopic‐assisted transcolumellar approach, besides offering a wide opening for endoscopic management of the clivus, also allowed the surgeon to perform a double‐handed procedure and to associate the use of a microscope if needed. The use of endoscopes, although lacking the three‐dimensional view, gave a thorough and closer exposure of the surgical field with the advantage of a multiangled perspective.
Distinguishing Non‐Hodgkin Lymphoma From Squamous Cell Carcinoma Tumors of the Head and Neck by Computed Tomography Parameters
Authors: Urquhart Andrew C. , Hutchins Lawrence G. , Berg Richard L. 
Published: November 2003

AbstractObjective Computed tomography (CT) remains the first‐line imaging procedure for pre‐therapeutic staging of head and neck tumors. Non‐Hodgkin lymphoma (NHL) is not easily distinguished from squamous cell carcinoma (SCC), especially because NHL often appears in extranodal locations. We sought to explore whether specific CT characteristics could be used to distinguish these tumor types.Method Cases of NHL and SCC involving the head and neck were retrospectively identified. Of 165 subjects (110 NHL, 55 SCC) identified, 45 patients (19 NHL, 26 SCC) had complete CT scan records. The scans with no group identifiers were randomly presented to the radiologist for blinded review. Radiologic distribution, size, and tumor characteristics were recorded. Descriptive summaries of the data were analyzed by standard univariate statistical procedures.Results Significant differences between NHL and SCC tumors were observed: stage IV tumors (17% vs. 85%;P <.001), extranodal occurrence in the oral cavity (0% vs. 38%;P = .002), evidence of primary or extranodal tumor (11% vs. 73%;P <.001), tumor necrosis (5% vs. 54%;P <.001), non‐isodensity nodes (16% vs. 50%;P = .03), and nodes in zones 5–7 (32% vs. 4%;P = .03). No significant difference was seen in the total number of nodes, the number of large nodes, or the maximum nodal diameter.Conclusion While none of these features can be considered pathognomonic for either type of tumor, the distinctions may assist in distinguishing NHL from SCC of the head and neck until more sophisticated imaging techniques become widely available.
Inducible Nitric Oxide Synthase Expression in Pharyngeal Squamous Cell Carcinoma: Relation to p53 Expression, Clinicopathological Data, and Survival
Authors: Pukkila Matti J. , Kellokoski Jari K. , Virtaniemi Jukka A. , Kumpulainen Eero J. , Johansson Risto T. , Halonen Pirjo M. , Kosunen Ari S. T. , Nuutinen Juhani , Kosma Veli‐Matti 
Published: November 2003

AbstractObjective To investigate the expression of inducible nitric oxide synthase (iNOS) in oropharyngeal and hypopharyngeal squamous cell carcinoma (SCC) and its relation to p53 expression, histologic differentiation, clinical data, and prognosis.Study Design A retrospective survey.Methods Primary tumors for analyses were obtained from 118 patients diagnosed with SCC of the oropharynx or hypopharynx between 1975 and 1998 in eastern Finland. Immunohistochemical analysis was used to evaluate the expression of iNOS and p53. The expression pattern of iNOS was related to p53 expression, clinical data, and survival.Results High iNOS score was associated significantly with high nuclear p53 expression index (P = .006) and positive cytoplasmic p53 expression (P =.025). The score for iNOS expression was significantly lower in the largest (T4) tumors (P = .043). No association was seen between iNOS score and N or M class, tumor stage, or histologic differentiation. The score for iNOS expression was not related to overall survival.Conclusions The expressions of iNOS and p53 seem to be inter‐related in pharyngeal SCC, although the causality remains to be clarified. The expression of iNOS shows no prognostic value in pharyngeal SCC.
Endoscopic Resection of the Submandibular Gland in a Porcine Model
Authors: Monfared Ashkan , SÁenz Yamil , Terris David J. 
Published: November 2003

AbstractObjective To examine the feasibility of endoscopic resection of the submandibular gland in a porcine model.Study Design Experimental, nonrandomized prospective study.Methods Twelve endoscopic submandibular gland resections were performed on seven Yorkshire adult pigs using a combination of balloon dissection and low‐pressure CO2 insufflation. The operative time, blood loss, blood pressure, oxygen saturation, temperature, arterial blood gas values, and weight of the glands were measured.Results All 12 submandibular gland resections were successfully performed endoscopically, and no conversions to open resection were necessary. The procedures lasted 42 to 140 minutes (median duration, 59 min). The median estimated blood loss was 15 mL. The submandibular glands weighed 13.3 ± 1.5 g. The arterial blood pH varied from a decrease of 0.08 to an increase of 0.09 units from the beginning to the end of the operation. Similarly, the arterial CO2 pressure at the end of the case varied from a decrease of 15.8 to an increase of 16.2 mm Hg from the starting value. The presence of normal glandular architecture and lack of trauma or thermal injury were confirmed histologically. There were no cases of pneumothorax or air embolism, and no animals had to be killed. In one animal, a modest amount of subcutaneous emphysema could be appreciated, which was confined to the area over the operative pocket.Conclusion Endoscopic resection of the submandibular gland is possible by combining balloon dissection with low‐pressure CO2 insufflation, thereby avoiding complications of high‐pressure insufflation such as pneumothorax and air embolism.
Global Genetic Differences in Squamous Cell Carcinoma of the Head and Neck
Authors: Ell Stephen R. , Ashman James E. , Stafford Nicholas D. , Greenman John 
Published: November 2003

AbstractObjectives/Hypothesis The objectives are to determine the frequency of chromosomal aberrations in 22 patients in the United Kingdom with head and neck squamous cell carcinoma and to compare our results with studies reported from western Europe and North America and highlight changes common to all groups, thus enabling focused study of important gene loci.Study Design Prospective experimental, then comparative observational study.Methods Comparative genomic hybridization was used to detect regions of chromosomal gain or loss across the entire genome. The aberration frequency was contrasted with other published series, and similarities and differences were highlighted.Results The most common chromosomal gain in all studies was 3q (50% to 87%). Other common chromosomal gains varied considerably between centers. The most common loss was 3p in three of the studies; one group in the United States reported 19p loss most frequently. The frequency of other losses varied considerably.Conclusions Comparative genomic hybridization has highlighted a number of common genetic events in head and neck squamous cell carcinoma. The prevalence of individual aberrations differed between centers. Further cooperative multicenter studies of this technique are warranted.
Stapedectomy Revision in Elderly Patients
Authors: Lippy William H. , Wingate Jennifer , Burkey John M. , Rizer Franklin M. , Schuring Arnold G. 
Published: November 2003

AbstractObjective the objective was to determine the effectiveness of stapedectomy revision in patients 65 years of age or older. Although stapedectomy revision has been discussed in the literature, as well as primary stapedectomy surgery for elderly patients, we could find no study dedicated to stapedectomy revision in elderly patients.Study Design Retrospective.Methods One hundred twenty patients 65 years of age or older who had a stapedectomy revision between 1980 and 2001 were included. A randomly selected group of 120 patients younger than 65 years of age who had stapedectomy revision were included for comparison. Audiometric results were compared for the two groups. Surgical findings for each group are also discussed.Results The mean pure‐tone average hearing improvement for each group was 17.6 dB. The success rate was 70.8% for the elderly group and 67.6% for the younger group. Surgical findings during revision in elderly patients were generally the same as those found for younger patients.Conclusion Advanced age should not be seen as a contraindication to stapedectomy revision.
No Effect of a Nasal Decongestant on Eustachian Tube Function in Children With Ventilation Tubes
Authors: van Heerbeek Niels , Ingels Koen J. A. O. , Zielhuis Gerhard A. 
Published: November 2003

AbstractObjective The aim of the study was to assess the effect of a topical decongestant on eustachian tube function in children with ventilation tubes because of persistent otitis media with effusion.Study Design A randomized, double‐blinded, placebo‐controlled study.Methods At the outpatient departments of a secondary referral hospital and a tertiary referral hospital, eustachian tube function was measured before and after intranasal administration of five drops of 0.05% xylometazoline hydrochloride or placebo in 80 randomly selected children with ventilation tubes because of otitis media with effusion.Results Xylometazoline nose drops had no effect on the ventilatory or the protective function of the eustachian tube.Conclusions Topical decongestants do not have a positive effect on eustachian tube function in children. Therefore, the use of topical decongestants to prevent or treat otitis media with effusion in children is not justified and should be discouraged.