bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of Hypoxia Inducible Factor 1 α and Von Hippel Lindau Protein in Human Middle Ear Cholesteatoma
Authors: Adunka Oliver , Gstoettner Wolfgang , Knecht Rainald , Kierner Antonius C. 
Published: November 2003

AbstractObjective To evaluate the role of hypoxia in cholesteatoma progression.Study Design Immunohistochemical analysis of paraffin‐embedded human specimens.Methods Thirteen middle ear cholesteatomas and 10 samples of normal human external ear canal skin were stained immunohistochemically for the presence of hypoxia inducible factor 1 α (HIF 1 α) and Von Hippel Lindau protein. Specimens were then analyzed semiquantitatively.Results Staining for both antibodies could be detected in all cholesteatomas (perimatrix and matrix), as well as in the samples of normal human ear canal skin. Cholesteatoma specimens showed statistically significant increased staining when compared with normal human skin and mucosa. The age of patients and relapse surgery affected immunohistochemical staining of HIF 1 α and Von Hippel Lindau protein.Conclusions Elevated staining intensities for HIF 1 α and Von Hippel Lindau protein in cholesteatoma tissue indicated that cholesteatoma may be hypoxic. In addition, our data indicated that relapse cholesteatomas yield a higher degree of hypoxia than ears without surgery.
Cochlear Implantation in Children With Otitis Media
Authors: Fayad Jose N. , Tabaee Abtin , Micheletto Jennifer N. , Parisier Simon C. 
Published: November 2003

AbstractObjective To describe the outcome of cochlear implantation in a cohort of pediatric patients with a history of otitis media.Study Design Retrospective chart review and follow‐up phone survey.Methods The medical records of patients younger than 48 months of age who underwent cochlear implantation were reviewed for demographics, complications, and history of otitis media and bilateral myringotomy and ventilation tubes. A follow‐up phone survey was performed to determine the long‐term natural history of otitis media.Results The records of 126 profoundly deaf pediatric patients were reviewed. Seventy‐two percent had a history of at least one episode of otitis media, 31% had a history of greater than three episodes, and 2% had a history of chronic serous otitis media. Twenty‐three percent underwent bilateral myringotomy and tubes in the distant past, 6 to 8 weeks before implantation, at the time of implantation, or after implantation. A phone survey was successfully completed for 76 patients with a mean follow‐up period of 46 months. There was a significant decrease in the incidence of otitis media after the cochlear implantation in the majority of patients with a history of otitis media with and without a history of bilateral myringotomy and tubes.Conclusions Placement of ventilation tubes either before or at the time of cochlear implantation seems to adequately prevent infectious disease–related complications in otitis‐prone children. Therefore, implantation should not be delayed, and subsequent episodes of otitis media can be managed by conventional therapy.
Swallowing Function and Tracheotomy Dependence After Combined‐Modality Treatment Including Free Tissue Transfer for Advanced‐Stage Oropharyngeal Cancer
Authors: Skoner Judith M. , Andersen Peter E. , Cohen James I. , Holland John J. , Hansen Eric , Wax Mark K. 
Published: November 2003

AbstractObjectives/Hypothesis There are many treatments available for advanced oropharyngeal cancer. Organ‐sparing protocols reserve surgery for salvage and are thought to provide adequate rehabilitation. Surgical resection with free tissue transfer may also provide adequate functional rehabilitation. The objective was to describe swallowing status and time to decannulation in a series of patients treated with combined‐modality therapy that included free flap reconstruction.Study Design Retrospective chart review.Methods Patient data were obtained from medical records of 20 patients with stage III or IV oropharyngeal carcinoma, who were consecutively treated with surgical tumor extirpation, free flap reconstruction, and postoperative irradiation at a tertiary academic center from 1985 to 2002. The following variables were identified: patient and tumor characteristics, free flap type, irradiation data, and airway and swallowing status before and after treatment.Results One patient underwent total laryngopharyngectomy, and the remaining 19 patients underwent tracheotomy at the time of definitive surgery. Free flap reconstructions included 1 ulnar and 15 radial forearm fasciocutaneous flaps and 4 fibula osteocutaneous flaps. Postoperatively, all 19 tracheotomized patients had successful decannulation. Average time to decannulation was 15 days (range, 3–42 d). After surgery and before irradiation, 13 patients initiated oral intake, on average, at 19.5 days (range, 7–28 d); 6 patients required no additional supplementation. By 4 months after surgery, having completed radiation therapy, 10 patients were consuming all nutrition orally; the other 10 patients still required tube‐feed supplementation, although 6 of these patients were also eating by mouth.Conclusion Combined‐modality treatment that includes free flap reconstruction for advanced‐stage oropharyngeal cancer may provide reasonable functional rehabilitation with respect to postoperative airway and swallowing.
A New Method for Closing Tympanic Membrane Perforations Using Basic Fibroblast Growth Factor
Authors: Hakuba Nobuhiro , Taniguchi Masafumi , Shimizu Yoshitaka , Sugimoto Akira , Shinomori Yusuke , Gyo Kiyofumi 
Published: November 2003

AbstractObjective To present a new method for closing tympanic membrane perforations using basic fibroblast growth factor (bFGF) combined with an atelocollagen/silicone bilayer membrane as a patch material.Study Design Closure of tympanic membrane perforations was attempted using bFGF, which is thought to facilitate the growth of fibroblasts and collagen fibers at the margin of the perforation.Methods Under an operating microscope, the margin of the perforation was trimmed, and a piece of an atelocollagen/silicone bilayer membrane infiltrated with 0.2 mL Trafermin (0.1% solution) (bFGF group) or saline (control group) was then placed in the perforation with the silicon layer facing outward. Nine patients were treated with bFGF, and five were treated with saline. Data obtained from patient records included patient age, perforation size, and duration of treatment, with a focus on hearing improvement and complete tympanic membrane closure.Results The mean perforation size before treatment was 16.5% in the bFGF group and 9.6% in the control group. Closure of the tympanic membrane perforation was achieved in all cases in the bFGF group, whereas it was achieved in only two of five cases in the control group. With bFGF treatment, the tympanic membrane perforations closed completely within 3.7 weeks, and hearing improved by 13.3 dB in the bFGF group.Conclusion The study demonstrated that bFGF combined with an atelocollagen/silicone bilayer membrane is effective for the conservative treatment of tympanic membrane perforation.
Cochlear Implants: Growing Pains
Authors: Parisier Simon C. 
Published: November 2003

AbstractObjectives/Hypothesis The objective was to make familiar the problems faced in the application of cochlear implants to the half‐million to a million severe to profoundly deaf individuals who are potential beneficiaries of this technology.Study Design Observations accumulated during 23 years as Medical Director of the Manhattan Eye Ear Throat Hospital Cochlear Implant Center.Methods The author reviewed insights gained while directing the Cochlear Implant Center since the early 1980s at Manhattan Eye, Ear and Throat Hospital (New York, NY).Results The rapid application of cochlear implant technology for patients with severe to profound hearing losses is creating critical problems. It is being hampered by inadequate reimbursement. There is a critical shortage of cochlear implant–trained audiologists, who are an essential keystone in the application of this technology. These audiologists are required to provide lifelong audiological services to patients who have received cochlear implants. At the same time, they must evaluate the exponentially growing number of new candidates.Conclusion The restoration of hearing with cochlear implants provides an enormous educational and societal benefit. However, the existing health care delivery system limits the application of cochlear implant technology. University audiological training programs must expand their curricula to include cochlear implant–related courses. The existing rehabilitation audiologist delivery system could be applied to provide long‐term, community‐based cochlear implant services.
Advances in Head and Neck Reconstruction
Authors: Urken Mark L. 
Published: November 2003

AbstractThere are numerous advances that have taken place over the last several years in head and neck reconstruction. In this article, the author has outlined three exciting developments. The first is in the area of palatomaxillary reconstruction using free tissue transfer. In select cases, depending on the nature of the defect, soft tissue flaps have been highly successful. However, in more extensive defects, the author chooses to transfer vascularized bone composite flaps to achieve successful dental restoration as well as closure of the palatal defect. Sensory restoration through the use of sensate flaps has been a topic of considerable controversy. The author presents his experience with three patients who underwent a unique reconstruction of the laryngopharynx that has demonstrated conclusively that targeted sensory restoration can be achieved through neural anastomoses. By anastomosing the sensory nerve to the superior laryngeal nerve, there are implicit physiologic implications with respect to the feedback that is achieved and its role in achieving glottic closure during deglutition. Extensive laryngeal reconstruction with subglottic involvement can be a very challenging problem. The author describes a new technique using vascularized tracheal autografts with the thyroid gland as a carrier. This provides the necessary ingredients for transferring a cartilaginous infrastructure within a thin layer of vascularized mucosa to restore the framework and the lining to the laryngotracheal region. Three patients have been restored who had extensive glottic and subglottic stenoses that have since been decannulated and are successfully eating as well as speaking. In addition, the author feels that this is a very promising technique for the management of chondrosarcomas, in which a significant portion of the cricoid arch requires reconstruction.
Mitomycin C for the Treatment of Pharyngoesophageal Stricture After Total Laryngopharyngectomy and Microvascular Free Tissue Reconstruction
Authors: Annino Donald J. , Goguen Laura A. 
Published: November 2003

AbstractObjectives To assess the role of mitomycin C (MMC) in the management of pharyngoesophageal stricture after total laryngopharyngectomy and free flap reconstruction.Study Design Five patients since 1998 underwent evaluation and treatment for pharyngoesophageal stricture after total laryngopharyngectomy and free flap reconstruction. The method of reconstruction included four tubed radial forearm free flaps and one jejunal free flap. All patients underwent barium swallow, computed tomography, and endoscopic examination and were proven to be free of recurrent disease.Methods The patients were taken to the operating room. After dilation, the stenotic segment was exposed, and 1 mL of 0.4 mg/mL mitomycin‐C was applied for 4 minutes using a cotton pledget. The patients were then followed clinically and with barium swallows for a minimum follow‐up period of 18 months.Results All five patients experienced improved swallowing ability. The need for further dilatations was either eliminated or lessened. All patients were happy with the treatment results. No complications occurred.Conclusions This small case series suggests that MMC is a safe and effective adjunctive treatment for pharyngoesophageal stricture after total laryngopharyngectomy and free flap reconstruction.
Treatment Outcomes in the Management of Inverted Papilloma: An Analysis of 160 Cases
Authors: Lawson William , Kaufman Matthew R. , Biller Hugh F. 
Published: November 2003

AbstractObjective The objective of this study is to compare the surgical options for treatment of inverted papilloma to determine the appropriate indications for conservative and aggressive management.Study Design and Setting A retrospective review of 160 patients with a diagnosis of inverted papilloma treated by the two senior authors (w.l. and h.f.b.) between 1973 and 2001.Results The study group consisted of 124 male and 36 female patients with an average age of 56 years. The follow‐up period ranged from 10 months to 16 years (mean, 5.2 years). Seventy‐eight patients (49%) had undergone prior surgery. Lateral rhinotomy was performed in 112 patients (70%), with a recurrence rate of 18%. Conservative removal was performed in 41 patients (26%), including 30 (19%) endoscopic approaches, with a recurrence rate of 12%. The remaining patients underwent midfacial degloving, osteoplastic approach, or craniofacial resection. The rate of malignant transformation was 7%.Conclusion We present the largest personal series of cases of inverted papilloma to date. Our data suggest that conservative approaches, especially endoscopic removal, can be performed on selected lesions with recurrence rates that are comparable to those of more aggressive techniques. Those inverted papillomas that recur after treatment may represent a subset of lesions with an inherent aggressiveness, for which optimal treatment has yet to be determined.
Detection of Helicobacter pylori in Nasal and Maxillary Sinus Specimens From Patients With Chronic Sinusitis
Authors: Morinaka Setsuko , Ichimiya Masato , Nakamura Hiroyuki 
Published: November 2003

AbstractObjectives In patients with chronic sinusitis, the colonization of nasal and maxillary sinus tissues by Helicobacter pylori (HP) was investigated using polymerase chain reaction, urease test (CLO test), culture, and immunohistochemical analysis.Study Design A prospective clinical study.Methods The subjects were 11 patients aged 20 to 72 years with chronic sinusitis who had undergone sinus surgery under local anesthesia. In 7 of 11 patients, the HP status of the stomach was also studied. Nasal and maxillary sinus tissues were studied using polymerase chain reaction, urease test, culture, and immunohistochemical analysis. Helicobacter pylori infection of nasal and maxillary sinus tissues was defined by at least two positive results of different tests.Results Three (16%) of 19 nasal and maxillary sinus specimens from two patients were shown to be HP‐positive (positive by polymerase chain reaction and immunohistochemical analysis and weakly positive by the CLO test). In one of these two patients, HP infection of the stomach was confirmed. In the other, a positive findings on immunohistochemical analysis suggested HP infection of the stomach. Immunoreactive structures were seen by immunohistochemical analysis in the nasal, maxillary sinus, and gastric specimens of these two patients but were partially degraded.Conclusion Helicobacter pylori may exist in the nasal and maxillary sinus tissue specimens of some patients with chronic sinusitis with gastric HP infection.
Promoting Healing With Recombinant Human Platelet‐Derived Growth Factor–BB in a Previously Irradiated Problem Wound
Authors: Hom David B. , Manivel J. Carlos 
Published: November 2003

AbstractObjectives/Hypothesis Persistent, poorly healing wounds are a significant clinical problem in patients who have had previous irradiation. Despite current treatments, refractory nonhealing soft tissue wounds persist. The study described one of the earliest reported uses of recombinant human platelet‐derived growth factor‐BB (rhPDGF) gel to improve the healing of a previously irradiated refractory dermal wound to the neck that had been present for 12 years.Study Design Case report and literature review.Methods Review of local healing management of previously irradiated wounds and review of patients chart one year after follow‐up treatment.Results A 47‐year‐old man had a 12‐year history of a persistent, painful, nonhealing full‐thickness dermal wound on the left side of his neck after radiation therapy and chemotherapy for a T2N2bM0 nasopharyngeal carcinoma. He had been tumor free for 12 years. Despite multiple modalities of therapy over a 1‐year period (including moist hydrogel dressings, topical and oral antibiotics, serial debridement, and hyperbaric oxygen), the wound did not heal. After 6 months of topical rhPDGF gel treatment, sufficient granulation tissue developed within the dermal wound that a split‐thickness skin graft was successfully performed. Symptomatically, the patient's continuous pain at the neck resolved after rhPDGF treatment. Serial histological biopsy specimens before and after rhPDGF treatment confirmed the wound transformation from a chronic state to a short‐term healing state.Conclusion In previously irradiated tissue, rhPDGF can be useful in helping refractory wounds to heal by inducing further granulation formation. If such treatment is planned, the patient should be informed of the possible theoretical risks of its use when it is in proximity to a previously treated neoplastic site.
Cost‐effectiveness of intraoperative facial nerve monitoring in middle ear or mastoid surgery
Authors: Wilson Leslie , Lin Eddie , Lalwani Anil 
Published: November 2003

AbstractObjectives: Despite the utility of intraoperative facial nerve monitoring in reducing the risk of iatrogenic facial nerve injury during neurotologic surgery, its routine use during primary or revision surgery remains controversial. One of the major barriers to its acceptance is cost. This study evaluates the cost‐effectiveness of intraoperative facial nerve monitoring during middle ear or mastoid surgery. Research Design/Methods: A simple decision analytic cost‐effectiveness model and a societal approach were used to evaluate three cohorts of individuals who received (1) intraoperative facial nerve monitoring for both primary and revision middle ear or mastoid surgeries, or (2) facial nerve monitoring for revision surgeries only, or (3) no monitoring for any middle ear or mastoid surgeries. Results: Our results strongly favored the use of intraoperative facial nerve monitoring in all patients undergoing middle ear or mastoid surgery, adding about $222.73 to $528.00 to the total cost. The strategy to monitor primary and revision surgeries had the greatest effectiveness and lowest cost, with an average quality‐adjusted life‐year (QALY) of 45.68 at an average cost of $238. Facial nerve monitoring in revision patients only had similar QALYs (45.67) and higher costs ($292.1). Finally, the strategy not to monitor had the lowest QALY (45.65) and highest cost ($449.8). The analysis was robust across a wide range of changes in both costs and probabilities. Conclusions: Facial nerve monitoring is cost‐effective, and its routine use should be adopted to reduce the risk of iatrogenic facial nerve injury during otologic surgery.
Antibodies to HSP‐70 in normal donors and autoimmune hearing loss patients
Authors: Yeom Kristen , Gray J. , Nair T. S. , Arts H. A. , Telian S. A. , Disher M. J. , El‐Kashlan H. , Sataloff R. T. , Fisher S. G. , Carey T. E. 
Published: November 2003

AbstractObjective: To evaluate serum antibody to heat shock protein (HSP) 70 as a marker for autoimmune sensorineural hearing loss (AISNHL). Design: Sera from 20 patients with rapidly progressive sensorineural HL and 20 control volunteers without HL were tested for antibody reactivity against multiple HSP 70 substrates. Substrates included recombinant human HSP (rHuHSP) 72, purified bovine brain heat shock cognate (HSC) 73 and HSP 72, as well as heat‐shocked and non‐heat‐shocked protein extracts from bovine kidney (MDBK) cells. All serum donors were previously tested for antibody to guinea pig inner ear supporting cells; 17 of 20 patients but none (0 of 20) of the controls were positive. Methods: Sera were tested using Western blots. Results: Reactivity with rHuHSP 70 was observed in 16 patients and 17 controls. Similarly, 15 of 20 patients and 17 of 20 controls stained for both HSP 72 and HSC 73 from the bovine brain. When tested against the heat‐shock‐induced and control MDBK extracts, six patients and nine controls had greater reactivity with the induced HSP 72. Conclusion: The frequency of antibodies to HSP substrates did not differ in patients and controls. Prior studies reported that HSP 72 is the 68 kD antigen commonly detected by AISNHL sera. However, we show that HSP 72 antibodies are no more prevalent in patients than in normal controls. Thus, it is unlikely that the 68 kD protein is HSP 72. Therefore, HSPs are not appropriate substrates for serodiagnosis of AISNHL.
Level of vocal folds as projected on the exterior thyroid cartilage
Authors: Cinar Ugur , Yigit Ozgur , Vural Cetin , Alkan Seyhan , Kayaoglu Semra , Dadas Burhan 
Published: November 2003

AbstractObjective: This study aims to identify the level of the vocal folds as projected on the exterior thyroid cartilage. Study Design: Anatomic study of human cadaver larynges. Methods: The study includes 83 fresh larynges harvested at autopsy from 62 male and 21 female cadavers. The larynges were excised and divided in the midline posteriorly. One needle was inserted at the level of anterior commissure from endolarynx, and the other was inserted at the thyroid ala just anterior to the vocal process along the superior surface of the right vocal cord. Measurements of vocal cord projections on the thyroid ala were done with a caliper. Results: The mean value of the ratio of the distances from the superior thyroid notch to anterior commissure and the midline height from thyroid notch to the inferior border of thyroid cartilage was found to be 0.41 in males and 0.38 in females. No statistical differences were observed between these two groups (P = .062). We found that the distance from the anterior commissure to the inferior thyroid border in midline “c” was longer than the distance from the posterior border of the vocal cord to the inferior border of the inferior tubercle of the thyroid ala “d” in 44 (71%) males and in 7 (33%) females. On the other hand, “d” was longer than “c” in 8 (12.9%) males and in 8 (38.1%) females. These two distances were equal in 10 (16.1%) males and in 6 (28.6%) females. Conclusion: In this study, we found that the anterior commissure lies approximately at the juncture of the upper two fifths and lower three fifths of the midline height of thyroid cartilage in the majority of the larynges of the male and female cadavers. The position of the posterior border of the vocal cords was found to be at a lower level than anterior commissure in two thirds of males and in one third of females. This means that the vocal cords slope downward posteriorly in the majority of the larynges of the males. This may be one of the causes of failure of some type I thyroplasties.