bluuebunny/crossref_metadata_2025_split huggingface dataset:
Videostroboscopy of the pharyngoesophageal segment in total laryngectomees
Authors: Dworkin James Paul , Meleca Robert J. , Zormeier Michelle M. , Simpson Mark L. , Ma Ilene Garfield, , Jacobs John R. , Mathog Robert H. 
Published: November 2003

AbstractObjectives: The reconstructed pharyngoesophageal segment (PES) serves as the neoglottis following total laryngectomy, as it provides the source of vibration for production of tracheoesophageal puncture (TEP) voice. To date, little information exists regarding the vibratory characteristics of the PES. The purpose of this investigation was to study the anatomy and physiology of the PES using videostroboscopy. Study Design: Prospective study investigating the anatomy and physiology of the PES in 34 laryngectomees who used TEP speech as their primary form of communication. Materials and Methods: Videostroboscopy and voice recordings were graded by three trained, blinded judges using a seven‐point scale. Results: The patients demonstrated differences that allowed for separation of patients into two main groups: “poor” and “effective” TEP speakers. The voice quality differences were explained by anatomic and physiologic characteristics of the PES. Redundant, thick, and dyssynchronous PES features were observed in patients with poor TEP speech skills; the effective speakers exhibited less redundant, thinner mucosa and more synchronous vibratory patterns. Moreover, the latter subgroup consistently demonstrated a greater degree of volitional PES control and less spasmodic activity than their poorly speaking counterparts. Length of the PES opening (measured in the horizontal plane) as well as amount and consistency of secretions did not appear to influence TEP speech or voice proficiency. Conclusion: Videostroboscopy in laryngectomees is a noninvasive, inexpensive, easily performed procedure that may contribute valuable information regarding the anatomy and physiology of the PES, especially in patients who experience difficulties achieving satisfactory TEP voice and speech production.
A Model to Explain the Rapid Pressure Decrease After Air–Inflation of Diseased Middle Ears
Authors: Doyle William J. , Alper Cuneyt M. 
Published: November 2003

AbstractObjectives: Air‐inflation in humans and monkeys with significant negative middle ear pressure or with middle ear inflammation was shown to cause greater than ambient middle ear pressure initially, followed by a rapid rate of pressure decrease to approach the preinflation value.Study Design: A mathematical model of middle ear pressure regulation is presented and used to simulate air‐inflation of the normal and diseased middle ear.Materials and Methods: The model represents the total volume of the middle ear as consisting of three subcompartments representing the airspace, effusion, and mucosa/blood. Gas exchange among those compartments was assumed to be diffusion limited, and the gas exchange between the mucosa/blood compartment and systemic blood was assumed to be perfusion limited. Disease was modeled as an increase in mucosal blood flow or, alternatively, as an increase in the volumes of the effusion and mucosa/blood compartments.Results: The predictions of the model agree better with the experimental data when the increased rate of pressure change after middle ear inflation in diseased ears is driven by an increased volume of the effusion compartment as opposed to an increased perfusion rate. The responsible mechanism is a rapid redistribution among subcompartments of the gas volume introduced into the air compartment.Conclusions: These results suggest that middle ear inflation with inert gas can be used to diagnose the presence and relative amount of middle ear effusion, and that current protocols for treating otitis media with effusion using inflation need to be modified to optimize their intended effect.
Effect of Harvesting Autogenous Laryngeal Cartilage for Laryngotracheal Reconstruction on Laryngeal Growth and Support
Authors: Park Albert H. , Forte Vito 
Published: November 2003

AbstractObjective: Determine the effect of harvesting autogenous thyroid cartilage on subsequent laryngeal growth and stability in a kitten model. Study Design: Prospective controlled trial in animals. Methods: Seventeen kittens were divided into three groups. Group one (n = 5) included kittens that underwent a unilateral thyroid cartilage resection. Group two (n = 5) included kittens that underwent a bilateral cartilage resection. Group three (n = 7) comprised kittens that did not undergo any surgical procedure (controls). All animals underwent endoscopic examination followed by the surgical procedure designated for that group. Kittens were then assessed daily for 2.5 months. At the end of that period the now “adolescent” cats were examined endoscopically then euthanized. The larynx was removed for gross and histopathologic analysis. Results: All kittens tolerated the surgical procedure without airway compromise. Subsequent endoscopic examination 2.5 months after surgery revealed normal vocal cord function. Measurements of the true vocal cord and aryepiglottic and subglottic diameter did not differ significantly (one‐way analysis of variance, P = .05) with respect to the side or the group. Histopathologic evaluation of the laryngeal sections indicated a patent airway, stable and viable thyroid cartilage, and no evidence of cartilaginous regrowth. Conclusions: The removal of unilateral and bilateral superior thyroid alar cartilage can be performed in kittens without postoperative respiratory or wound problems. The harvesting of autogenous thyroid cartilage has no apparent effect on subsequent laryngeal growth and stability in a kitten model.
Physiologic and hypertonic saline solutions impair ciliary activity in vitro
Authors: Boek Wilbert M. , Keleş Nesil , Graamans Kees , Huizing Egbert H. 
Published: November 2003

AbstractObjective/Hypothesis: Physiologic saline (NaCl 0.9%) is commonly used in treating acute and chronic rhinosinusitis. Moreover, physiologic saline is used as a control medium, vehicle, or solvent in studies on ciliary beat frequency (CBF). Hypertonic saline (NaCl 7% and 14.4%) has been applied in attempts to enhance mucociliary transport in patients with cystic fibrosis or asthma and in healthy subjects. Therefore the objective of this study is to document in vitro effects of saline solutions in different concentrations on CBF. Study Design: Experimental, in vitro. Methods: The effects on CBF of cryopreserved mucosa of the sphenoidal sinus was measured by a photoelectrical method. Initial frequencies, measured in Locke‐Ringer's solution (LR), were compared with CBF after exposure to NaCl in concentrations of 0.9%, 7.0%, and 14.4% (w/v). Results: NaCl 0.9% has a moderately negative effect on CBF. The 7% solution leads to a complete ciliostasis within 5 minutes, although this effect turns out to be reversible after rinsing with LR. A hypertonic solution of 14.4% has an irreversible ciliostatic effect. Conclusion: LR is an isotonic solution that has no effect on CBF. Therefore it is probable that this solution is more appropriate than saline for nasal irrigation and nebulization or antral lavage. Moreover, the results of this study suggest that mucolytic effects induced by hyperosmolarity should be attained preferably with hypertonic saline 7% in patients with cystic fibrosis or asthma. At this concentration, the ciliostatic effect is reversible, whereas irreversible changes are to be expected at higher concentrations.
Frontal Sinus Obliteration Using a Laterally Based Pedicled Pericranial Flap
Authors: Ducic Yadranko , Stone Thomas L. 
Published: November 2003

AbstractObjective: Fractures of the frontal sinus represent one of the more uncommon injuries of the maxillofacial skeleton. In an effort to avoid potential mucocele formation, frontal sinus obliteration has been put forward as the treatment of choice when there has been significant disruption of normal frontal sinus drainage. Traditionally, sinus obliteration has been accomplished with nonvascularized free adipose tissue or bone grafts and a variety of alloplastic materials. We developed a laterally based pedicled pericranial flap to accomplish frontal sinus obliteration.Study Design/Methods: A total of 10 consecutive patients underwent obliteration of the frontal sinus with a vascularized, pedicled, laterally based pericranial flap. The patients were clinically followed prospectively to ascertain whether any adverse effects could be detected.Results: With a follow‐up ranging from 6 months to 2 years, we have observed no adverse effects in any of the patients in whom this procedure was performed.Conclusions: Based on our preliminary results, we believe that the laterally based pedicled pericranial flap appears to provide readily available vascularized tissue, with no distant donor morbidity. It represents an inexpensive, safe, and effective modality that should be considered when treating this type of injury.
Long‐Term Results of Surgery for Temporal Bone Paragangliomas
Authors: Briner Hans Rudolf , Linder Thomas E. , Pauw Bernard , Fisch Ugo 
Published: November 2003

AbstractObjectives:Assessment of the long‐term results of surgery for temporal bone paragangliomas with special consideration of the patient's ability to cope with the functional deficits.Study Design:Retrospective review of 36 patients who had undergone resection of a temporal bone paraganglioma 10 to 15 years previously. Assessment of the patients' subjective view of the functional outcome and quality of life by a questionnaire.Methods:Clinical records were reviewed regarding size of tumor, technique of surgery, supportive therapy, and tumor recurrence. Patients were sent a 50‐item questionnaire evaluating their quality of life and the preoperative and postoperative function of cranial nerves VII through XII.Results:A complete tumor removal was achieved in 30 patients (83%). There was only one tumor recurrence. The major negative effects of surgery involved hearing and dysphagia, which deterioriated in 14 and 12 patients, respectively. Thirty‐five of the 36 patients (97%) reported that, despite deterioration, the cranial nerve deficits were still acceptable. Seventy‐five percent of the patients regained their preoperative quality of life and 97% returned to their previous occupation in 1 to 2 years.Conclusions:The otologic extradural approach allowed complete tumor removal in 83%, with minimal perioperative morbidity. No surgically induced central nervous system lesions occured. Tracheostomy was avoided and all patients resumed oral feeding. Full rehabilitation after removal of class C and CD paragangliomas may take 1 to 2 years. However, the fact that 97% of the patients finally resumed normal social life showed the ability of most patients to cope with the sequelae of surgery even in class C and CD paragangliomas.
Do corticosteroids induce apoptosis in nasal polyp inflammatory cells? in vivo and in vitro studies
Authors: Saunders Michael W. , Wheatley A. Hugh , George Sarah J. , Lai Theresa , Birchall Martin A. 
Published: November 2003

AbstractObjective/Hypothesis: Corticosteroids are an effective treatment for nasal polyposis. The exact mechanism of action is not certain. Recent research demonstrates that apoptosis (programmed cell death) in inflammatory cells is an important factor in the resolution of inflammation, and apoptosis is induced in eosinophils in cell culture with steroids. We hypothesized that inflammatory cell apoptosis is a key feature of regression of nasal polyps on exposure to steroids and examined this hypothesis in vivo and in vitro. Methods: A double‐blind, placebo‐controlled pilot study of fluticasone propionate aqueous nasal spray (FPANS) in nasal polyposis in humans in vivo was undertaken, and the effect of treatment on indices of cell death and proliferation measured. In addition, explants of nasal polyp tissue were maintained in vitro in short‐term tissue culture with dexamethasone at increasing doses (0.1–50 μmol) over varying time intervals and then analyzed for similar indices of proliferation and cell death. Results: Apart from a marginal increase in apoptotic: mitotic ratio in epithelium, little difference between the effect of FPANS and placebo was demonstrated in vivo. However, in vitro, apoptotic index was significantly increased in the stromal layers in relation to time of incubation (P = .0169), and a significant dose‐response relationship was demonstrated at 24 hours between stromal cell apoptosis and dexamethasone concentration (P = .001). Eosinophil apoptosis was confirmed by in situ end labeling and transmission electron microscopy. No steroid or time effect on epithelial cells was demonstrated in vitro. Conclusion: Corticosteroids induce apoptosis in inflammatory cells in human nasal polyps in vitro. This is not reflected by a similar response to FPANS at 14 days in vivo, but may still play a part in regression of polyps with other forms of administration or at other time points.
Predictive factors of nodal metastases in oral cavity and oropharynx carcinomas
Authors: Giacomarra Vittorio , Tirelli Giancarlo , Papanikolla Ledia , Bussani Rossana 
Published: November 2003

AbstractObjective: To estimate the value of tumor (T)‐related parameters (singly or in association) in predicting the presence of occult metastases in oral cavity and oropharynx carcinomas. Study Design: We considered tumor size (T size), Broders' grading of histologic differentiation (G), invasive cell grading (ICG), and thickness. For every single factor, we evaluated the correlation between the parameter and occult metastases in N0 neck disease, the correlation between the parameter and metastases independently from node (N) class, and the relation between the parameter and extracapsular spread. On the basis of previous results, we gave a score to each parameter that showed higher significativity the sum of which we called global score (GS). We compared the predictivity of metastasis of the GS to that of the single parameters to obtain a more efficacious index. Methods: Sixty‐one patients with carcinomas of the oral cavity and oropharynx who underwent surgery on T and N were examined. Results: Our preliminary results have highlighted a significant correlation between G, ICG, and the presence of occult metastases. No correlation between T size and metastases was highlighted. The GS obtained from G and ICG turned out to be highly significant. A strong correlation was found between the ICG score and extracapsular spread: a high risk of extracapsular spread was found in patients with an ICG score ⩾13. Conclusion: We perform elective neck dissection in T1–T2 N0 neck disease with ICG ⩾13 and GS1 ⩾9.
Stereotactic radiotherapy for locally recurrent nasopharyngeal carcinoma
Authors: Mitsuhashi Norio , Sakurai Hideyuki , Katano Susumu , Kurosaki Hiromasa , Hasegawa Masatoshi , Akimoto Tetsuo , Nozaki Miwako , Hayakawa Kazushige , Niibe Hideo 
Published: November 2003

AbstractObjective: To determine the efficacy of stereotactic radiotherapy (SRT) in the treatment of recurrent nasopharyngeal carcinoma. Study Design: A retrospective review of the outcome of SRT for patients with recurrent nasopharyngeal carcinomas following definitive conventional radiation therapy. Methods: Five patients were treated with daily static multiportal irradiation. Two Gy was administered with eight isocentric portals in a single plane 5 days a week, and the plane was changed for every 20 to 30 Gy. Of these patients, three had poorly differentiated squamous cell carcinoma. Tumor sizes ranged from 1 to 15 cm3, with a median size 3.2 cm3. Median follow‐up time from SRT was 34 months (range, 4–61 mo). Results: Four of five recurrent tumors responded well and achieved complete regression. Three patients have survived without evidence of local recurrence with a median follow‐up time of 34 months. Marginal recurrence was observed at the posterosuperior wall in a patient with adenoid cystic carcinoma at 30 months after SRT. One patient who received SRT after the two complete courses of radiation therapy died 6 months after SRT as a result of rupture of a branch of the left carotid artery, but autopsy revealed no local residual tumor. Conclusions: Stereotactic radiotherapy with isocentric multiportals in one plane, which is changed at every 20 to 30 Gy, can provide local control with acceptable toxicity in patients with recurrent nasopharyngeal carcinoma, but increased clinical experience and longer follow‐up will be necessary to evaluate the overall role of this technique in nasopharyngeal carcinoma.
Uses and limitations of fdg positron emission tomography in patients with head and neck cancer
Authors: Hanasono Matthew M. , Kunda Larisa D. , Segall George M. , Ku Grace H. , Terris David J. 
Published: November 2003

AbstractObjective: Numerous authors have reported the potential usefulness of positron emission tomography (PET). These studies have had conflicting results, at least partly owing to limited sample sizes. The objective of this study is to define not only the uses, but also the limitations of PET in patients with head and neck cancer. Study Design: Nonrandomized, retrospective analysis of PET at an academic institution. Methods: The authors performed 146 PET scans on 133 patients with head and neck cancer. Eighteen patients (19 PET scans) with thyroid disorders were excluded. A minimum 1 year of follow‐up was available in 84 patients, who were separated into groups based on whether the PET was used to detect unknown primary cancers (n = 20), stage neck nodal and distant metastases (n = 8), monitor response to nonsurgical therapy (n = 22), or detect recurrent or residual cancers (n = 34). The results of PET were compared with results from computed tomography (CT) and magnetic resonance imaging (MRI) performed in the same patients. Results: Of the unknown primary cancers, PET correctly identified 7 of 20 primary sites, giving a sensitivity of 35%. When combined with CT or MRI, the sensitivity increased to 40%. When used for detection of metastatic disease, PET demonstrated five of five nodal metastases (100%) and two of four distant metastases (50%). In evaluating the response to nonsurgical therapy, PET had a sensitivity of 50% and a specificity of 83% for detecting tumor at the primary site and a sensitivity of 86% and a specificity of 73% for detecting nodal disease. When used for evaluation of recurrent/residual disease, PET identified seven of seven cases of local recurrences/residual disease and had a specificity of 85%. PET also detected seven of seven cases of nodal disease and had a specificity of 89%. Conclusions: For staging purposes, PET is limited by its lack of anatomic detail. However, PET compares favorably with CT and MRI in detecting recurrent/residual cancers. PET imaging complements the more traditional imaging modalities (CT or MRI), especially for an unknown primary cancer. Key Words: Head and neck cancer, squamous cell carcinoma, positron emission tomography, unknown primary cancer, cervical lymph node metastasis.
Human temporal bone study on the postnatal ossification process of auditory ossicles
Authors: Yokoyama Tomoko , Iino Yukiko , Kakizaki Keiko , Murakami Yoshihiko 
Published: November 2003

AbstractObjective: In infancy the head of the malleus and body of the incus normally contain bone marrow, which is gradually replaced by bone and converted into vascular channels with age. This study was carried out to clarify the age at which ossification of the ossicles is complete and to examine factors influencing the ossification process. Study Design: Human temporal bone sections from 32 infants and children with or without congenital anomalies, aged 1 day to 9 years, who were born at term were studied. Methods: The percentage bone marrow area occupying the head of the malleus and body of the incus was calculated in three horizontal temporal bone sections for each case, using computer‐aided digital processing of images. Results: Bone marrow was observed in both the malleus and incus in children until 25 months of age, while after the age of 25 months no bone marrow tissue was present in either of the ossicles. It appeared that the bone marrow space disappeared somewhat earlier in the malleus than in the incus. The bone marrow space around the otic capsule disappeared much earlier than that within the ossicles. The age at completion of ossification was correlated with neither the presence of congenital anomalies nor the presence of residual mesenchyme in the middle ear. Conclusions: Ossification of the ossicles seems to occur steadily throughout fetal life and after birth during development of the middle ear. Although the clinical significance of postnatal residual bone marrow within the ossicles is not known, it possibly plays a role as a blood‐forming organ in early infancy. Key Words: Ossicles, bone marrow space, ossification, otic capsule, congenital anomaly.
Chronology of labyrinthitis ossificans induced by streptococcus pneumoniae meningitis
Authors: Nabili Vishad , Brodie Hilary A. , Neverov Nikita I. , Tinling Steven P. 
Published: November 2003

AbstractObjective: Labyrinthitis ossificans consists of novel osteogenesis that fills the normally patent cochlear and vestibular lumen as an end‐stage sequelae to various pathologies. This study was designed to establish the sequence of events and chronology of the osteoneogenesis and calcification. Study Design: A prospective randomized double‐blind study. Methods: By using serial application of different colored fluorochromes, which deposit in newly forming bone, the timing of bone deposition and bone remodeling can be established. Labyrinthitis ossificans was induced in she groups (n = 5) of gerbils by an intrathecal injection of live Streptococcus pneumoniae. Group 1 received no fluorochrome labels, group 2 received one label, group 3 received three labels, and groups 4, 5, and 6 received four labels. The temporal bones were harvested after 2 weeks (group 1), 1 month (group 2), 3 months (group 3), 4 months (group 4), 6 months (group 5), and 12 months (group 6). Results: Sixteen of the 25 animals that received labels developed ossification, demonstrated with fluorescent microscopy. In the animals that developed labyrinthitis ossificans, newly formed disorganized bone began calcifying as early as 3 weeks (label 1) after S pneumoniae injection. Osteoneogenesis continued as evidenced by the presence of the other labels when first applied at 6 weeks (label 2), and 10 weeks (label 3). Ossification, calcification, and remodeling proceeded through a 12‐month course, wherein a reduction of labels was present at 6 months and total disappearance by 12 months. Conclusions: The use of fluorescent stains in this animal model provides a means to establish a timeline of the ossification seen in labyrinthitis ossificans. Key Words: Ossified cochlea, labyrinthitis, deafness, cochlear implant, meningitis.