bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of Enhanced Magnetic Resonance Imaging in the Evaluation of Endocochlear Disease
Authors: Hegarty Joseph L. , Patel Sandy , Fischbein Nancy , Jackler Robert K. , Lalwani Anil K. 
Published: November 2003

AbstractBackground Gadolinium‐enhanced magnetic resonance imaging (GdMRI) is routinely used in the evaluation and management of suspected retrocochlear pathology such as vestibular schwannoma. However, its value in the evaluation and diagnosis of cochlear pathology associated with sensorineural hearing loss (SNHL) has been less clear.Study Design Retrospective review of case histories and imaging studies of patients with SNHL and cochlear enhancement on GdMRI diagnosed between 1998 and 2000.Results Five patients with SNHL who required gadolinium administration to establish the diagnosis of endocochlear disease were identified. Diagnosed lesions included an intralabyrinthine schwannoma, intracochlear hemorrhage, radiation‐induced ischemic change, autoimmune labyrinthitis, and meningogenic labyrinthitis. In these illustrative cases, the GdMRI demonstrated intrinsic high signal or contrast enhancement within the cochlea and labyrinth in the absence of a retrocochlear mass. In one patient with meningogenic labyrinthitis, cochlear enhancement on MRI led to prompt cochlear implantation before the potential development of cochlear ossification.Conclusion Our experience suggests that GdMRI plays a crucial role in the diagnosis of cochlear pathology associated with sensorineural hearing loss and may directly impact patient management.
MeroGel Hyaluronic Acid Sinonasal Implants: Osteogenic Implications
Authors: Jacob Abraham , Faddis Brian T. , Chole Richard A. 
Published: November 2003

AbstractObjectives/Hypothesis The study sought to evaluate the effects of MeroGel (Medtronic Xomed Surgical Products, Jacksonville, FL) hyaluronic acid sinonasal implants by using a mouse model. We expected that this material would dissolve, elicit minimal inflammation, and leave intact mucosa. However, pilot data showed that MeroGel may be osteogenic. The present work focuses on the description and quantification of these bony changes.Study Design Animal experiment.Methods The effects of MeroGel were evaluated using sinonasal and calvarial implants in C57BL/6 mice. The calvarial experiments employed both light microscopy (bone histomorphometry) and fluorochrome labeling (mineral apposition). Each implant study was subdivided into normal control animals, sham‐operated control animals, a foreign body control, and MeroGel implants. MeroGel was also placed within subcutaneous pockets remote from bone. All mice were killed 1 month after surgery. Both percentage of bone area within the sinonasal cavity and total calvarial bone area were quantified and compared. Fluorochrome images and the subcutaneous implants were examined qualitatively.Results MeroGel placement engendered new bone formation within the nasal lumen of mice. Compared with normal control animals, sham‐operated control animals, and a foreign body control, this increase was statistically significant. The calvaria from MeroGel‐implanted mice were thickened as compared with normal animals, sham‐operated control animals, and a foreign body control. Tetracycline labeling demonstrated mineral apposition along the dorsal and ventral surfaces of the calvaria and within enlarged marrow spaces. MeroGel placed subcutaneously did not engender bone formation.Conclusions MeroGel, a unique esterified form of hyaluronic acid, induced bone formation within the sinonasal cavity and on the calvaria of mice implanted with it. Our experiments suggest that, when placed adjacent to traumatized, remodeling bone, MeroGel may have osteogenic potential.
Elective, Therapeutic, and Delayed Lymph Node Dissection for Malignant Melanoma of the Head and Neck: Analysis of 1444 Patients From 1970 to 1998
Authors: Fisher Samuel R. 
Published: November 2003

AbstractObjective The purpose of this article is to evaluate the effects on survival, disease‐free interval, and recurrence patterns for patients undergoing elective, therapeutic, and delayed lymph node dissection for malignant melanoma of the head and neck.Study Design and Methods A retrospective computer‐aided analysis was performed comparing 1444 patients treated from 1970 to 1998 at Duke University Medical Center. A total of 446 of the 1444 (32%) of patients with head and neck melanoma underwent some form of lymph node dissection. Survival, disease‐free interval, and recurrence rates for patients having 1) no initial lymph node dissection (no LND), 2) elective lymph node dissection (ELND) within 2 months of date of diagnosis, 3) therapeutic lymph node dissection (TLND) for metastatic regional disease at diagnosis, or 4) delayed lymph node dissection (DLND) for patients developing regional lymph node metastasis later than 3 months from the date of diagnosis were compared.Results A total of 246 patients undergoing ELND demonstrated 11% with occult disease. DLND for regional lymph node recurrence was reported at a median time interval of 1.2 years from diagnosis. Multivariate analysis indicated a significant improvement in survival for DLND when compared with patients undergoing ELND⊕ or TLND (P = .01). Distant metastasis was the site of first recurrence in 12% of patients undergoing no initial LND. Five‐year survival after DLND and TLND was 56% and 36%, respectively.Conclusion Patients undergoing DLND had an overall better survival than patients undergoing TLND or ELND with positive nodes. The progression of metastatic disease following regional node disease occurred in 35% to 45% of cases, underscoring the need for effective adjunctive therapy.
Relationships Between Otoacoustic Emissions and Auditory Brainstem Responses in Neonates and Young Children: A Correlation and Factor Analytical Study
Authors: Cacace Anthony T. , Pinheiro Joaquim M. B. 
Published: November 2003

AbstractObjectives To establish relationships among transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR) variables in a sample of normal hearing neonates and young children, ranging in age from approximately 3 weeks to 4 years.Study Design Retrospective, non‐randomized, cross‐sectional analysis of clinical data obtained at a tertiary care medical center.Methods Pearson product moment and Spearman rank order correlation analyses to evaluate pairwise relationships between TEOAE variables, ABR variables and age; factor analysis, to identify the structural composition and dimensionality of these relationships.Results Significant pairwise correlations were obtained between variables within each test paradigm (TEOAEs, ABRs) and between ABR absolute and interpeak latencies with age. However, the most striking effect was the absence of strong correlations between ABR and TEOAE variables, indicating that these test measures provide independent information about auditory system integrity and sensitivity. Two factors, accounting for over 55% of the variance, characterized this data set: 1) a frequency‐dependent OAE factor, which showed an inverse relation between biologic noise and whole wave percent reproducibility and half‐octave band TEOAE amplitudes; and 2) a central nervous system (CNS) maturational factor, which showed an inverse relationship between age and certain absolute and interpeak ABR latency components.Conclusions TEOAE and ABR test results provide unique and functionally independent information about normal auditory system integrity and sensitivity. Therefore, a combination of both tests is well suited for use within a pediatric test battery. These results confirm that biologic noise and age at test differentially affect OAE and ABR test measures, and both effects require consideration during data acquisition and interpretation.
Otolaryngology Retirement Profile in the Southeastern United States
Authors: McGuirt W. Frederick , McGuirt William F. 
Published: November 2003

AbstractObjective To document retirement‐related issues and trends among otolaryngologists.Study Design Survey of 438 retired members in the Southern geographical region of the American Laryngological, Rhinological and Otological Society, Inc.Methods A questionnaire was mailed to retired members, completed anonymously, and returned to the author.Results A total of 138 (31.5%) surveys were received. Respondents' average age at retirement was 63.2 years; approximately half had retired in the last 5 years. Since 1995, most had left either a group practice (45%) or a solo practice (41%). The majority of respondents (40%) retired for previously planned or personal reasons. Two thirds of respondents reported that they were more satisfied with retirement than expected. This greater satisfaction was seen in those with a higher average income after retirement. The most common advice for colleagues still practicing was to save more money and invest more money.Conclusions Although these results are biased because of a self‐selected group of respondents, they illustrate that for this group of retired otolaryngologists, although retirement is being planned for, it is not occurring earlier than in previous years. The experience of retirement was largely positive for these respondents.
The Role of Computed Tomography and Magnetic Resonance Imaging in Patients With Sinusitis With Complications
Authors: Younis Ramzi T. , Anand Vinod K. , Davidson Beverly 
Published: November 2003

AbstractObjectives This study compares the use of computed tomography (CT) with magnetic resonance imaging (MRI) and clinical assessment in the diagnosis and surgical management of patients with sinusitis with complications. The common CT findings of patients with intracranial or orbital infection of sinusitis are reviewed.Study Design We reviewed the charts of 82 adult and pediatric patients with the diagnosis of sinusitis with intracranial or orbital infection who were seen at the University of Mississippi Medical Center from January 1985 through December 1999. We assessed the diagnoses and outcomes to determine the most effective use of CT, with or without MRI, in the treatment of these patients.Methods Clinical presentations were reviewed, along with the CT and MRI findings, for patients who had sinusitis with complications. Clinical, CT, and MRI findings were compared for accuracy in diagnosing 43 patients with orbital infections and 39 patients with intracranial infections.Results For patients with orbital complications, most of whom had unilateral ethmoiditis, the diagnostic accuracy was 82% for clinical assessment compared with 91% for CT. For patients with intracranial complications, meningitis was the most common diagnosis, and MRI was more accurate (97%) in determining the diagnosis than CT (87%) or clinical findings (82%).Conclusion CT remains the standard modality for diagnosing sinusitis, but MRI frequently is necessary, especially for patients with intracranial complications. Both diagnostic methods have improved the management and outcomes of patients who have sinusitis with complications.
Preoperative versus Postoperative Role of Vestibular‐Evoked Myogenic Potentials in Cerebellopontine Angle Tumor
Authors: Chen Cheng‐Wei , Young Yi‐Ho , Tseng Ham‐Min 
Published: November 2003

AbstractObjective/Hypothesis Vestibular‐evoked myogenic potential (VEMP) examination was performed on patients with a cerebellopontine angle (CPA) tumor to evaluate its clinical role.Methods Patients with a CPA tumor were subjected to caloric test and VEMP examination. Follow‐up study was performed 1 year after the surgery.Results Six (69%) of the 9 tumors did not exhibit either caloric response or VEMP on the lesioned side. Three patients received tumor excision and all tumors involved both the superior and inferior vestibular nerves. Two (22%) of the 9 tumors had normal caloric responses but no VEMP. One underwent surgical excision, and the tumor originated from the inferior vestibular nerve. In the follow‐up study, only 1 patient with epidermoid cyst presented complete recovery of caloric response and VEMP, whereas in the other 3 patients with vestibular schwannoma, the responses were all absent persistently.Conclusion Before surgery, VEMP test can be used to predict the nerve of origin and to formulate the best surgical approach. After surgery, VEMP test can be used to define the nature of the tumor (compressing or infiltrating the nerve) and disclose the residual function of the inferior vestibular nerve.
Endoscopic Repair of Bilateral Congenital Choanal Atresia
Authors: Khafagy Yasser W. 
Published: November 2003

AbstractObjective The literature about endoscopic repair of bilateral choanal atresia is scarce. The advantages and difficulties encountered with this technique are discussed.Study Design Prospective case series in a tertiary care center.Methods Nine infants with bilateral choanal atresia underwent transnasal endoscopic repair. On computed tomography scans, six had mixed atresia and three had bony atresia. Extra‐long burrs, ear curettes, and dissectors all have been used with 4‐ and 2‐mm, 0° telescopes. The neochoana has been stented for 5 to 8 weeks. All cases were examined with the endoscope on removal of the stent; any granulation or polyps were removed at that time.Results Five cases remained patent after removal of stenting. Two patients required revision surgery because of repeat stenosis; one case remained patent and the other had repeat stenosis on one side. One infant died because of unrelated medical problems that occurred later. In one case the atretic tissue was thick, and the procedure was stopped because of bleeding; the infant died in the postoperative period after resuscitation.Conclusion Careful review of the computed tomography scan and experience with endoscopic nasal surgery makes the transnasal endoscopic treatment a safe and effective approach for managing bilateral choanal atresia.
CO2 Laser Cordectomy for Early‐Stage Glottic Carcinoma: A Long‐Term Follow‐up of 156 Cases
Authors: Gallo Andrea , de Vincentiis Marco , Manciocco Valentina , Simonelli Marilia , Fiorella Maria Luisa , Shah Jatin P. 
Published: November 2003

AbstractObjectives To define when laser resection of early‐stage glottic carcinoma is indicated and to compare the results obtained by laser surgery with other therapeutic options.Study Design Retrospective study of 151 patients treated from April 1982 to June 1996 in the Department of Otorhinolaryngology at “La Sapienza” University. We provide analysis of indications, techniques, and oncologic results of this study.Methods Glottic tumors were treated with type III, type IV, and type Va cordectomies according to the classification of endoscopic cordectomies proposed by the European Laryngological Society in 2000.Results The results are summarized as follows: all patients with carcinoma in situ Tis are free of disease with local control rate at 3 years of 100%; 2 died of other causes without evidence of local recurrence with an overall survival rate at 3 years of 83.2%. Of the 117 patients with stage T1a cancer, 110 are free of disease at 3 years with local control rate of 94%; 4 patients died of other causes without evidence of local recurrence with an overall survival rate of 96.5%. Of the 22 patients with stage T1b cancer, 20 are free of disease at 3 years with a local control rate of 91%; 1 patient died of other causes without evidence of local recurrence with an overall survival rate at 3 years of 95.4%.Conclusions According to our experience, we can conclude that endoscopic laser surgery is an efficacious and cost‐effective treatment for early stage glottic cancer.
First Evidence of Genetic Imbalances in Angiofibromas
Authors: Schick Bernhard , Brunner Christian , Praetorius Mark , Plinkert Peter Karl , Urbschat Steffi 
Published: November 2003

AbstractObjective/Hypothesis Angiofibromas are clinically well characterized by their origin at the posterior lateral nasal wall close to the sphenopalatine foramen, their occurrence in male adolescent patients, and the histological findings of a benign fibrovascular neoplasm with irregular, endothelium‐lined vascular spaces in a fibrous stroma. However, their etiology and genetic causes remain unknown. The present study addresses genetic imbalances in angiofibromas.Study Design The present pilot study compared genomic hybridization in three angiofibromas to search for chromosomal abnormalities in this rare tumor.Methods Fluorescence‐marked normal DNA and angiofibroma DNA were compared using genomic hybridization screening to detect chromosomal abnormalities. Their binding ratio to metaphase chromosomes were analyzed by special digital image analysis.Results Chromosomal gains and losses showing a high level of agreement were detected in all three angiofibromas. Specifically, DNA gains were observed on chromosomes 3q, 4q, 5q, 6q, 7q, 8q, 12p, 12q, 13q, 14q, 18q, 21q, and X, and DNA losses were screened on chromosomes 17, 19p, 22q, and Y. Finding chromosomal abnormalities at the sex chromosomes X and Y of this rare tumor is remarkable. Concurrent chromosomal gain on 8q12q22 was noted in all three tumor specimens.Conclusions Comparative genomic hybridization is suitable for screening angiofibromas on a genetic level. The results on these screens indicate that further genetic investigations of this rare benign tumor may provide more details about the tumor's genetic abnormalities and perhaps clarify the etiology of angiofibromas.
Prognostic Indicators of Occult Metastases in Oral Cancer
Authors: Russolo Mario , Giacomarra Vittorio , Papanikolla Ledia , Tirelli Giancarlo 
Published: November 2003

AbstractObjective We evaluated the importance of several tumor factors related to predicting the presence of occult metastases in the oral cavity.Study Design Retrospective case study.Methods The study comprises 29 patients treated at the Department of Otorhinolaryngology (University of Trieste, Cattinara Hospital, Trieste, Italy) between January 1990 and December 2000, who had T1‐T2 carcinoma of the oral cavity that had or had not extended to the oropharynx and were clinically evaluated as N0 neck. The patients all underwent surgery with removal of tumor and neck dissection. Four tumor‐related parameters were examined with the aim of evaluating their predictivity of metastasis: tumor class, degree of keratinization, degree of differentiation according to Brooler's histopathological grading, and invasive cell grading (ICG). With the exception of tumor class, these parameters were evaluated both in the biopsy and in the surgical specimen and the findings were then compared. We evaluated existing correlations between each individual parameter and the histopathological presence of micrometastases (pN+) and extracapsular spread revealed when specimens from the neck were examined.Results There was a highly significant correlation between ICG equal to or greater than 13 (range, 5–20) and the presence of occult metastases (P = .0017). On the basis of our findings, the ICG parameter correctly identified 9 of 10 (pN+) patients and could have reduced overtreatment from 65.5% to 17.2% in histopathological necks (pN0).Conclusion It would appear that with a delay in programming a neck dissection so as to consider ICG in combination with thickness, as in seven recent patients, identification of locoregional occult metastases (pN+) might be more precise.
Parotid Gland Metastasis From Renal Cell Carcinoma
Authors: Park Youn W. , Hlivko Thomas J. 
Published: November 2003

AbstractObjectiveTo discuss the diagnosis and management of metastatic renal cell carcinoma presenting as a parotid mass by studying such cases.Study DesignRetrospective review.MethodsIdentification of 24 previously reported cases of renal cell carcinoma metastatic to the parotid gland in the English language literature and an analysis of a total of 25 patients including our case.ResultsParotid metastasis was the initial presenting sign of the malignancy in the kidney in 14 of 25 (56%) cases; 11 of 25 (44%) cases presented with metachronous metastasis to the parotid. The most common presenting complaint was parotid mass. No case presented with facial paralysis. In three of six (50%) patients, fine‐needle aspiration biopsy was diagnostic.ConclusionsIn the majority of cases, parotid metastases are the first clinical sign of the renal cell carcinoma. Fine‐needle aspiration biopsy can provide crucial information without parotidectomy as in our case. Parotidectomy with facial nerve preservation should be considered as a therapeutic option for solitary parotid metastasis.
Epstein‐Barr Virus Latent Membrane Protein‐1 (LMP‐1) Expression in Oral Squamous Cell Carcinoma
Authors: Gonzalez‐Moles M. A. , Gutierrez J. , Rodriguez M. J. , Ruiz‐Avila I. , Rodriguez‐Archilla A. 
Published: November 2003

AbstractObjectives Epstein‐Barr virus (EBV) is frequently associated with malignant cell transformation through the action of the oncoprotein latent membrane protein‐1 (LMP‐1). The present study aimed to determine the presence of EBV in oral squamous cell carcinomas (OSCCs) and the expression of LMP‐1 in neoplastic cells of EBV‐positive OSCCs.Study Design/Methods In a retrospective study of 78 OSCCs, we investigated the presence of the DNA of EBV by polymerase chain reaction, the expression of the oncoprotein LMP‐1 by immunohistochemistry, and the presence of EBV‐encoded RNA (EBER) by in situ hybridization.Results EBV DNA was detected in 19.2% of the cases. Expression of LMP‐1 in neoplastic cells was found in 85.7% of the EBV‐positive OSCCs. EBV presence was significantly more frequent (P <.05) in OSCCs localized on the lateral tongue. EBV‐positive OSCCs more frequently presented (P <.05) greater nuclear atypia.Conclusion EBV can appear in latent form in OSCC and express its main oncoprotein, LMP‐1.
The Axillary Flap Approach to the Frontal Recess
Authors: Wormald Peter John 
Published: November 2003

AbstractObjectives To evaluate the access to the frontal recess using the axillary flap approach by identifying the frontal ostium during endoscopic sinus surgery.Study Design Prospective review of 64 consecutive patients (118 sides) undergoing axillary flap exposure of the frontal recess between November 1998 and July 1999.Methods Demographic data, identification of the frontal ostium, findings at surgery, use of nasal packing, the presence of postoperative symptoms, revision surgery, and the endoscopic appearance of the frontal recess were collected. The operative technique is presented.Results The frontal sinus ostium was identified in 96% of patients (104 of the 118 sides). Eight sides had Kuhn type 3 cells that required removal for clearance of the frontal ostium. Eighty‐two percent of sides (97 sides) had endoscopically healed sinuses without symptoms after an average follow‐up of 15.4 months. Six sides had middle meatal adhesions requiring division under local anesthetic. One patient has required revision surgery.Conclusion The axillary flap approach to the frontal recess provides excellent access to the frontal recess and allows clearance of cells in the recess with identification of the frontal ostium in the vast majority of cases.