bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facial nerve rehabilitation after radical parotidectomy
Authors: Reddy Pavan G. , Arden Richard L. , Mathog Robert H. 
Published: November 2003

AbstractObjective: Examine functional outcomes in patients undergoing radical parotidectomy and facial nerve grafting. Identify factors that may affect rehabilitation in these patients. Study Design: Retrospective chart review and photographic analyses of 12 patients undergoing radical parotidectomy with interposition nerve grafts for facial nerve reconstruction. Methods: Data obtained for each patient regarding age, sex, histology of parotid neoplasm, cable graft source, administration of postoperative radiotherapy, and treatment for eye rehabilitation. Functional outcomes were assessed with the House‐Brackmann grading system at 6 months, 1 year, and 2 years after surgery. Results: All nerve grafts were harvested from cervical plexus sensory nerves with microscopic epineural repair performed for all neurorrhaphies. Overall, 9 of 12 patients achieved a grade III 2 years after surgery. All patients under age 30 obtained a grade III. Of the seven patients receiving postoperative radiation, five achieved a grade III. Older patients often required surgical procedures to facilitate eye closure. Conclusions: Facial nerve rehabilitation after radical parotidectomy can be successfully achieved with cervical plexus interposition nerve grafts. Postoperative radiotherapy did not appear to affect return of function, and younger patients consistently achieved good functional outcomes after nerve grafting. Older patients frequently require surgical procedures for eye rehabilitation after radical parotidectomy. Key Words: Radical parotidectomy, facial nerve, facial nerve rehabilitation, interposition nerve grafts, functional outcome.
An anatomical study of anastomoses between the laryngeal nerves
Authors: Sañudo Jose‐Ramón , Maranillo Eva , León Xavier , Mirapeix Rosa‐María , Orús Cesar , Quer Miquel 
Published: November 2003

AbstractObjective: To systematize the anatomy of the connecting branches between laryngeal nerves. Methods: Microdissection of 90 larynges obtained from necropsies (57 men and 33 women; age range, 41–95 y). Results: Anastomoses between the internal and recurrent nerves appeared in four different patterns: 1) Galen's anastomosis, as the connection between the dorsal branches of both nerves (100%); 2) arytenoid plexus, as the connection between the arytenoid branches of both nerves, in relation with the arytenoid muscle, and divided in a deep part (100%) and a superficial part (86%); 3) cricoid anastomosis, previously only described in cows, located in the front of the cricoid lamina (6/10 cases); and 4) thyroarytenoid anastomosis, as the connection of a descending branch of the internal laryngeal nerve and an ascending branch of the recurrent nerve (14%). Anastomosis between the internal laryngeal and the external laryngeal nerves appeared as a connecting branch throughout the foramen thyroideum (21%). Anastomosis between the external laryngeal and recurrent nerves appeared as a connecting branch throughout the cricothyroid muscle (68%). Conclusion: At least two anastomoses (Galen's anastomosis and arytenoid plexus) appeared in 21% of hemilarynges, and 79% of cases had three or more anastomoses between the laryngeal nerves. The different prevalence of this complex anastomotic pattern suggests functional differences in the sensory and motor innervation of individual subjects. Key Words: Larynx, innervation, anastomosis, nerves.
Pulmonary function after total laryngectomy
Authors: Hess Markus M. , Schwenk Ragnhild A. , Frank Wolfgang , Loddenkemper Robert 
Published: November 2003

AbstractObjective: To present data on pulmonary function in 59 laryngectomees using a specially designed silicone adapter for connection of the stoma to the bodyplethysmograph. Study Design: Prospective assessment of pulmonary function in 59 patients, and comparison of lung function before and after bronchodilator testing in selected cases. Methods: The usefulness of the adapter was examined. Data of patients with airway obstruction were tabulated according to large airway obstruction (LAO), peripheral airway obstruction (PAO), and small airway disease (SAD) types. Results: Findings show that pulmonary airway obstruction was present in 81% of patients and normal pulmonary function was present in only 11 of the 59 participants (19%). LAO was found in 25%, PAO in 17%, and SAD in 39% of cases. Emphysema was diagnosed in 14% of cases within the above‐mentioned LAO and PAO groups. Improvement of pulmonary function was achieved in 12 of 16 laryngectomees with airway obstruction, when a bronchodilator aerosol was administered. In 60% of cases with LAO and PAO, the laryngectomees did not know of any marked obstruction of their airways, and only 10% of those knowing about their obstruction received appropriate medical treatment. Conclusions: These results suggest that 42% of the laryngectomees tested may have benefited from further medical treatment. After laryngectomy, pulmonary function assessment was performed elsewhere in 1 of 59 cases. In light of the high prevalence of airway obstruction in laryngectomees, more frequent postoperative assessments of pulmonary function should be offered to prevent or to reduce impairment of respiratory function in this postlaryngectomy vulnerable pulmonary status. Further studies are also needed to determine the effects of therapeutic intervention, e.g., assessment of therapy outcome and influence on quality of life. Key Words: Adapter, bodyplethysmography, bronchodilator response, laryngectomy, pulmonary function.
Cochlear Implantation in Children With Enlarged Vestibular Aqueducts
Authors: Bent John P. , Chute Patricia , Parisier Simon C. 
Published: November 2003

AbstractObjectives: This report details our experience with cochlear implantation in children with both profound sensorineural HL (SNHL) and enlarged vestibular aqueducts (EVAs). It seeks to determine if the abnormal anatomy of EVA predisposes to any adverse events during or after cochlear implantation. Study Design: A retrospective review. Methods: Charts were reviewed for details of the procedure, complications, and audiologic outcome. Results: Between 8/25/93 and 9/16/98, 10 children with EVAs received cochlear implants, of whom 8 children (5 males, 3 females; mean age 7.8 y) had audiologic follow‐up of at least 6 months. The implant was inserted without difficulty in all patients. Pulsatile clear fluid via the cochleostomy was observed in five patients, but was easily controlled in each instance. There have been no major complications, although two patient had shortlived postoperative vestibular symptoms and one child has experienced an intermittent pulsing sensation in her head. Speech perception measures were obtained using a battery of tests that assessed the children's ability to perceive speech in both open‐ and closed‐set formats. Two patients were excluded because the implant was placed within the last 6 months. Of the remaining eight children identified with EVAs, seven (86%) demonstrated open‐set word recognition. Conclusions: These favorable results may be attributed in part to HL that occurs relatively late in childhood, allowing implantation in postlingual candidates. Cochlear implantation can be safely and effectively performed in children with SNHL associated with EVAs.
Orbital Measurement in Black and White Populations
Authors: Barretto Roberto L. , Mathog Robert H. 
Published: November 2003

AbstractObjective: Obtain measurements of globe projection, intercanthal distance (ICD), interpupillary distance (IPD), palpebral fissure width (PFW), and palpebral fissure height (PFH) in a population of presumably normal white and black adults to determine if any significant differences exist between these groups. Study Design: Prospective direct measurement of cohorts regarding orbital and globe measurements in a tertiary medical center. Methods: Measurements of globe projection, ICD, IPD, PFW, and PFH were taken in 61 black adults and directly compared with measures taken from 65 white adults in an outpatient setting. Mean values and ranges were calculated and compared between races and sexes using an unpaired t test. Results: A significant difference was found between races for globe projection, with black males demonstrating a mean projection of 18.23 ± 2.26 mm as compared with 17 ± 2.65 mm for white males (P > .025). Black females demonstrated a mean projection of 17.27 ± 1.44 mm as compared with 15.98 ± 2.22 mm for white females (P > .01). Similar differences were seen for measures of IPD and PFW, with greater mean values for black as compared with white adults. No racial differences existed for ICD or PFH. Conclusions: These findings suggest that racial differences exist for certain measures of globe and orbital position, i.e., projection, IPD, and PFW. Racial background should be considered when evaluating orbital anatomy.
An External Landmark for the Anterior Commissure
Authors: Adams Jeff , Gross Neil , Riddle Seth , Andersen Peter , Cohen James I. 
Published: November 2003

AbstractObjective: The ability to predict the level of the true vocal cords based on external landmarks is crucial to the success of many laryngeal surgical procedures. This study examines the reliability of one such landmark on the thyroid cartilage. Methods: Twenty‐four cadaver larynges were examined. A pin was placed through the landmark, best described as a small diamond shaped area of color change and surface depression along the anterior midline of each thyroid cartilage through which travels a very small unnamed artery. The endolaryngeal position of the pin was checked with a flexible nasopharyngoscope. Results: In all 24 cadavers, the pin entered the larynx at the anterior commissure, just above or at the level of the true vocal cords. Conclusions: This external landmark reliably predicts the position of the true vocal cords. It serves as a useful adjunct to existing external landmarks used to direct thyroid cartilage cuts in laryngeal procedures.
Characterization of Cyclooxygenase in Laryngeal Papilloma by Molecular Techniques
Authors: Robinson Ann B. , Das Sanjoy K. , Bruegger Daniel E. , Hoover Larry A. , Sanford Thomas R. 
Published: November 2003

AbstractObjectives: Demonstrate the induction of cyclooxygenase‐2 (COX‐2) in laryngeal papilloma. Discuss the possible causal role of COX‐2 in papilloma formation. Consider the potential for treatment of papilloma using selective COX‐2 inhibitors. Study Design: Molecular biological analysis of COX‐1 and COX‐2 in laryngeal papilloma. Methods: Tissue samples from five patients with recurrent respiratory papillomatosis (RRP) were analyzed by in situ hybridization, immunohistochemical staining, and reverse transcription polymerase chain reaction (RTPCR) techniques. Results: In situ hybridization to COX‐2 mRNA showed strong autoradiographic signal surrounding fibrovascular cores. COX‐1 autoradiographic signal was low intensity or nondetectable. Normal buccal mucosa biopsies showed low‐density or nondetectable autoradiographic signal for both COX‐1 and COX‐2 mRNAs. In situ hybridization results were corroborated by RT‐PCR studies. Levels of COX‐2 mRNA were 13‐fold more than those in normal mucosa. Immunohistochemical staining for COX‐1 and COX‐2 showed a similar pattern to that seen with in situ hybridization in both normal and papilloma tissues. Conclusions: There is an elevation of COX‐2 expression in papilloma tissues. This may represent a causal role of COX‐2 in the formation and proliferation of laryngeal papilloma. There may also be a role for selective COX‐2 inhibition for the treatment of RRP.
Upper Aerodigestive Tract Liposarcoma: Report on Four Cases and Literature Review
Authors: Mandell David L. , Brandwein Margaret S. , Woo Peak , Som Peter M. , Biller Hugh F. , Urken Mark L. 
Published: November 2003

AbstractObjective: To report on the clinical behavior, histopathology, treatment, and prognosis of laryngeal, hypopharyngeal, and cervical esophageal liposarcomas.Study Design: Retrospective reviews of pathology files and hospital records at a tertiary care hospital and a retrospective search of the English‐language literature.Methods: Cases of upper aerodigestive tract (UADT) liposarcoma with adequate histopathologic documentation and clinical information were included for review.Results: Four cases of UADT liposarcomas were identified. The literature review revealed 26 cases of laryngeal liposarcomas, 7 cases of hypopharyngeal liposarcomas, and 6 cases of esophageal liposarcomas: the mean age at presentation was 55.8 years, the male:female ratio was 5:1, and 60% of the patients presented with dysphagia. Eighty‐six percent of tumors had low‐grade histologic findings. The recurrence rate after primary resection was 50%. Recurrence correlated with surgical procedure rather than with histologic subtype; 94.7% of recurrences happened after simple excision. Distant metastases occurred in three patients; two of them died of the disease.Conclusions: The literature supports that UADT liposarcomas are rare and usually of low‐grade histologic type. The rate of metastatic disease and tumor‐related mortality is low. However, high recurrence rates have been noted, particularly when less radical surgery is employed.
Utilization of Panoramic Radiographs to Evaluate Short‐Term Complications of Mandibular Fracture Repair
Authors: Childress Curtis S. , Newlands Shawn D. 
Published: November 2003

AbstractObjectives/Hypothesis: Detection of complications after mandibular fracture repair is generally based on the clinical examination. However, postoperative evaluation of the patient often includes imaging of the repaired mandible. At our institution, the majority of patients with mandibular fracture have had at least one panoramic mandible radiograph taken post‐operatively. The purpose of this study was to assess whether these radiographic studies contributed to detection of complications and thereby had an impact on the clinical course of the patient.Study Design: Retrospective review.Methods: The available medical records over a 5‐and‐a‐half‐year period of all patients who were treated at our institution for a fractured mandible were reviewed. Patients included in the study were those who were followed for at least 2 months and two postoperative visits.Results: Our series of 289 patients included 25 patients with complications. Of these patients, 24 had postoperative panoramic radiographs. All of the complications were discovered based on history and physical examination. In six of the patients with complications, the panoramic radiograph was suspicious for a complication. There were five false‐positive studies of the 240 postoperative studies performed in patients without complications. No complications were diagnosed based on radiography.Conclusions: After surgical treatment of mandibular fractures, panoramic radiographs add little to the physical examination and history toward the detection of complications. We believe that panoramic radiographs need not be used routinely, but may be reserved for patients who have complaints or physical findings suggestive of complications.
Increased Stability of Airflow Following Botulinum Toxin Injection
Authors: Finnegan Eileen M. , Luschei Erich S. , Gordon James D. , Barkmeier Julie M. , Hoffman Henry T. 
Published: November 2003

AbstractObjectives: The purpose of this study was to determine whether stability of airflow, as well as mean airflow, increased following botulinum toxin injection to laryngeal and extralaryngeal muscles in persons with spasmodic dysphonia (SD), some with associated vocal tremor (VT).Study Design: Aerodynamic data were collected from five subjects before and at 2, 4, and 8 weeks after they received treatment by each of two different arms in an injection protocol in a crossover study. One arm of the protocol involved treatment of the thyroarytenoid muscles only. The other arm involved treatment of both the thyroarytenoid muscles and the strap muscles.Methods: Measures of mean airflow and coefficient of variation (COV) of airflow during phonation were obtained. A decrease in the COV of airflow would indicate increased stability of phonatory airflow.Results: Before treatment, all subjects with SD/VT exhibited mean airflows that were similar to controls. The COV of airflow ranged from normal to substantially elevated. Following botulinum injection, mean airflow characteristically increased and COV of airflow decreased.Conclusions: This finding suggests there is a change in the type, as well as the level, of activity in the muscles of speech production following botulinum toxin injection. The increase in airflow stability identified could be due to increased stability of the laryngeal system and possibly of the respiratory system as well.
Conductive Hearing Loss Results in a Decrease in Central Auditory System Activity in the Young Gerbil
Authors: Tucci Debara L. , Cant Nell B. , Durham Dianne 
Published: November 2003

AbstractObjectives/Hypothesis: The impact of childhood conductive HL (CHL) on development of auditory function has long been debated. The present study was conducted to define and compare the consequences of CHL and cochlear ablation (CA) in young and adult animals, using 2‐deoxyglucose (2‐DG) uptake as a measure of metabolic activity. It was hypothesized that, for both ages, CHL would result in a decrease in activity in the major ascending central auditory system pathway of the manipulated ear, but that this decrease would be significantly less than that observed with CA.Study Design: Sham‐controlled study of metabolic effects of CHL during sound stimulation.Methods: Gerbils (aged 21 days or adult), underwent malleus removal, CA, or a sham procedure. Young animals survived either 48 hours or 3 weeks; adults survived 3 weeks. Each age/survival CHL group contained eight animals; otherwise, each group (CA and sham) contained five animals, for a total number of 54. At the appropriate survival time, animals were given an intracardiac injection of 14C‐2‐DG, and sacrificed under anesthesia after 45 minutes of exposure to normal laboratory sounds. Tissue sections were prepared for exposure to x‐ray film for optical density measurements, and alternate sections stained for identification of nuclei. Measurements from auditory nuclei of experimental animals were corrected against an unaffected control area (abducens nucleus) and compared with measurements taken from animals in the sham group. Auditory evoked potential thresholds to both air‐ and bone‐conducted stimuli were obtained in a second group of neonatal and adult animals.Results: Both CHL and CA resulted in a marked decrease in 2‐DG uptake in the major ascending projection of the manipulated ear, in both the neonatal and adult animals. In young animals, effects of CHL and CA were similar. Effects of CHL in adult animals were less marked and significantly different from either effects of CHL in young animals or effects of CA in adult animals. HL following malleus removal only was purely conductive and ranged from 38 to 55 dB across frequency.Conclusions: Results suggest that, particularly in young animals, a unilateral CHL may have profound effects on metabolic activity in the central auditory system.
Second Laryngeal Cancers in Previously Treated Larynges
Authors: McGuirt W. Frederick , Ray Mark 
Published: November 2003

AbstractObjectives: To review the management and outcome of patients with new second primary cases of laryngeal cancer occurring more than 3 years after the initial cancer was treated.Study Design: Retrospective review of 855 patients with newly diagnosed and treated laryngeal cancers.Methods: Charts were reviewed and tabulated for occurrence of second primary laryngeal tumors, method of treatment for the index and second primary laryngeal tumors, and effect of smoking status or cessation of smoking.Results: Of the 855 patients, 532 patients retained their larynx; of these 377 lived more than 3 years and thus were at risk for a second new primary cancer. Of these 377 patients at risk, 19 or 5.1% developed second primary tumors. The rate of second primary disease was lower in patients whose index laryngeal cancer was treated by irradiation (4.3%) compared with those treated surgically (9.2%). However, surgical treatment of second primary laryngeal tumors resulted in far higher rates of laryngeal voicing (82%) compared with irradiation (33%).Conclusion: When possible, management of the index primary tumor by endoscopic resection has resulted in the highest future retention of laryngeal speech, leaving all treatment options available should a second laryngeal cancer occur. Lifelong follow‐up of patients with laryngeal cancer for secondary primary tumors is important. Second primary tumors were equally distributed between patients who continued to smoke and ceased to smoke after their index primary lesion was diagnosed.
Maxillary Sinus Mucoceles: Clinical Presentation and Long‐Term Results of Endoscopic Surgical Treatment
Authors: Busaba Nicolas Y. , Salman Salah D. 
Published: November 2003

AbstractObjective: To describe the clinical presentation of maxillary sinus mucoceles, understand their pathogenesis, and determine the long‐term efficacy of the endoscopic surgical treatment.Study Design: Retrospective review.Methods: Thirteen consecutive patients who presented with maxillary sinus muco(pyo) celes were studied. Subjects with history of preceding sinus/nasal surgery or facial trauma were excluded. The presenting signs and symptoms, radiological findings, and surgical management were reviewed.Results: There were six women and seven men with an age range of 31 to 71 years. Two patients had environmental allergies. Nine patients complained of cheek pressure or pain, six of nasal obstruction, and eight of nasal drainage. On endoscopic nasal examination, the medial wall of maxillary sinus was bulging with prolapsed middle meatal mucosa in 10; drainage was seen in 7, but none had polyps. The sinus involvement was limited to the maxillary sinus and the ipsilateral ethmoid on computed tomographic studies in 10 cases. Patients were treated with endoscopic ethmoidectomy, middle meatal antrostomy, and marsupialization of the mucocele. Intraoperative cultures grew organisms in five patients. Postoperative follow‐up ranged between 10 and 66 months. Two patients required lysis of adhesions in the middle meatus, and one, revision antrostomy. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa at latest follow‐up. The presenting symptoms resolved or improved in 12 cases.Conclusions: The etiology of maxillary sinus mucoceles is not well understood. Mechanical obstruction or allergy or both do not seem to play an important role. An infectious origin is also not supported by the above data. Endoscopic sinus surgery is a reliable therapeutic measure with a favorable long‐term outcome.