bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic antibiotics in surgery for chronic ear disease
Authors: Hester T. Oma , Jones Raleigh O. 
Published: November 2003

AbstractObjectives/Hypothesis: The role of prophylactic antibiotics in otologic surgery continues to be debated and perhaps misused. Prior studies have provided conflicting evidence with regard to the benefit obtained from the use of prophylactic antibiotics in surgery for chronic otitis media. The current study was designed to evaluate the role of prophylactic antibiotics in the outcomes of surgery for chronic ear disease. It was the authors' impression that there was no indication for prophylactic antibiotics in such surgery. Study Design: Randomized prospective study performed in a tertiary care facility. Methods: Patients who met inclusion criteria (n = 146) were randomly assigned to an antibiotic treatment group or a control group receiving no prophylactic antibiotics. Patients in the antibiotic treatment group were given preoperative intravenous antibiotics followed by oral antibiotics for 5 days after surgery. Patients were followed postoperatively and observed for clinical evidence of infection and graft failure. Results: There was no statistically significant difference between the two groups with regard to the incidence of postoperative infection or graft survival. Conclusions: The use of prophylactic antibiotics in surgery for chronic ear disease cannot be recommended based on the findings of this study.
Familial mondini dysplasia
Authors: Griffith Andrew J. , Telian Steven A. , Downs Catherine , Gorski Jerome L. , Gebarski Stephen S. , Lalwani Anil K. , Sheldon Susan 
Published: November 2003

AbstractObjectives/Hypothesis: To determine the mode of inheritance of familial nonsyndromic Mondini dysplasia. Study Design: Correlative clinical genetic analysis of a single kindred. Methods: Clinical history, physical examination, audiologic analysis, computed tomography of the temporal bones, and cytogenetic analysis. Results: The male proband, three affected sisters, and an affected brother are offspring of unaffected parents. The mother and an unaffected brother have audiologic findings suggestive of heterozygous carrier status for a recessive hearing loss gene. Conclusions: Pedigree analysis indicates autosomal recessive inheritance in this family. The observed inheritance and clinical, audiologic, and radiologic findings are different from those previously described for another family with nonsyndromic Mondini dysplasia.1 The phenotype in this study family therefore represents a distinct subtype, indicating clinical and genetic heterogeneity of this disorder. This information should facilitate future molecular linkage analyses and genetic counselling of patients with inner ear malformations. Key Words: Mondini, sensorineural, hearing loss, familial, inner ear.
Management of thyroid carcinoma invading the aerodigestive tract
Authors: Bayles Stephen W. , Kingdom Todd T. , Carlson Grant W. 
Published: November 2003

AbstractObjectives: To evaluate approaches to thyroid carcinoma invading the aerodigestive tract, with particular attention to well‐differentiated carcinomas. Study Design: Retrospective review of experience with thyroid carcinoma invading the aerodigestive tract over a 20‐year period at a tertiary referral hospital. Methods: The medical records of all patients with a diagnosis of thyroid cancer treated at Emory University Hospital, Atlanta, Georgia, from 1977 through 1997 were reviewed. Multiple clinical variables were analyzed including treatment, development of recurrence, and survival. Survival and time to local recurrence were determined by Kaplan‐Meier analysis, and statistical comparisons were made using log‐rank analysis. Results: Five hundred thirty‐six cases were identified; 28 patients (5.2%) were identified with invasive disease involving the aerodigestive tract. Histologic findings at the time of invasion included 15 well‐differentiated (WD) carcinomas and 13 poorly differentiated (PD) carcinomas. Eight of the 28 patients (5 WD, 3 PD) underwent surgical resection of some portion of the aerodigestive tract with curative intent. Ten patients (8 WD, 2 PD) underwent incomplete resection with tumor left adjacent to aerodigestive tract structures. All patients undergoing incomplete resection developed local recurrence. Six required salvage resection, as opposed to no recurrences in WD carcinomas following complete resection (P = .01). Survival at 5 years for WD carcinomas undergoing complete resection versus initial incomplete resection was 100% versus 50%, respectively (P = .27). Conclusion: Review of our experience shows that complete resection of thyroid carcinoma invading the aerodigestive tract can offer prolonged palliation, improved local control, and the opportunity for cure in selected patients.
Facial nerve outcome in lateral skull base surgery for benign lesions
Authors: von Doersten Peter G. , Jackson C. Gary , Manolidis Spiros , Pappas Dennis , Glasscock Michael E. 
Published: November 2003

AbstractObjective:To statistically identify factors most important in affecting CN7 outcome in lateral skull base surgery for benign lesions.Study Design:A retrospective review of 217 nonmalignancy lateral skull base procedures from 1970 to 1995 at the Otology Group in Nashville.Methods:Charts were reviewed for epidemiology, histopathology, staging, type of CN7 mobilization (none, short, long, severance with reanastomosis, and resection), preoperative and postoperative CN7 function, surgery performed, and survival.Results:Average House‐Brackman (HB) scores for mobilizations were as follows: short, 1.65: long, 2.74: and grafting, 4.33. Factors found to affect outcome in a statistically significant fashion were preoperative HB score, staging, type of CN7 manipulation, and surgical approach. Meningiomas were found to have a worse outcome than glomus tumors.Conclusions:Complete resection of tumors should be performed with minimal manipulation of the facial nerve based on regional anatomy and tumor anatomy.Laryngoscope, 108:1480–1484, 1998
Further evidence for allergic pathophysiology in allergic fungal sinusitis
Authors: Manning Scott C. , Holman Marie 
Published: November 2003

AbstractControversy continues over whether allergic fungal sinusitis represents a true allergy, an infection, or a point somewhere along a spectrum between allergy and infection. The present study describes two experiments that add weight to the argument that allergic fungal sinusitis (AFS) is truly an immunologically mediated hypersensitivity and not a form of infection. In the first experiment, eight patients withBipolarisculture‐positive AFS were prospectively evaluated withBipolarisantigen skin testing and with inhibition radioallergosorbent (RAST) and enzyme‐linked immunosorbent assay (ELISA) forBipolaris‐specific IgE and IgG antibodies. TheBipolarisAFS cases were compared with 10 control patients with no history of AFS. All eight AFS cases demonstrated positive skin testing toBipolarisand in addition, all tested positive by RAST and ELISA for IgE and IgGBipolarisantibodies, respectively. In the control group one patient had a positive skin test, ELISA, and RAST and one additional patient had a positive ELISA only. Good correlation was noted between skin test, RAST, and ELISA results. In the second experiment, sinus mucosa from 14 AFS patients and 10 control patients with other forms of surgical sinus disease was analyzed by immunohistocytochemistry for the eosinophilic inflammatory mediators major basic protein (MBP) and eosinophil derived neurotoxin (EDN) and the neutrophil mediator neutrophil elastase. All AFS cases demonstrated evidence of eosinophilic mediator release, and MBP and EDN predominated over neutrophil elastase. In the control group eosinophil and neutrophil mediator release in sinus mucosa was equal. The two experiments support the concept that AFS is an antigen‐triggered, IgE‐ and IgG‐mediated hypersensitivity response with a late‐phase inflammatory reaction involving release of eosinophilic mediators.Laryngoscope, 108:1485–1496, 1998
Malignant neoplastic disease of the parotid lymph nodes
Authors: Schroeder Walter A. , Stahr William D. 
Published: November 2003

AbstractObjectives: To review the management and outcome of patients with malignant neoplastic disease of the parotid lymph nodes excluding those with primary salivary gland tumors. Study Design: Retrospective review of 14 patients who had malignant parotid lymph nodes from metastatic cutaneous malignancies, direct extension from primary cutaneous malignancies, or lymphoproliferative disorders. Methods: Charts were reviewed from three institutions and tabulated for age, gender, histopathology, treatment, and outcome. Results: Fourteen patients met the criteria for study. Ten patients had neoplastic nodes from cutaneous malignancies. Seven involved squamous cell carcinoma, two were metastatic from melanoma, and one was metastatic from basal cell carcinoma. Four patients had involvement from lymphoproliferative disorders. Conclusions: Metastatic disease to the parotid nodes or direct extension to nodes from primary cutaneous malignancy demonstrates a poor prognosis in this series. Prognosis of lymphoproliferative disorder is more favorable. Laryngoscope, 108:1514–1519, 1998
Ki‐67 and p53 in T2 laryngeal cancer
Authors: Kropveld Arvid , Slootweg Pieter J. , Blankenstein Marinus A. , Terhaard Chris H. J. , Hordijk Gerrit J. 
Published: November 2003

AbstractObjective: To study the relationship between the proliferative capacity, represented by the immunohistochemical labeling index (LI) of proliferation marker Ki‐67, and the p53 status, as in theory an intact p53 cell cycle checkpoint system should result in a lower proliferative capacity. Study Design: From a group of 128 patients with a T2 laryngeal carcinoma, presented from 1989 to 1993 at the University Hospital Utrecht, 20 patients with recurrent disease and 16 patients without recurrent disease were randomly selected. All patients received primary irradiation. Methods: Denaturing gradient gel electrophoresis and immunohistochemistry determined the p53 status. MIB‐1 staining was used to determine the Ki‐67 LI. Results: In 36% of specimens we found a p53 mutation with overexpression (LI, 31%). In 8% a p53 mutation without p53 overexpression was found (LI, 18%). Forty‐two percent showed no mutation but, nevertheless, overexpression (LI, 35%). Neither mutation nor overexpression was found in 14% (LI, 38%). No correlation exists between p53 status and proliferative capacity of tumors (analysis of variance [ANOVA]; P = .104). The proliferation rate as established with Ki‐67 LI positively correlates with response to radiotherapy (P = .006). Conclusions: 1. Overexpression of wild‐type p53 protein does not result in cell cycle arrest measurable by a lower Ki‐67 LI in comparison with cases overexpressing mutant type p53 protein. 2. A high Ki‐67 LI correlates with a favorable response to radiotherapy. Laryngoscope, 108:1548–1552, 1998
Computer‐assisted three‐dimensional reconstruction of head and neck tumors
Authors: Moharir Vik M. , Fried Marvin P. , Vernick David M. , Janecka Ivo P. , Zahajsky Janos , Hsu Liangge , Lorensen William E. , Anderson Mark , Wells William M. , Morrison Paul , Kikinis Ron 
Published: November 2003

AbstractObjective: Because head and neck tumors reside in a complex area, having a three‐dimensional (3‐D) model of the patient's unique anatomical features may assist in the delineation of pathology. The authors describe a new computer technique of 3‐D anatomical reconstruction from two‐dimensional computed tomography (CT) and magnetic resonance (MR) data and discuss how it represents a step forward in the continuing evolution of 3‐D imaging. Study Design: The authors selected three patients with solitary head and neck tumors and reconstructed their anatomy in a 3‐D format for study. The tumors represented locations in the nose and central skull base (patient 1), temporal bone (patient 2), and neck (patient 3). Materials and Methods: MR and CT images from the individual patients were electronically transferred to workstations in the Surgical Planning Laboratory of the authors' institution. Registration (or fusion) was carried out between the MR and CT images. The desired anatomic components underwent segmentation (identification and isolation). Assembly of the segmented images was performed and the resulting structures were integrated to produce a 3‐D model. Results: 3‐D models of the following were constructed and displayed in an interactive format on high‐capacity computer workstations: 1) a skull base sarcoma with extension into the nasopharynx and nose; 2) an acoustic neuroma with internal auditory canal involvement; and 3) a metastatic recurrence of a tongue base squamous cell carcinoma in the posterior triangle of the right side of the neck with extension to the skull base. Conclusion: The authors' Surgical Planning Laboratory has developed a 3‐D reconstruction technique that has several new features. The models provided a very good 3‐D interactive representation of the tumors and patient anatomy. The need now exists to develop this method of 3‐D reconstruction of head and neck tumors for potential applications in treatment, research, and medical education. Laryngoscope, 108:1592–1598, 1998
Functional endoscopic sinus surgery training simulator
Authors: Rudman David T. , Stredney Don , Sessanna Dennis , Yagel Roni , Crawfis Roger , Heskamp David , Edmond Charles V. , Wiet Gregory J. 
Published: November 2003

AbstractObjective/Hypothesis: To determine the efficacy of a haptic (force feedback) device and to compare isosurface and volumetric models of a functional endoscopic sinus surgery (FESS) training simulator. Study Design: A pilot study involving faculty and residents from the Department of Otolaryngology at The Ohio State University. Methods: Objective trials evaluated the haptic device's ability to perceive three‐dimensional shapes (stereognosis) without the aid of image visualization. Ethmoidectomy tasks were performed with both isosurface and volumetric FESS simulators, and surveys compared the two models. Results: The haptic device was 77% effective for stereognosis tasks. There was a preference toward the isosurface model over the volumetric model in terms of visual representation, comfort, haptic‐visual fidelity, and overall performance. Conclusions: The FESS simulator uses both visual and haptic feedback to create a virtual reality environment to teach paranasal sinus anatomy and basic endoscopic sinus surgery techniques to ear, nose, and throat residents. The results of the current study showed that the haptic device was accurate in and of itself, within its current physical limitations, and that the isosurface‐based simulator was preferred. Laryngoscope, 108:1643–1647, 1998
Management of malar folds in blepharoplasty
Authors: Farrior Richard T. , Kassir Ramtin R. 
Published: November 2003

AbstractObjectives/Hypothesis:To define the anatomy and location of malar folds as distinguished from lower eyelid skin and orbital fat and to teach a new surgical technique for the management of the aging eye.Study Design:Retrospective report of a surgical procedure designed to address the malar folds.Methods:Analysis of preoperative and postoperative photographic documentation for surgical planning and long‐term result.Results:Patient satisfaction and lack of recurrence, without the requirement of direct excision, were noted in all patients studied.Conclusion:This presentation describes a new simple technique for the management of the folds and cutaneous and subcutaneous prominences that occur inferior to the lower eyelid skin. The operation addresses the correction by a combination of skin/muscle flap lower eyelid blepharoplasty with immediately subcutaneous (skin flap) elevations over the carefully delineated malar prominences; the removal of the deep fat that may or may not be associated with dehiscence of fat through the thin inferior fibers of the orbicularis muscle; and finally suspension of the remaining subcutaneous tissue and the muscle to the periosteum of the inferior orbital rim as well as suspension of the orbicularis muscle margin to the lateral orbital periosteum or the lateral canthal ligament area. The technique is designed to manage the more commonly found malar prominences but can be applied in the management of more pronounced festoons involving skin, muscle, and fat.Laryngoscope, 108:1659–1663, 1998
Bilateral radical neck dissection with unilateral internal jugular vein reconstruction
Authors: Dulguerov Pavel , Soulier Christian , Maurice Jean , Faidutti Bernard , Allal Abdelkarim S. , Lehmann Willy 
Published: November 2003

AbstractObjective: To describe and evaluate the functional and oncologic results of one internal jugular vein replacement after bilateral radical neck dissection (RND). Study Design: A retrospective historical cohort study. Methods: Since 1972 all patients (n = 9) undergoing bilateral RND with resection of both internal jugular veins had a reconstruction of one internal jugular vein. In six cases the RNDs were staged, and in three cases the RNDs were performed simultaneously. In every case a vascular reconstruction was performed with an autologous vein graft. All patients received radiation therapy, in five patients before and in four patients after the vein grafting. Functional results were evaluated in terms of postoperative head and neck and neurologic complications. In some patients a Doppler scan was performed to assess vein patency. Oncologic results are reported as relapse‐free survival and mortality intervals. Results: In all patients the postoperative course was uneventful, without neurologic complications. Facial edema was noted in four patients, mild in three and moderate in one. Two patients are alive, with follow‐ups of 8 and 18 years. Seven patients are dead, two without evidence of recurrence, four with cervical recurrence after a mean survival of 10 months, and one after distant metastasis after a survival of 7 years. In patients with long‐term survival a Doppler scan confirmed the patency of the vein graft. Conclusion: The lack of operative complications and the absence of postoperative neurologic complications make a unilateral internal jugular vein replacement after bilateral RND attractive, although the oncologic results remain poor. Laryngoscope, 108:1692–1696, 1998
Functional magnetic resonance imaging of auditory cortex in children
Authors: Ulualp Seckin O. , Biswal Bharat B. , Yetkin F. Zerrin , Kidder Thomas M. 
Published: November 2003

AbstractObjective: To obtain images of auditory cortex activation in children by using functional magnetic resonance imaging (FMRI). Methods: Seven healthy children (three girls and four boys), ages 6 to 10 years, were studied. Hearing evaluation was performed by puretone audiometry on the day of FMRI study. Brain imaging was performed on a commercial 1.5 T imager using a three‐axis local gradient coil. During scanning the children were instructed to lie still and avoid any lip, eye, jaw, or other facial movements. Subjects were asked to listen to a standard text presented in on‐off sequences. Functional images of the auditory cortex were acquired with FMRI technique. Functional imaging processing was done using cross‐correlation techniques with a coefficient of 0.5 (P < .0001). Results: Functional correlation images of the auditory cortex activation were obtained in six of seven children after image processing. All children showed activation in the superior temporal gyrus, Heschl's gyrus, planum temporale, frontal lobe, and parietal regions. There was no significant difference in the number and percentage of activated pixels on right and left auditory cortices. Conclusions: Functional images of auditory cortex activation were obtained in healthy children following binaural text presentation. Consistent activation was observed in primary and secondary auditory cortices with no hemispheric dominance. FMRI characteristics of the auditory cortex activation in healthy children should be established in order to study those with hearing impairment.
Safety of paranasal sinus surgery in patients with cystic fibrosis
Authors: Schulte Douglas L. , Kasperbauer Jan L. 
Published: November 2003

AbstractObjective: Document the safety of paranasal sinus surgery in cystic fibrosis patients and review the changing trends in paranasal sinus surgery in the cystic fibrosis population. Study Design: Retrospective review. Materials and Methods: Chart review of cystic fibrosis patients who underwent paranasal sinus surgery from 1955 to 1997. Results: Indications for surgery included chronic sinusitis, nasal obstruction, purulent rhinorrhea, head pain, and pyocele. Average duration of anesthesia was 2.1 hours. The complication rate from general anesthesia was zero. Excessive bleeding and significant hypoxia did not occur. Conclusions: Paranasal sinus surgery and general anesthesia can be safely performed in cystic fibrosis patients. The indications for paranasal sinus surgery are changing from symptomatic nasal obstruction to pre‐lung transplantation care. Today, treatment has evolved to include placement of sinus catheters for direct topical instillation of antibiotics and consideration of maxillary and frontal sinus obliteration.
Long‐term follow‐up after subtotal parathyroidectomy in patients with renal failure
Authors: Yu Irene , Devita Maria V. , Komisar Arnold 
Published: November 2003

AbstractObjectives/Hypothesis: The most appropriate type of surgery for hyperparathyroidism secondary to renal failure remains controversial. We report a 5‐year experience of patients with hyperparathyroidism secondary to end‐stage renal disease who underwent subtotal parathyroidectomy. We believe that this is the procedure of choice, offering several advantages over total parathyroidectomy with and without reimplantation. Study Design: Retrospective review. Methods: Review of 14 consecutive renal failure patients who underwent subtotal parathyroidectomy by one surgeon (A.K.) was performed. Follow‐up ranged from 4 to 54 months. All patients were receiving chronic maintenance dialysis. All patients came to surgery with clinical symptoms of parathyroid bone disease, elevated serum calcium levels (10.1–12.4 mg/dL), and intact parathyroid hormone levels (619–4160 pg/mL), despite maximal medical therapy. At exploration four glands were identified in all patients and three and a half were removed. Results: All patients experienced symptomatic relief postoperatively with normalization or near‐normalization of serum calcium concentration and intact parathyroid hormone concentrations. One patient developed recurrent disease 4 months after surgery, and on re‐exploration a supernumerary substernal gland was identified. A second patient developed recurrent symptoms 4 years after surgery and at the time of this writing was awaiting re‐exploration. Conclusions: All patients had either resolution of or marked improvement in their subjective complaints. There have been no cases of permanent hypoparathyroidism. We believe that subtotal parathyroidectomy is the best procedure for patients with refractory symptoms of secondary hyperparathyroidism.