bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review of Facial Nerve Outcome in 100 Consecutive Cases of Acoustic Tumor Surgery
Authors: McElveen John T. , Belmonte Raymond G. , Fukushima Takanori , Bullard Dennis E. 
Published: November 2003

AbstractObjective To determine the facial nerve outcomes at a tertiary neurotological referral center specializing in acoustic neuroma and skull base surgery.Study Design Retrospective review of 100 consecutive patients in whom acoustic neuromas were removed using all of the standard surgical approaches.Methods Functional facial nerve outcomes were independently assessed using the House‐Brackmann facial nerve grading system.Results The tumors were categorized as small, medium, large, and giant. If one excludes the three patients with preoperative facial palsies, 100% of the small tumors, 98.6% of the medium tumors, 100% of the large tumors, and 71% of the giant tumors had facial nerve function grade I‐II/VI after surgery.Conclusion Facial nerve results from alternative nonsurgical treatments must be compared with facial nerve outcomes from experienced surgical centers. Based on the facial nerve outcomes from our 100 consecutive patients, microsurgical resection remains the preferred treatment modality for acoustic tumors.
Vestibular Schwannoma Growth: The Continuing Controversy
Authors: Charabi Samih , Tos Mirko , Thomsen Jens , Charabi Birgitte , Mantoni Margit 
Published: November 2003

AbstractObjective To investigate the growth of vestibular schwannoma (VS) in a series of 123 patients with 127 tumors allocated to the “wait and scan” group in the period 1973–1999.Study Design Retrospective review of prospectively registered data on all patients with VSIÈ from the entire country who were allocated to the wait and scan group.Method Clinical charts, audiometric data, and neuroradiological images were reviewed and tabulated for age, hearing level expressed as speech reception threshold (SRT) and speech discrimination score (SDS), maximum extracanalicular tumor extension, and possible changes in tumor diameter. The material was updated three times (in June 1993, June 1996, and June 1999). Via the Danish national register, data on whether the included patients were alive or dead were collected in 1999.Results The tumor growth, growth rate, and growth patterns were calculated in three periods 1973 to 1993 (mean observation period, 3.4 y), 1973 to 1996 (mean observation period, 3.8 y), and from 1973 to 1999 (mean observation period, 4.2 y). By termination of the first period, 94 tumors (74%) exhibited measurable growth, 23 tumors (18%) no measurable growth, and 10 tumors (8%) revealed negative growth. By the end of the extended observation period, tumor growth was observed in 104 tumors (82%), no tumor growth in 15 tumors (12%), and negative growth in 8 tumors (6%). Subsequent to the third observation period, growth was observed in 108 tumors (85%), no growth in 11 tumors (9%) and negative growth in 8 tumors (6%). However, the results may also be interpreted in another way: 52 patients (42%) were alive at the time of writing, tumor growth did not demand any intervention, 23 patients (19%) died as a result of non–tumor‐related causes, and 35 patients (28%) were previously treated and alive by the termination of the third observation period.Conclusion Depending on the observation period, three sets of growth results were obtained. The long observation period, updating and re‐updating the results, gave us the opportunity for a de novo interpretation of the results and the long‐term consequences of the wait and scan policy. Combined with other factors, the achieved results should be considered when timing of surgery is to be decided.
Resection of Cancer of the Tongue Base and Tonsil via the Transhyoid Approach
Authors: Agrawal Amit , Wenig Barry L. 
Published: November 2003

AbstractObjective To assess whether transhyoid resection of the tongue base and tonsil lesions is an effective approach to tumors involving this region compared with more traditional anterior surgical approaches that arbitrarily involve either segmental resection or division of the mandible.Study Design Retrospective review.Methods Since 1988, we have used a combined transhyoid and transoral approach to resect lesions involving the tongue base, tonsil, or both. Forty‐one patients were identified who underwent surgical resection of lesions involving this region via this combined approach during this period. A stage‐matched group of 41 patients was also identified in which patients underwent resection via traditional composite or mandibulotomy approaches and was used as a basis for comparison. Factors assessed included status of surgical margins, postoperative complications, degree of postoperative dysphagia, and long‐term outcome.Results Comparison between the two groups revealed similar rates of negative surgical margins. Levels of postoperative dysphagia, notably severe primarily in patients with either T4 or recurrent disease, were also similar between groups. Complication rates, especially with regard to fistula occurrence and mandible‐healing problems, were significantly lower in the transhyoid group. Analysis of long‐term outcome revealed similar patterns with regard to disease status in both groups.Conclusions The combined transhyoid and transoral approach is an effective surgical option for a number of lesions affecting the tongue base, tonsil, or both. Although similar to other approaches with regard to postoperative function and disease outcome, the transhyoid approach is associated with decreased postoperative morbidity. However, tumors that e‐tend to involve the mandible or pterygoid musculature or skull base are probably best suited for traditional approaches that involve division of the mandible.
Acetaminophen Versus Acetaminophen With Codeine After Pediatric Tonsillectomy
Authors: Moir Melinda S. , Bair Ellen , Shinnick Pam , Messner Anna 
Published: November 2003

AbstractObjective To compare the effectiveness of acetaminophen versus acetaminophen with codeine after pediatric tonsillectomy and adenoidectomy.Study Design Prospective, randomized, double‐blind study.Methods Fifty‐one children ages 3 to 12 years scheduled for outpatient tonsillectomy and adenoidectomy were studied. Patients were randomly assigned to receive acetaminophen or acetaminophen with codeine in unlabeled bottles for postoperative pain control. The Wong‐Baker FACES pain rating scale was used to help children quantify their level of pain after surgery. The level of pain, quantity of pain medication required, presence of side effects, and the percentage of a normal diet consumed was recorded for 10 postoperative days.Results There was no difference (P > .05, all time points) in the level of postoperative pain reported by the parents and children in the two groups. The acetaminophen with codeine group tended to have increased problems with nausea, emesis, and constipation, but these differences did not reach statistical significance. Children in the acetaminophen group consumed a significantly higher percentage of a normal diet on the first 6 postoperative days (P < .05, all time points).Conclusion There was no difference in the level of pain control provided by acetaminophen and acetaminophen with codeine as measured by the Wong‐Baker FACES pain rating scale. Postoperative oral intake was significantly higher in children treated with acetaminophen alone.
Embryological Development and Large Vestibular Aqueduct Syndrome
Authors: Mark Pyle G. 
Published: November 2003

AbstractObjectives/Hypothesis Large vestibular aqueduct syndrome (LVAS) is a significant cause of hearing loss in early childhood. Many theories on the origins and causes of LVAS have been proposed, including arrest or maldevelopment of the vestibular labyrinth in embryonic life. Prior studies have described postnatal and adult vestibular aqueduct anatomy, but none has analyzed aqueduct growth throughout embryonic life. This study was undertaken to characterize the growth of the developing vestibular aqueduct to gain a better understanding of the possible origins of LVAS.Study Design Basic science, temporal bone histopathological study.Methods Serial sections from 48 temporal bones from human embryos ranging in age from 5 weeks' gestation to full term were studied with computer image analysis. Measurements of vestibular aqueduct internal and external aperture, midportion diameter, and length were analyzed to obtain a growth model of development.Results The vestibular aqueduct grows in a nonlinear fashion throughout embryonic life. All parameters fit a similar growth curve and never reached a maximum or began narrowing during development. Growth in one parameter correlated well with growth of another. There was good side‐to‐side correlation with all but the external aperture.Conclusions Most of the membranous labyrinth reaches adult size by 20 weeks' gestation, but the vestibular aqueduct grows throughout embryonic life. The measurements and growth model obtained in this study are not consistent with the theory that LVAS results from an arrest in development early in fetal life. The data suggest that LVAS may result from postnatal and early childhood maldevelopment.
Variables Affecting Treatment in Benign Paroxysmal Positional Vertigo
Authors: Macias John D. , Lambert Kim M. , Massingale Shelly , Ellensohn Andrea , Ann Fritz Jean 
Published: November 2003

AbstractObjective To identify variables affecting outcome in patients with benign paro‐ysmal positional vertigo (BPPV) treated with canalith repositioning maneuvers.Study Design Retrospective review of patients at a tertiary vestibular rehabilitation center.Methods Variables identified for statistical analysis included method of diagnosis, age, se‐, onset association with trauma, semicircular canal involvement, presence of bilateral disease, treatment visits, and cycles of canalith repositioning maneuvers per treatment visit. Multivariate statistical analysis using Pearson χ2, likelihood ratio, linear‐by‐linear association, and cross‐tabulation tests were performed.Results Two hundred fifty‐nine patients with BPPV who received treatment were identified from 1996 to 1998. Average follow‐up time was 16.9 months. 74.8% required one treatment visit, 19.0% required a second treatment visit, and 98.4% were successfully treated after three treatment visits. The remainder required up to seven treatment visits for relief of symptoms. Variables affecting the number of treatment visits included bilateral disease or location of disease other than in the posterior semicircular canal. Patient age, se‐, method of diagnosis, and onset association with trauma had no statistically significant impact.Conclusion Patients with benign paro‐ysmal positional vertigo not located in a single posterior semicircular canal are more likely to require multiple visits for canalith repositioning.
Selective Neck Dissection in the Management of the Clinically Node‐Negative Neck
Authors: Sefik Hosal A. , Carrau Ricardo L. , Johnson Jonas T. , Myers Eugene N. 
Published: November 2003

AbstractObjective To evaluate the efficacy of the selective neck dissection (SND) in the management of the clinically node‐negative neck.Study Design Case histories were evaluated retrospectively.Methods The results of 300 neck dissections performed on 210 patients were studied.Results The primary sites were oral cavity (91), oropharyn‐ (30), hypopharyn‐ (16), and laryn‐ (73). Seventy‐one necks (23%) were node positive on pathological e‐amination. The number of positive nodes varied from 1 to 9 per side. Of necks with positive nodes, 17 (24%) had e‐tracapsular spread. The median follow‐up was 41 months. Recurrent disease developed in the dissected neck of 11 patients (4%). Two recurrences developed outside the dissected field. The incidence of regional recurrences was similar in patients in whom nodes were negative on histological e‐amination (3%) when compared with patients with positive nodes without e‐tracapsular spread (4%). In contrast, regional recurrence developed in 18% of necks with e‐tracapsular spread. This observation was statistically significant. Patients having more than two metastatic lymph nodes had a higher incidence of recurrent disease than the patients with carcinoma limited to one or two nodes. Recurrence rate in the pathologically node positive (pN+) necks was comparable to recurrence in those pathologically node negative (pN0) necks in the patients who did not have irradiation.Conclusion SND is effective for controlling neck disease and serves to detect patients who require adjuvant therapy.
Time to First Relapse as an Outcome and a Predictor of Survival in Patients With Squamous Cell Carcinoma of the Head and Neck
Authors: Hall Stephen F. , A Groome Patti , Rothwell Deanna 
Published: November 2003

AbstractObjective To identify patterns and predictors of relapse and to determine whether the time to relapse influences survival.Study Design Multivariate analysis of prospective database.Methods We present findings in 446 consecutive prospective patients from a regional cancer center with invasive squamous cell carcinoma who were treated for cure and were declared disease free. Time to relapse, site of relapse, and survival are reported by stage and site using bivariate and multivariate analysis.Results Thirty‐si‐ percent of patients relapsed. The median time to relapse was 8.3 months, and 95% of relapses occurred within 3 years. T stage in the TNM staging system was associated with relapse, and N stage was not. In patients who relapsed before the median time to relapse, prognosis was worse than in those who relapsed after that time.
Histopathology of the Inferior Turbinate With Compensatory Hypertrophy in Patients With Deviated Nasal Septum
Authors: Berger Gilead , Hammel Ilan , Berger Rachel , Avraham Shabtai , Ophir Dov 
Published: November 2003

AbstractObjective To measure the dimensions, composition, and possible structural and/or histopathological changes of the compensatory hypertrophic inferior turbinate in patients with deviated nasal septum.Study Design A prospective, nonrandomized, and morphometric study.Methods Nineteen patients with deviated nasal septum and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity underwent surgery for correction of nasal obstruction. Patients' specimens were compared with those of a control group consisting of 10 inferior turbinates removed at autopsy. Quantitative measurements of the inferior turbinate histological sections were carried out and included the width of the layers and morphometric calculations of the relative proportions of the soft tissue constituents. Also, qualitative study was performed to detect pathological changes.Results Of all layers, the inferior turbinate bone underwent a twofold increase in thickness and manifested the most significant expansion (P ≤.001), whereas the contribution of the mucosal layers to the inferior turbinate hypertrophy was modest. The morphometric analysis revealed a larger proportion of venous sinusoids in hypertrophic turbinates, but the difference was small and statistically insignificant. Qualitative assessment disclosed normal mucosal architecture in all inferior turbinates with compensatory hypertrophy. Eleven remained intact, while eight disclosed mild to moderate pathological changes.Conclusions The data gathered in the present study are of importance to the decision‐making process regarding turbinate surgery. The significant bone expansion and the relative minor role played by the mucosal hypertrophy would support the decision to excise the inferior turbinate bone at the time of septoplasty.
Expression of MUC5AC mRNA in the Goblet Cells of Human Nasal Mucosa
Authors: Kim Chang‐Hoon , Song Kyoung Seob , Kim Sung‐Shik , Kim Hyun‐Ung , Seong Je‐Kyung , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives/Hypothesis Mucus hypersecretion is a common feature in chronic sinusitis with polyps. Because mucus hypersecretion is commonly accompanied by goblet cell hyperplasia, it is important to identify which mucin gene mRNAs are expressed in the goblet cells of the surface epithelium in the human airway. This study aims to investigate the pattern of expression of MUC5AC messenger RNA (mRNA) in the goblet cells of human nasal mucosa.Methods Six nasal polyps, five inferior turbinate mucosa specimens, and three normal‐appearing mucosa specimens of the posterior ethmoid sinus were obtained. Each of the specimens was cut into 10‐μm‐thick serial frozen sections, and in situ hybridization of MUC5AC mRNA was performed with an oligonucleotide probe. Alcian blue (pH 2.5)–periodic acid–Schiff (AB‐PAS) staining was performed on the serial sections.Results In human nasal polyps, MUC5AC mRNA was expressed in the cytoplasm of most of the goblet cells. However, in the inferior turbinate, MUC5AC mRNA was expressed in only some of the goblet cells. On the contrary, in the normal‐appearing mucosa of the posterior ethmoid sinus, MUC5AC mRNA was barely expressed in the goblet cells. Furthermore, MUC5AC mRNA was mainly expressed in some of the PAS‐positive goblet cells.Conclusions Only a portion of the goblet cells in the human nasal mucosa expressed MUC5AC mRNA. This result suggests that surface goblet cells might have other mucin genes, in addition to MUC2 and MUC5AC.
Early Clinical Results: SOUNDTEC Implantable Hearing Device Phase II Study
Authors: Hough J. V. D. , Dyer R. Kent , Matthews Pamela , Wood Mark W. 
Published: November 2003

AbstractObjective To assess the safety and efficacy of a new semi‐implantable electromagnetic hearing device, the SOUNDTEC™ Direct Drive Hearing System (DDHS), and to compare its performance with that of subjects' previously worn, optimally fit hearing aids. Preliminary results for the first 10 subjects are presented.Study Design The protocol specified in the Investigational Device Exemption is used in this ongoing FDA phase II 100‐subject multicenter clinical trial.Methods For baseline, each subject is tested wearing his or her own optimally fit hearing aid in the ear to be implanted. Six‐month postoperative outcome measures using the SOUNDTEC DDHS are compared with the baseline. Multiple objective and subjective outcomes (as listed under Results) were measured.Results When compared with the subjects' optimally fit hearing aids, the SOUNDTEC DDHS provided an average improvement of 52% in functional gain (250–6000 Hz), 22% in aided thresholds, 3.8% for speech discrimination in quiet, 17% for speech in noise, 13.1% in articulation index scores, 28% in aided benefit, 27.3% in sound quality of speech, and a 16.7% increase in overall subject satisfaction. In addition, with the SOUNDTEC DDHS, subjects reported absence of acoustic feedback, little or no occlusive effects, and more natural sound perception.Conclusion Analysis of data on the first 10 subjects using the SOUNDTEC DDHS indicates positive outcomes regarding safety and efficacy, although the small sample size is not sufficient to permit valid statistical inferences to be drawn from our preliminary data. Results also demonstrate improvement in performance compared with the subjects' optimally fit hearing aids and an improvement in quality of life as demonstrated by objective and subjective tests and measures.
Insecticidal Activity of Common Reagents for Insect Foreign Bodies of the Ear
Authors: Antonelli Patrick J. , Ahmadi Anis , Prevatt Angela 
Published: November 2003

AbstractObjective Insects commonly present as painful and distressing foreign bodies of the external ear canal. Removing live insects can be challenging, especially for primary care physicians who have limited equipment. The purpose of this study is to compare the insecticidal activity of commonly available preparations for insects that are most frequently recovered from ear canals: cockroaches (German and American), ticks, beetles, and honeybees.Study Design Prospective, blinded.Methods One hundred seventy insects of each species were placed in test tubes and submerged in 17 test preparations (10 tubes per preparation, 1 insect per test tube). Insect activity was stimulated by agitation of the test tube. Responses were monitored, and the time until death was measured.Results Most test preparations exhibited some insecticidal activity against most insect species. Ticks were completely resistant to all of the test reagents. Ethanol killed the American cockroaches (mean time, 32.6 s), German cockroaches (mean time, 29.6 s), and honeybees (mean time, 19.6 s) the most rapidly.Conclusion Many commonly available reagents may be used to kill or immobilize insect foreign bodies of the ear.
Middle Ear Effusions and Structure of the Tympanic Membrane
Authors: Wielinga Eize W. J. , Peters Theo A. , Tonnaer Edith L. G. M. , Kuijpers Wim , Curfs Jo H. A. J. 
Published: November 2003

AbstractObjective To study the effect of various middle ear effusions on the structure of the lamina propria of the tympanic membrane.Methods Sterile and infective middle ear effusions were induced by obstruction of the eustachian tube in specific pathogen‐free (SPF) rats and in rats with upper airway infections (URI), respectively. The condition of the tympanic membrane was monitored at regular intervals. After varying survival times, the animals were killed and the tympanic membranes processed for light and electron microscopy.Results Sterile effusions always resulted in tympanosclerotic lesions. These lesions did not develop in the presence of primary‐infected effusions. These effusions had a severe destructive effect on the lamina propria, followed by fibrosis. Generally, secondary infection did not markedly affect preexisting tympanosclerotic lesions. Moreover, calcification disappeared when re‐aeration of the middle ear occurred, but the abnormal collagen depositions persisted.Conclusions Both sterile and infective effusions result in comprehensive irreversible changes in the lamina propria of the pars tensa. The development of tympanosclerosis is confined to sterile effusions. Mechanical injury and compromised vascularization of the lamina propria are likely to be important etiological factors in the development of tympanosclerosis.