bluuebunny/crossref_metadata_2025_split huggingface dataset:
Status of Internal Jugular Veins in Patients with Carcinomas of the Head and Neck Area
Authors: Prim M. P. , De Diego J. I. , Moreno P. , Madero R. , Gavilan J. 
Published: October 2004

OBJECTIVETo assess the status of internal jugular veins (IJV) in patients with head and neck carcinomas.STUDY DESIGN AND SETTINGThis study included 108 IJV of 54 cancer patients who were prospectively evaluated between September 1994 and February 1997. Patency, presence of thrombosis, characteristics of vein wall, compressibility, area of the veins both in rest and during Valsalva maneuver, expiratory flow speed, Valsalva flow speed, jugular flow in each side, and total jugular flow were registered in all cases. Also, 30 IJV of 15 normal volunteers were used as a control group. The study was performed in a tertiary care referral center.RESULTSRight expiratory flow speed was higher in volunteers (P = 0.0280), and left basal area was bigger in oncologic patients (P = 0.0394). No significant changes were found between cancer patients and controls in the remaining parameters (P > 0.05).CONCLUSIONS AND SIGNIFICANCEAccording to these results, head and neck carcinomas do not seem to affect the ultrasonographic characteristics of IJV. Thus, preoperative evaluation of IJV is not mandatory in these patients.
Small and Large Middle Meatus Antrostomies in the Treatment of Chronic Maxillary Sinusitis
Authors: Albu Silviu , Tomescu Ermil 
Published: October 2004

OBJECTIVEThe study goal was to compare the postoperative endoscopic appearance of the middle meatus antrostomy with symptomatic relief in patients undergoing endoscopic endonasal sinus surgery for chronic maxillary sinusitis.STUDY DESIGNWe conducted a prospective randomized study encompassing 133 patients with chronic rhinogenic maxillary sinusitis who underwent endoscopic ethmoid surgery and middle meatal antrostomies. One of the tasks was to compare small‐sized (less than 6 mm) antrostomies with large‐sized (more than 16 mm) antrostomies in relieving the symptoms of chronic maxillary sinusitis. During follow‐up an attempt was made to correlate endoscopic findings with symptomatic failure.RESULTSWe could not demonstrate a statistically significant correlation between the degree of improvement of the main sinusitis symptoms (obstruction, headache, and nasal discharge) and the post‐operative size of the antrostomy. Nevertheless, persistent accessory maxillary ostia, scarring within the ethmoid were statistically significant predictors of poor surgical outcome.CONCLUSIONWe conclude from this study that the size of the middle meatal antrostomy has no influence on the outcome of endonasal surgery for chronic rhinogenic maxillary sinusitis.
Long‐Term Otological Outcome of Hamular Fracture During Palatoplasty
Authors: Sheahan Patrick , Miller Ian , Sheahan Jerome N. , Earley Michael J. , Blayney Alexander W. 
Published: October 2004

OBJECTIVEIt has been suggested that fracture of the hamulus during palatoplasty in children with cleft palate may lead to adverse otological sequelae, however, there is little evidence to support this.STUDY DESIGN AND SETTINGThe otological records of 42 children with repaired cleft palate (excluding submucous cleft palate) aged 8 years old or older were examined. A questionnaire regarding the incidence, treatment, and outcome of middle ear problems was completed by the parents of 68 children with repaired cleft palate, aged 9 years old or older.RESULTSThere was no significant difference between children who did and did not undergo hamular fracture with regard to tympanic membrane appearance, audiometry, history of ear problems (P = 1.000), ear infections (P = 0.622), ventilation tube insertion (P = 0.532), or surgery for chronic otitis media (P = 1.000). Parents of children not undergoing hamular fracture reported a higher incidence of below normal hearing (P = 0.023).CONCLUSION AND SIGNIFICANCEThere is no evidence that hamular fracture during palatoplasty affects long‐term otological outcome in cleft palate.
Salvage Surgery for Locally Recurrent Nasopharyngeal Carcinoma—A 10‐Year Experience
Authors: Chang Kai‐Ping , Hao Sheng‐Po , Tsang Ngan‐Ming , Ueng Shir‐Hwa 
Published: October 2004

OBJECTIVETo evaluate the result of salvage surgery for patients with primary recurrence of nasopharyngeal carcinoma (NPC) after radiation therapy.STUDY DESIGN AND SETTINGProspective cohort at a tertiary referral center.PATIENTS AND METHODSThirty‐eight consecutive patients with primary recurrence of NPC after radiation failure underwent salvage surgery for curative intention via the facial translocation approach from July 1993 to December 2002. The follow‐up time ranged from 2 to 88 months. Twelve patients with intracranial and skull base invasion needed a combined neurosurgical approach. Eight patients had additional postoperative radiation therapy.RESULTSThe actuarial 3‐year survival and local control rate was 60% and 72.8%, respectively. Ten (83.3%) of 12 patients with intracranial and skull base invasion achieved local control. There was no surgical mortality, and the morbidity rate was only 13.2%.CONCLUSION AND SIGNIFICANCEThe results of this study reveal better outcome of salvage surgery than that of most published literature of reirradiation for recurrent NPC. With the adequate exposure provided by the facial translocation approach, an integrated concept of skull base surgery, and the collaboration of neurosurgeons, we can extend our surgical indications of salvage surgery and resect many advanced lesions with acceptable mortality and morbidity.
Parotidectomy for Primary Nonparotid Diseases
Authors: Plopper Caio , Cernea Claudio Roberto , Ferraz Alberto Rosetti , Dos Santos Luiz Roberto Medina , Regis Adrian Berenguer 
Published: October 2004

OBJECTIVETo analyze the indications and results of parotid gland resections for patients with primary nonparotid diseases.STUDY DESIGN AND SETTINGRetrospective analysis of 442 consecutive parotidectomies (76 for primary nonparotid disease) in a referral head and neck surgery service, tertiary care university hospital.RESULTSSkin cancer (mainly squamous cell and basal cell carcinomas) was the most common indication for parotidectomy. Superficial parotidectomy with preservation of the facial nerve was the most commonly performed operation (61.8%), with some form of nerve sacrifice necessary in 31.6%. Parotid gland parenchyma and/or lymph nodes were pathologically positive in 46 cases. Neck dissections were carried out in conjunction with parotidectomy in 42 patients (1 patient had had previous neck dissection), of which 16 turned out to be pN+.CONCLUSIONParotidectomy should be considered as part of the surgical treatment of tumors whenever oncologically necessary for appropriate margins, lymph node dissection, and for proper identification and preservation of the facial nerve.
An Objective Assessment of the Advantages of Retrograde Parotidectomy
Authors: Bhattacharyya Neil , Richardson Marc E. , Gugino Laverne D. 
Published: October 2004

OBJECTIVEThis study was undertaken to determine whether the retrograde parotidectomy approach is more efficient than standard anterograde parotidectomy without compromise of surgical effectiveness.METHODSA retrospective analysis of patients undergoing parotidectomy was conducted. Cases were divided into those undergoing retrograde facial nerve dissection and those undergoing standard anterograde facial nerve dissection. From the review of medical records, standard demographic information, surgical time, histopathology, estimated blood loss, and use of facial nerve monitoring were determined. Pathology was reviewed to determine the size of the overall resection specimen as well as the size of the lesion excised and margin status. Postoperative complications were also recorded. Statistical comparisons were conducted between these 2 approaches for these clinical variables such as surgical time, blood loss, tumor margin status and relative volume of tissue removed during parotidectomy.RESULTS45 patients undergoing parotidectomy met inclusion criteria. The average patient age was 50.8 years with a female preponderance (73%). There were 19 standard parotidectomies and 26 retrograde approaches. Compared to standard parotidectomy, retrograde parotidectomy consumed less operative time (3.2 versus 1.8 hours, respectively), decreased intraoperative blood loss (67.9 cc versus 40.3 cc, respectively), and resulted in less removal of normal parotid tissue (volume of normal parotid tissue removed in excess of tumor: 23.0 cc versus 6.0 cc, respectively). No significant difference in surgical margin status was noted between anterograde and retrograde parotidectomy (P = 0.452).CONCLUSIONSIn appropriately selected cases, compared with standard anterograde parotidectomy, retrograde parotidectomy is more efficient and spares normal parotid tissue without compromising surgical margins. Facial nerve monitoring provides a useful adjunct for retrograde dissection.
Surface Electromyographic Studies of Swallowing in Normal Subjects: A Review of 440 Adults. Report 1. Quantitative Data: Timing Measures
Authors: Vaiman Michael , Eviatar Ephraim , Segal Samuel 
Published: October 2004

OBJECTIVESurface electromyographic studies were performed on 440 normal adults to establish normative database for duration of muscle activity during swallowing and drinking clinically useful for outpatient ENT department.STUDY DESIGNProspective observational study of healthy volunteers.METHODSParameters evaluated during swallowing include the timing of activity of the orbicularis oris, masseter, submental, and infrahyoid muscle groups covered by platisma. Five tests were examined including voluntary single swallows of saliva (“dry” swallow), voluntary single water swallows as normal, voluntary single swallows of excessive amount of water (20 mL), continuous drinking of 100 mL of water (duration and number of swallows), monitoring of spontaneous swallowing of saliva during 1 hour period. The duration of oral, pharyngeal, and initial esophageal stages of swallowing (mean + SD) were measured for groups of adults of different age (18–30, 31–40, 41–50, 51–60, 61–70, 70+ years old).RESULTSNormative data for duration of muscle activity during single swallowing and continuous drinking are established for healthy adults. The duration of swallows and drinking in all tests showed insignificant increase with the age except for the geriatric group, in which this tendency is statistically significant (1‐dimensional analysis of variance, SPSS, Chi‐square criterion, 95% confidence interval). There was no statistically significant difference between male and female adults duration of muscle activity during single swallowing and continuous drinking in all age groups (P ≥ 0.05). The relevance and clinical utility of new and alternative measures, in particular, are discussed.CONCLUSIONSurface EMG of swallowing is a simple and reliable noninvasive method for screening evaluation of swallowing with low level of discomfort during the examination. Stage‐by‐stage evaluation of duration can be very important for topical diagnosis of etiology of dysphagia. The normative timing of events data can be used for evaluation of complaints and symptoms, as well as for comparison purposes in preoperative and postoperative stages and in EMG monitoring during ENT treatment. These parameters represent stages required for normal deglutition, and can be used to identify abnormalities in ENT patients, and provide a basis for comparison of swallowing performance both within and between patients.
Factors Associated with Failure of Frontal Sinusotomy in the Early Follow‐Up Period
Authors: Chandra Rakesh K. , Palmer James N. , Tangsujarittham Thianchai , Kennedy David W. 
Published: October 2004

OBJECTIVESTo understand factors associated with failure of endoscopic frontal sinusotomy.METHODSRetrospective review of 130 consecutive frontal sinusotomies. The preoperative extent of disease was graded radiologically in each frontal sinus as total opacification, partial opacification, or mucosal thickening. Records were also reviewed to determine the incidence of comorbid conditions.RESULTSPatency at most recent follow‐up was observed in 117/130 (90%). Patency was achieved after our first procedure in 107 sinusotomies. These were considered successes. Ten required revision surgery, and an additional 13 were not patent at last follow‐up. These 23 sinusotomies were considered failures. Among those failing our initial surgery, 19/23 (83%) were partially or totally opacified preoperatively. In contrast, only 47/107 (44%) in the success group contained partial or total opacification preoperatively (P = 0.003), with the majority exhibiting mucosal thickening only. Mean follow‐up was 8.3 months for the successes and 10.7 months for the failures (P = NS). No significant differences were observed between the success and failure groups with respect to the prevalence of asthma, aspirin sensitivity, or allergic fungal disease. Patients in the failure group, however, had a higher mean number of prior surgeries before undergoing frontal sinusotomy at our institution (1.8 vs 0.9, P = 0.033).CONCLUSIONSDuring the early follow‐up period, failure of endoscopic frontal sinusotomy is associated with advanced degrees of preoperative disease within the sinus and is also more likely in patients who have failed prior surgical management.
Vocal Fold Augmentation with Calcium Hydroxylapatite
Authors: Belafsky Peter C. , Postma Gregory N. 
Published: October 2004

OBJECTIVESVoice disorders affect more than 3% of the general population. Vocal fold atrophy is a part of the normal aging process, with up to 60% of 60‐year‐old individuals displaying evidence of glottal insufficiency. A safe, effective, and durable substance for injection augmentation of the vocal folds is not currently available. The purpose of this investigation was to describe our preliminary experience with calcium hydroxylapatite (CaHA) for vocal fold augmentation.METHODOLOGYAll patients undergoing injection augmentation of the vocal folds with CaHA between January 1, 2002 and June 1, 2003 were pro‐spectively evaluated. Data concerning indications, technique, functional outcome, and complications were collected. In addition, the larynx donated from a woman who underwent vocal fold augmentation with CaHA and subsequently died from terminal cancer was histologically examined.RESULTSA total of 39 vocal folds in 23 individuals were injected with CaHA. The mean age of the cohort was 62. Fifty‐two percent were male. The indications for augmentation were unilateral vocal fold paralysis (9/23), unilateral vocal fold paresis (5/23), presbylarynx (3/23), Parkinson's (3/23), bilateral vocal fold paresis (2/23), and abductor spasmodic dysphonia (1/20). There were no adverse reactions. All individuals reported improvement on a self‐administered disease‐specific outcome measure (P < 0.001). The pathology from the donated larynx 3 months after injection revealed intact CaHA spherules in good position with a minimal, monocellular inflammatory reaction to the gel carrier and no evidence of implant rejection.CONCLUSIONSInitial experience with vocal fold augmentation using CaHA is promising. Long‐term safety and efficacy needs to be established.
Safety of Outpatient Tonsillectomy in Children: A Review of 6 Years in a Tertiary Hospital Experience
Authors: Granell Jose , Gete Pilar , Villafruela Miguel , Bolaños Caridad , Vicent Juan Jose Alvarez 
Published: October 2004

OBJECTIVEWe present our experience with outpatient tonsillectomy in children and critically review safety to support the outpatient policy.STUDY DESIGN AND SETTINGWe conducted a retrospective chart review from January 1995 through December 2000 in the pediatric otolaryngology unit of a tertiary care university hospital.RESULTSOne thousand two hundred forty‐three patients were accepted in the outpatient program with permissive criteria. Postoperative observation time ranged from 3 to 5 hours (median, 4.5 hours). The overall rate of complications was 9.3% (n = 116). Primary and secondary bleeding rates were 6.27% (n = 78) and 0.48% (n = 6), respectively. Thirty‐six children (2.9%) had major bleeding; 2 of them were not identified in day‐hospital (0.16%). Discharge was delayed in 103 patients (8.3%), and 13 patients showed complications after discharge (about 1% readmission rate).CONCLUSIONOur program outcomes support safety. Outpatient surgery is meant to provide comfort to the patient and efficiency to the health care system, without impairing safety; in our experience, most tonsillectomies in children comply with these objectives.SIGNIFICANCEOutpatient tonsillectomy in children may be safe even with permissive criteria, when an appropriate setting is available.
Revision Cochlear Implant Surgery: Causes and Outcome
Authors: Fayad Jose N. , Baino Tony , Parisier Simon C. 
Published: October 2004

OBJECTIVETo review experience with cochlear implant reimplantations, including effect of reinsertion on audiological performance.STUDY DESIGN AND SETTINGRetrospective review of cochlear implant reinsertions in patients seen in a private tertiary neurotologic practice. Forty‐three patients (8 adults and 35 children) underwent revision cochlear implant surgery for device failure or upgrade. Findings at initial and repeat operations were noted, including number of electrodes inserted, and speech perception performance data were obtained when available.RESULTSFive complications occurred in the reinsertion operations, 2 (6%) intraoperative cerebral spinal fluid leaks and 3 (7%) postoperative flap break‐downs with implant extrusion. Number of electrodes inserted was unchanged in 40/43 patients. Speech perception abilities remained stable or improved.CONCLUSIONCochlear reimplantation is technically feasible and allows for continued auditory stimulation.SIGNIFICANCEPatients facing reimplantation must be aware of the possibility of differences in sound quality and speech recognition performance with their replacement device, but speech perception ability will typically remain the same or improve.
Harmonic Scalpel versus Cold Knife Dissection in Superficial Parotidectomy
Authors: Blankenship D. Russ , Gourin Christine G. , Porubsky Edward A. , Porubsky Edward S. , Klippert Frederick N. , Whitaker Elizabeth G. , Terris David J. 
Published: October 2004

OBJECTIVESUse of the Harmonic Scalpel has recently been described in thyroid surgery, in which it appears to result in decreased operative time and blood loss without increasing the incidence of nerve injury when compared to conventional techniques of vessel ligation and tissue division. We sought to determine whether the use of the Harmonic Scalpel in superficial parotidectomy was associated with a difference in operative time, blood loss, or facial nerve injury compared with conventional techniques.STUDY DESIGN AND SETTINGThe medical records of all patients who underwent superficial parotidectomy for benign parotid pathology at the Medical College of Georgia and Veterans Affairs Hospital of Augusta, Georgia, from 1999 to 2002 were retrospectively reviewed. Patients were excluded if they had a history of a bleeding disorder, prior facial nerve weakness, prior parotid surgery, malignant pathology, or required total parotidectomy.RESULTSForty‐two patients were eligible for inclusion. Nineteen patients underwent Harmonic Scalpel parotidectomy (HS) and 21 patients underwent conventional parotidectomy (control group). There were no significant differences between the 2 groups with respect to demographic data, pathology, or tumor size. Use of the Harmonic Scalpel was associated with a significant reduction in length of surgery (167.5 ± 42.6 min vs. 195.5 ± 37.4 min for controls, P = 0.03) and intraoperative blood loss (37.5 ± 25.8 mL vs. 60.0 ± 37.1 mL for controls, P = 0.03). There were no significant differences between the HS or control groups with respect to postoperative drain output (48.7 ± 33.8 mL vs. 48.0 ± 22.9 mL, respectively, P > 0.05) or facial nerve function.CONCLUSIONUse of the Harmonic Scalpel for superficial parotidectomy is safe and may result in reduced operative time and blood loss compared with conventional techniques.SIGNIFICANCEA safe alternative to cold knife superficial parotidectomy is presented with the potential benefits of reduced operative time and blood loss demonstrated.
The Effect of Tonsillectomy and Adenoidectomy on Inattention and Impulsivity as Measured by the Test of Variables of Attention (TOVA) in Children with Obstructive Sleep Apnea Syndrome
Authors: Avior Galit , Fishman Gadi , Leor Agnes , Sivan Yakov , Kaysar Nehemia , DeRowe Ari 
Published: October 2004

OBJECTIVETo evaluate children with obstructive sleep apnea syndrome (OSAS) for features of attention deficit disorder (ADD) using an objective test of inattention and impulsivity: Test of Variables of Attention (TOVA) and then to determine whether tonsillectomy and adenoidectomy (T+A) results in an improvement in TOVA scores.STUDY DESIGN AND SETTINGThis study was a prospective interventional comparative trial in a tertiary care children's hospital. Nineteen children ages 5 to 14 years with OSAS, and otherwise healthy, with a clinical indication for T+A. Preoperative and 2 months postoperative OSA‐18, CBCL questionnaires, and TOVA scores were evaluated.RESULTSThe preoperative TOVA scores were in the abnormal range in 12/19 (63%) of the children. The mean preoperative TOVA score was −2.9 (± 3.1). The mean postoperative TOVA score was −0.4 (±2.8). The improvement in the TOVA scores was significant (P < 0.0001, t‐test).CONCLUSIONThis preliminary data suggests that treatment of OSAS with T+A results in significant improvement in objective parameters of inattention and impulsivity.SIGNIFICANCEThese findings may be important in understanding the impact of OSAS and therapeutic interventions on behavioral problems in children.
Mutant Nbs1 Enhances Cisplatin‐Induced DNA Damage and Cytotoxicity in Head and Neck Cancer
Authors: Tran Hao Mimi , Shi Guoli , Li Gouyan , Carney James P. , O'Malley Bert , Li Daqing 
Published: October 2004

OBJECTIVEEnhanced DNA double‐strand break (DSB) repair could be a primary cause for development of resistance in tumor cells to cisplatin, which induces crosslinks and DNA DSBs. A protein complex consisting of hMre11, hRad50, and Nbs1 (MRN) has been identified as a critical component in repair of DNA DSBs. The present study investigates whether the expression of a truncated form of Nbs1 interrupts the function of the MRN complex and therefore enhances cisplatin‐induced DNA damage and cytotoxicity in human head and neck squamous cell carcinoma (HNSCC).METHODS AND MEASURESTwo human HNSCC cell lines, JHU006 and JHU029, were used. A dominant negative recombinant adenovirus expressing domains of Nbs1 was constructed. Adenovirus‐mediated mutant Nbs1 (Ad‐Nbs1) gene transfer was performed with replication‐defective virus (DL312) and no treatment as controls. Transgene expression and cell viability were evaluated in transfected cells. Neutral comet assay was performed and the “tail moment,” the product of the amount of DNA in the tail and the distance of tail migration, was analyzed for evaluating DNA DSB damage at 24, 48, and 72 hours.RESULTSTransgene expression of mutant Nbs1 was confirmed by Western blotting. Ad‐Nbs1 gene transfer significantly increased cisplatin‐induced cytotoxicity as shown by stunting of 6‐day growth curves. Neutral comet analysis revealed that the mean tail moment, indicative of DNA damage, was significantly elevated in cells treated with combined cisplatin and Ad‐Nbs1 compared to cisplatin alone in both cell lines.CONCLUSIONSExpression of mutant Nbs1 significantly increases cisplatin‐induced DNA DSBs and cytotoxicity. The increase in double‐strand DNA damage corresponds to the level of cytotoxicity in the different treatment groups and suggests that tumor chemosensitization occurs through augmentation of DNA DSBs.CLINICAL SIGNIFICANCEAlteration of DNA repair may provide a novel approach to enhancing sensitivity of HNSCC to chemotherapy. Our study supports the potential application of Ad‐Nbs1 in combination with cisplatin for treatment of advanced and metastatic HNSCC.