bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between middle ear pressure, mucosal lesion, and mastoid pneumatization
Authors: Aoki Kazuhiro , Mitani Yukie , Tuji Tomihiko , Hamada Yukio , Utahashi Hiroya , Moriyama Hiroshi 
Published: November 2003

AbstractObjectives: The inflammatory changes of pneumatic space mucosa are thought to affect the development of pneumatic space and the function of transmucosal gas exchange. So, it is assumed that the mucosal change is deeply involved in the onset and healing process of otitis media with effusion (OME). The objective of this study is to investigate whether the growth of the mastoid cells and the middle ear transmucosal gas exchange function in patients with OME are affected by the histopathologic changes in middle ear mucosa, and whether these two factors are changed by the treatment of OME. Materials and Methods: From 65 children with OME, middle ear mucosal specimens were collected during indwelling of a tympanic tube, and their histopathologic changes were compared with cell growth area measured on radiographic films and with the change in the middle ear total pressure (METP). Results: Suppression of the cell growth area was stronger and the METP stayed lower in cases with a higher degree of mucosal lesion. Significant expansion of pneumatic area was observed after 2 years of tube indwelling, and the peak METP showed a significant increase after 1.5 years. This increase in the METP was caused by diffusion/absorption of CO2 and O2 and indicated recovery of the transmucosal gas exchange function. Conclusions: The growth of the mastoid cells and the middle ear transmucosal gas exchange function are closely affected by the subepithelial histopathologic changes in middle ear mucosa, and these two factors recover by the treatment of OME.
Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy
Authors: Hartikainen Jouko , Antila Jukka , Varpula Matti , Puukka Pauli , Seppä Heikki , Grénman Reidar 
Published: November 2003

AbstractObjectives and Study Design: The advent of the rigid endonasal endoscope and the development of functional endoscopic sinus surgery (FESS) technique have awakened interest in an endonasal endoscopic dacryocystorhinostomy (EESC‐DCR) in treating nasolacrimal obstruction. This prospective, randomized study compares EESC‐DCR with traditional external dacryocystorhinostomy (EXT‐DCR) for their success rates, surgical duration, and postoperative symptoms. Patients and Methods: Sixty‐four cases in 60 patients with primary acquired nasolacrimal sac or duct obstruction were divided into two subgroups by symptoms (simple epiphora/ chronic dacryocystitis). These patients were randomized within both subgroups into two operation groups. Altogether 32 EESC‐DCRs and 32 EXT‐DCRs were performed. The final follow‐up visit was at 1 year. The patency of the lacrimal passage was investigated by irrigation and patients were questioned about their symptoms. Results: The success rate at 1 year after surgery was 75% for EESC‐DCR and 91% for EXT‐DCR after primary surgery. The difference was not statistically significant (P = .18). The success rate after secondary surgery with a follow‐up time of 1 year was 97% in both study groups. The average duration for EESC‐DCR was 38 minutes, and 78 minutes for EXT‐DCR, (P < .001). Conclusions: EXT‐DCR, when compared with EESC‐DCR, appears to give a higher, although not statistically significant, primary success rate, but the secondary success rates are equal, indicating that these two different DCR techniques are acceptable alternatives.
Malignant Glomus Tumors
Authors: Manolidis Spiros , Shohet Jack A. , Jackson C. Gary , Glasscock Michael E. 
Published: November 2003

AbstractObjectives/Hypothesis: To ascertain the incidence of malignancy in a large glomus and skull base series and to compare the clinical course of such patients with those who do not have malignant skull base lesions. Study Design: Retrospective review of all skull base surgery cases treated at the Otology Group between 1970 and 1995. Results: In a series of 175 jugulotympanic glomus tumors, 9 cases (5.1%) were identified. The surgery required for their extirpation is more extensive than nonmalignant glomus tumors. Attendant deficits and mortality from these procedures are accordingly greater. Five‐year survival in this limited population was 72%. Prolonged periods of survival are possible with distant metastases. Conclusions: This rate of malignancy should advocate against a watchful, waiting approach. Radiation therapy is not advocated as a primary modality for this type of tumor, as it may lead to recurrence/persistence with either subsequent malignant degeneration and metastases or local recurrence.
Effects of Atropine and Scopolamine on Bradycardia and Emetic Symptoms in Otoplasty
Authors: Honkavaara Pekka , Pyykkö Ilmari 
Published: November 2003

AbstractObjective: To assess the effects of unilateral or bilateral otoplasty on bradycardia and postoperative nausea and vomiting (PONV) and the efficiency of transdermal scopolamine in the prophylaxis of PONV. Study Design: Post hoc assessment of the data from a double‐blind, randomized study. Methods: Fifty otoplasty patients were studied; half of them received randomly and in double‐blind fashion a transdermal therapeutic system (patch) of scopolamine (TTS‐scopolamine) as prophylaxis against PONV before general anesthesia. The placebo group received atropine 10 μg·kg−1 intravenously during induction. Results: The scopolamine‐treated patients suffered more from moderate peroperative bradycardia (8/25; P < .05) than the atropine‐treated patients (1/25). Two patients wearing a half of the TTS‐scopolamine patch needed intravenous atropine. After unilateral otoplasty, none of the TTS‐scopolamine‐treated patients and 50% of the atropine‐treated patients suffered from PONV. After bilateral operation, the respective incidences were 39% and 81% (P < .01). After unilateral otoplasty no patient needed droperidol, but after bilateral otoplasty, 12 of 19 of the atropine‐treated and 4 of 18 (P < .05) of the scopolamine‐treated patients needed droperidol. The mean numbers of doses of droperidol were 0.8 ± 0.9 and 0.3 ± 0.6 (P < .05), respectively. Two additional patients, wearing half of the TTS‐scopolamine patch, suffered from mild central anticholinergic syndrome. Conclusion: TTS‐scopolamine offers effective prophylaxis against PONV (auriculoemetic reflex), but does not protect from bradycardia (auriculocardiac reflex) in otoplasty. Cutting of the TTS‐scopolamine patch may lead to undesirable side effects.
Laryngeal Motion During Exercise
Authors: Beaty Mark M. , Wilson Jeff S. , Smith Richard J. H. 
Published: November 2003

AbstractObjective: To compare laryngoscopically observed changes in the larynx during exercise in persons with exercise‐induced laryngomalacia (EIL) with changes in asymptomatic control subjects.Study Design: Clinical study using a standardized exercise protocol.Methods: Subjects exercised on an incremental ergometer: videotaped recordings of the larynx were obtained through the entire exercise; pulmonary function tests were completed before and/or immediately after the exercise.Results: Laryngeal lumen size decreases during exercise in subjects with EIL.Conclusion: Subjects with EIL had a significant decrease in laryngeal lumen size during exercise compared with asymptomatic control subjects.
Complications of Rhytidectomy in an Otolaryngology Training Program
Authors: Sullivan Christopher A. , Masin Jeffrey , Maniglia Anthony J. , Stepnick David W. 
Published: November 2003

AbstractObjectives/Hypothesis: Complications of rhytidectomy have been widely reported in the literature. This study examines the incidence of complications after rhytidectomy in the hands of chief residents under appropriate attending supervision in an otolaryngology—head and neck surgery training program. Materials and Methods: The charts of 96 consecutive SMAS rhytidectomy patients were retrospectively reviewed. Patients were selected for surgery from a clinic designed exclusively for cosmetic facial surgery patients. This clinic was run by the otolaryngology chief resident and was supervised by an attending staff surgeon. Most patients elected local anesthesia and sedation administered by the surgical team. Submental liposuction was performed followed by SMAS plication rhytidectomy. Results: Follow‐up ranged from 1 to 60 months. Complications included expanding hematoma (1%), temporary facial nerve weakness (3%), pretragal/mastoid skin slough (4.2%), permanent ear numbness (1%), hypertrophic scar (3.1%), wound infection (1%), and dissatisfaction with result (4%). There were no cases of permanent facial nerve injury. Conclusion: These complication rates compare favorably with reported rates of larger studies over the past 30 years. These data support the conclusion that rhytidectomy can be performed safely by otolaryngology residents with little morbidity and good patient satisfaction.
Squamous Cell Carcinoma of the Sinonasal Tract Invading the Orbit
Authors: Carrau Ricardo L. , Segas John , Nuss Daniel W. , Snyderman Carl H. , Janecka Ivo P. , Myers Eugene N. , D'Amico Frank , Johnson Jonas T. 
Published: November 2003

AbstractObjective/Hypothesis: The treatment of squamous cell carcinoma (SCC) of the sinonasal tract has evolved from routine exenteration of the orbital contents to sparing of the orbit when the SCC does not transgress the periorbita. Nonetheless, the influence of this change in treatment over the rate of local recurrence or survival has not been clearly elucidated. The objective was to ascertain whether orbital sparing surgery for the treatment of SCC of the paranasal sinuses influences the rate of local recurrence or survival. Study Design: This is a retrospective study of patients presenting with SCC arising in the sinonasal tract, treated primarily at the University of Pittsburgh Medical Center from 1977 to 1990, including meta‐analysis of the English literature regarding SCC of the sinonasal tract. Methods: Review of medical records regarding demographics, histology, extension of tumor, pathologic results, type of surgery, adjunctive therapy, and outcome. Articles for meta‐analysis were identified by Medline search and cross‐referencing. Results: Fifty‐eight patients with orbital invasion, including bone and/or soft tissue invasion, were included in the study. Patients presenting with invasion of the bony orbit without soft tissue invasion were treated with maxillectomy and/or ethmoidectomy, sparing the orbital contents. Patients presenting with invasion of the orbital bones and soft tissues were treated with ethmoidectomy or maxillectomy, including orbital exenteration. At 3 years' follow‐up, 52% of the patients whose orbit was exenterated were alive and without evidence of disease, compared with 59% of the patients whose orbit was spared. This difference was not statistically significant. Similarly, the rate of local recurrence was not statistically significant (P > .05). A meta‐analysis of the literature revealed similar results. Conclusions: Our data suggest that sparing of the soft tissues of the orbit when the periorbita has not been transgressed by SCC does not downgrade the rate of cure or local control.
Clinical Evolution of Laryngeal Granulomas: Treatment and Prognosis
Authors: De Lima Pontes Paulo Augusto , De Biase Noemi Grigoletto , Gadelha Maria Emília C. 
Published: November 2003

AbstractObjective/Hypothesis: To study the response to treatment by patients with granulomas not related to surgery, considering their respective causes. Methods: Retrospective study of larynx granulomas seen at the Institute da Laringe (Sǎo Paulo, Brazil) from June 1996, totaling 66 patients, being 20 (30,3%) diagnosed with gastroesophageal reflux syndrome, 22 (33,3%) due to vocal abuse, 15 (22,7%) to postorotracheal intubation, and 9 (13,6%) of idiopathic cause. Findings: Of the 66 patients diagnosed, 10 did not start the treatment, with only 56 being analyzed, 6 of whom later abandoned the treatment. The cause‐oriented treatment showed 100% control in postintubation granulomas. In the cases of reflux and vocal abuse, the success rates when considering only the cause were 75% and 87.5%, respectively. In the cases of undefined cause, all were subjected to surgical removal with or without clinical or speech‐therapy treatment; we attained only a 37.5% success rate in the first trial. Of these, after various unsuccessful rescue treatments, three which were treated with botulinum toxin type A had 100% resolution. The recurrence percentage varied according to the cause, being nonexistent in the postintubation cases, 21.4% in patients with reflux esophagitis, 35.2% in vocal abuse, and 62.5% in those of idiopathic etiology. Conclusion: Of the laryngeal granulomas, the best prognoses were given by the postintubation ones, whereas the worst were those of undefined cause. Those ascribed to gastroesophageal reflux and vocal abuse have a high resolution rate, although some cases need rescue procedures.
Differentiation of Spasmodic and Psychogenic Dysphonias With Phonoscopic Evaluation
Authors: Leonard Rebecca , Kendall Katherine 
Published: November 2003

AbstractObjectives: Identify laryngeal behaviors that differentiate patients with spasmodic dysphonia and patients with psychogenic dysphonia. Study Design: Retrospective review of patients evaluated over a 3‐year period with a diagnosis of either spasmodic or psychogenic dysphonia. Videotaped phonoscopic (laryngeal imaging) examinations of all noted aberrant behaviors were examined. Tally behaviors according to each subject group. Methods: Three examiners unfamiliar with patients' previous diagnoses reviewed videotaped studies. Aberrant behaviors were noted and each patient was assigned to spasmodic or psychogenic dysphonia group. Agreement among examiners and agreement with previous diagnoses was established. Results: Six abnormal behaviors were noted, including tremor, hyperadduction, false fold constriction, sphincteric constriction, hyperabduction and paradoxical movements of the true and false folds. Percentage of patients in each group with each behavior was determined. Conclusions: Individual behaviors did not generally appear to differentiate the two groups; however, patterns of behaviors did, and may be of considerable value in differentiating spasmodic and psychogenic dysphonias.
Cost‐Effectiveness of the Diagnostic Evaluation of Vertigo
Authors: Stewart Michael G. , Chen Amy Y. , Wyatt J. Robert , Favrot Steven , Beinart Sean , Coker Newton J. , Jenkins Herman A. 
Published: November 2003

AbstractObjective: To evaluate the cost‐effectiveness of several diagnostic tests used in the evaluation of vertigo.Study Design: Cost‐effectiveness analysis, using data from retrospective case review.Methods: Charts and test results were reviewed from 192 outpatients seen in an academic tertiary referral center for evaluation of vertigo. Cost‐effectiveness analysis was performed using decision analysis software, data from office and hospital charges, and expert‐based estimations of the utility of different test outcomes. Sensitivity analysis was performed using standard algorithms and wide variable ranges.Results: We found that audiologic testing, posturography, and electronystagmography were the most cost‐effective tests, and that magnetic resonance imaging and blood tests had the lowest cost‐effectiveness. The analysis was sensitive to the effects of financial costs of tests but, with a few exceptions, was typically not sensitive to the utility of test outcomes or the distribution of test results.Conclusions: The use of cost‐effectiveness analysis, the estimation of utility of test outcomes, and techniques of sensitivity analysis should help guide the clinician's decision making on appropriate testing for patients with vertigo.
Recognition of a Dominant Epitope in Bovine Heat‐Shock Protein 70 in Inner Ear Disease
Authors: Bloch Donald B. , Gutierrez Jesus A. , Guerriero Vince , Rauch Steven D. , Bloch Kurt J. 
Published: November 2003

AbstractObjective: To investigate the specificity of anti‐bodies to heat‐shock protein 70 (HSP70) in patients with idiopathic, progressive, bilateral sensorineural hearing loss (IPBSNHL) and Meniere disease.Study Design: Test immunoreactivity of patients' sera using recombinant human (rh) and bovine (rb) HSP70, as well as segments representing different regions of bovine HSP70 as antigen.Methods: Sera were tested by Western blotting.Results: Of 52 patients with IPB‐SNHL, 40 sera reacted only with rbHSP70; 12 reacted with both rbHSP70 and rhHSP70. Sera from 13 patients with IPBSNHL and from 8 with Meniere disease were tested on the panel of bovine HSP70 segments. Eleven and 7 samples, respectively, reacted with amino acid segment 427‐461 from the carboxy (C)‐terminal region of the molecule.Conclusion: In IPBSNHL and Meniere disease, antibodies are directed primarily against an epitope(s) within the C‐terminal region of HSP70 where diversity in sequence among different species, including possible pathogens, is greatest. These findings may provide clues to the pathogenesis or specific serodiagnosis (or both) of diseases of the inner ear.
Improved Nerve Regeneration With Neutralization of Transforming Growth Factor‐β1
Authors: Davison Steven P. , McCaffrey Thomas V. , Porter M. Nora , Manders Ernest 
Published: November 2003

AbstractObjectives: Recovery of injured peripheral nerves depends on a balance between Schwann cell regeneration and scar formation. Transforming growth factor‐β1 (TGF‐β1) has been implicated as a humoral stimulus in scar formation. The neutralization of TGF‐β1 has been beneficial in the reduction of fibrosis. This study was to identify the presence of TGF‐β1 in regenerating peripheral nerve and to measure motor nerve regeneration by the neutralization of TGF‐β1 in neural wounds.Study Design: A randomized study of rat sciatic nerve regeneration.Method: Sciatic nerve axotomy was performed, followed by serial immunohistochemical staining by anti‐TGF‐β1 at 12 to 216 hours (n = 5). Two groups (n = 10) with sciatic axotomy and epineural repair were treated with a 7‐day perineural administration of neutralizing antibody of TGF‐β1 or saline carrier via subcutaneous silicone infusion port. A control group (n = 10) without axotomy with anti‐TGF‐β1 administration was established. At 12 weeks the compound muscle action potential amplitude (CMAP) and the muscle twitch strength generated by the gastrocnemius‐soleus muscle complex were measured.Results: TGF‐β1 was qualitatively present with maximal concentration by 72 to 144 hours. CMAP amplitude in the anti‐TGF‐β1/axotomy group was 49.6% of the control and the axotomy/saline group was 31% of the control. Muscle twitch strength was 74% and 46.5%, respectively. These differences were statistically significant, P = .05.Conclusions: The presence of TGF‐β1 at regenerating nerve sites was confirmed. The benefit of neutralization of transforming growth factor on CMAP and muscle twitch strength was shown. These results suggest improved regeneration at nerve injury sites with neutralization of TGF‐β1.
A Prospective Randomized Double‐Blind Trial of Fibrin Glue for Pain and Bleeding After Tonsillectomy
Authors: Stoeckli Sandro J. , Moe Kris S. , Huber Alex , Schmid Stephan 
Published: November 2003

AbstractObjectives: The notable morbidity of tonsillectomy includes considerable postoperative pain and a rate of postoperative bleeding that have remained largely uninfluenced by modern surgical techniques or medication. Fibrin glue is known to have a hemostatic effect in some settings, and there is research suggesting it may also reduce postoperative pain. The objectives of this study were to evaluate the effect of fibrin glue on pain and bleeding after tonsillectomy.Study Design: A prospective randomized double‐blind study was performed on 50 consecutive adult patients undergoing tonsillectomy for chronic tonsillitis.Methods: After removal of both tonsils the tonsillar fossa randomly assigned to the treatment protocol was coated with fibrin glue. The other side was left unaltered. The patient was then monitored for postoperative bleeding and wound healing, and a patient‐based pain assessment instrument was used to evaluate symptoms every 8 hours for 10 days after surgery.Results: Detailed evaluation of the pain scores allowed the authors to create a pain profile for what the typical patient experiences over the first 10 postoperative days, as well as during the course of a single day. The pain remains relatively constant for the first 7 days and begins to decrease only on the eighth postoperative day. During a single day there is increased pain in the morning compared with noon and evening. However, no statistically significant difference was detected in postoperative pain, bleeding, or healing between the wounds treated with fibrin glue and controls.Conclusions: The patient‐based pain evaluation data should aid the physician in preoperative outcome counselling and targeted prescription of pain medication. However, contrary to previous indications, the authors cannot substantiate a significant beneficial effect of fibrin glue in postoperative pain control. Furthermore, we did not find its action as a hemostatic agent clinically applicable in this setting, and thus find no indication for the routine use of fibrin glue in tonsillectomy.
Radiofrequency energy tissue ablation for the treatment of nasal obstruction secondary to turbinate hypertrophy
Authors: Utley David S. , Goode Richard L. , Hakim Ishrat 
Published: November 2003

AbstractObjective/Hypothesis: We hypothesized that the success rate of radiofrequency energy (RFe) tissue ablation of the inferior turbinate for nasal obstruction achieved by previous investigators would be improved by using a longer needle electrode and creating two lesions per turbinate. Methods: Ten patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. A 40‐mm needle delivered RFe to two sites in each inferior turbinate. Patients used a visual analog scale (VAS) to grade nasal obstruction preoperatively and at 1 week and 8 weeks after surgery. Preoperative and postoperative digital images of the nasal cavity were graded for obstruction (0% to 100%) in a blinded manner. Results: All patients (100%) were subjectively improved at 8 weeks. Mean obstruction (VAS) improved from 50% ± 21% to 16% ± 15% (right side) and from 53% ± 29% to 13% ± 13% (left side). Mean improvements were 68% (right side) (P = .004) and 75% (left side) (P = .001). Mean obstruction graded during blinded review of nasal cavity images improved from 73.5% ± 8% to 51% ± 8% (right side) and from 76% ± 6% to 64% ± 7% (left side). Of nine patients using medications for nasal obstruction before treatment, eight (89%) noted no further need for medications at 8 weeks. Conclusion: The use of RFe for submucosal tissue ablation in the hypertrophied inferior turbinate is an effective modality for reducing symptoms of nasal obstruction. Improved results may occur by using a longer needle and creating two lesions per turbinate. Of patients in this study, 100% reported improvement of nasal obstruction.