bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Accuracy of Computed Tomography in the Diagnosis of Chronic Rhinosinusitis
Authors: Bhattacharyya Neil , Fried Marvin P. 
Published: November 2003

AbstractObjective To determine the sensitivity, specificity, and diagnostic accuracy of paranasal sinus computed tomography (CT) in the diagnosis of chronic rhinosinusitis (CRS).Study Design Prospective dual cohort study.Methods One hundred seventy‐one consecutive patients undergoing endoscopic sinus surgery for CRS were evaluated with CT and staged according to the Lund system. Histopathological findings from sinus specimens were reviewed and graded. A second contemporaneous control group of 130 patients undergoing CT of the sinus regions for other reasons but without a diagnosis of CRS was also staged. Sensitivity, specificity, and the receiver–operator characteristic were determined for the sinus CT in the diagnosis of CRS. Positive and negative predictive values were also computed.Results In the disease‐positive group of patients with CRS, the mean Lund score was 9.8 (95% confidence interval, 9.0–10.6). The mean inflammatory grade on histopathological study was 2.3 (range, 0–4). For the control group (without disease), the mean Lund score was 4.3 (95% confidence interval, 3.5–5.0). The AUC for the receiver–operator characteristic was 0.802 (P <.001). Selecting a Lund score cut‐off value of greater than 2 as abnormal, the sinus CT exhibited sensitivity and specificity of 94% and 41%, respectively. Increasing the cut‐off value to 4 changed the sensitivity and specificity to 85% and 59%, respectively.Conclusions The paranasal sinus CT scan exhibits good sensitivity and above‐average specificity for the diagnosis of CRS. When added to the history and physical findings, CT may add to the diagnostic accuracy of CRS.
Effects of Steel Scalpel, Ultrasonic Scalpel, CO2Laser, and Monopolar and Bipolar Electrosurgery on Wound Healing in Guinea Pig Oral Mucosa
Authors: Sinha Uttam K. , Gallagher Laura A. 
Published: November 2003

AbstractObjectiveThe study's objective was to compare instrument performance and tissue healing when steel scalpel, ultrasonic scalpel, monopolar or bipolar electrosurgical instruments, or CO2laser was used in an animal oral surgery model.Study DesignProspective, blinded, randomized.MethodsAdult guinea pigs (N = 70) were randomly assigned to 5 groups (14 animals per group) for excision of 2‐cm, full‐thickness oral mucosa using steel scalpel, ultrasonic scalpel, monopolar or bipolar electrosurgical instruments, or CO2laser. Postoperative pain was measured indirectly using weekly body weight changes. Animals from each group were killed on days 0, 7, 14, 21, and 28. Specimens were harvested for blinded histopathological study and tensile strength measurement. Instrument performance (hemostasis, tissue coagulation, tissue sticking) and wound healing (tissue re‐epithelialization, degree of inflammation) were primary outcomes. Statistical analysis was performed using analysis of variance.ResultsThe ultrasonic scalpel was the best tool in controlling hemostasis, tissue coagulation, and tissue sticking. Significantly higher body weight gain (P<.05) was noted at day 7 for monopolar and CO2laser groups. Greatest tensile strength was seen in the steel scalpel and ultrasonic scalpel groups at the end of 28 days. Tissue re‐epithelialization was fastest for the steel scalpel and ultrasonic scalpel groups (complete by day 7). Complete re‐epithelialization of wounds of all treatment groups occurred by day 28. All groups had acute inflammation. Complete resolution of inflammation by day 14 took place in the steel scalpel and ultrasonic scalpel groups only.ConclusionUse of the ultrasonic scalpel produced faster re‐epithelialization and greater tensile strength than laser or electrosurgical instruments, with results comparable to those seen with the steel scalpel.
Acoustic Rhinometry and Paranasal Cavities: A Systematic Study in Box Models
Authors: Mlynski Robert , Grützenmacher Stefan , Lang Christian , Mlynski Gunter 
Published: November 2003

AbstractObjective/Hypothesis Acoustic rhinometry (AR) is a well‐established diagnostic tool in rhinology. The aim of the study was to test the hypothesis that the paranasal sinuses are a main cause for inaccuracy of AR in the posterior part of the nose.Study Design Experimental study to evaluate the influence of simulated paranasal sinus volume and of the contralateral side of the nose on AR measurements in “box models.”Methods Models were measured with paranasal sinus volume simulated between 0 and 25 mL and with the junction between the models and the paranasal sinuses varying in length and diameter.Results Moderate but distinct modification of the posterior area–distance curve was found within the models after changing size of the paranasal sinuses and its junction to the cavity. The apparent cross‐sectional area (CSA) measured in the posterior cavum decreased with the volume of the paranasal sinuses. This effect was limited by the length and the diameter of the paranasal junction, as well as by the concha. No influence of the contralateral side on AR measurements was seen.Conclusions Acoustic rhinometry reveals reproducible measurements up to 4 cm from the nostril that correspond with the actual model CSA. Simulated paranasal sinuses appear to partially contribute to the inaccuracy in the posterior part of the area–distance curve.
Vertigo From Herpes Zoster Oticus: Superior or Inferior Vestibular Nerve Origin?
Authors: Lu Ying‐Chih , Young Yi‐Ho 
Published: November 2003

AbstractObjective/Hypothesis This study aims to analyze which division of vestibular nerve in the internal auditory canal is responsible for inducing vertigo in patients with herpes zoster oticus (HZO).Methods Eight patients (three men and five women) suffered from auricular vesicles, otalgia, and facial palsy, and five of them also had vertigo. Each patient received a battery of tests, including neurological examination, blood examination, audiometry, caloric test, electronystagmography, and vestibular evoked myogenic potential (VEMP) test.Results All five HZO patients with vertigo had facial palsy on the lesioned side and spontaneous nystagmus beating toward the healthy side. Absent VEMPs were noted in five patients, absent caloric response was noted in four, and sensorineural HL was noted in three. Compared to another three HZO patients without vertigo, all revealed normal responses in both the caloric test and the VEMP test. On MRI scan, two out of four had abnormal gadolinium enhancement along the nerve segments within the internal auditory canal. Six months after treatment, a follow‐up caloric test and VEMP test in these eight patients did not alter the results compared with before treatment.Conclusion The nerve trunks within the internal auditory canal are widely affected in HZO patients with vertigo. Both superior division and inferior division of the vestibular nerve attribute to the vertiginous attack. Further, large numbers of HZO patients undergoing caloric testing and VEMP testing are required to support this tentative conclusion.
Sudden Deafness and Lyme Disease
Authors: Lorenzi Maria Cecília , Bittar Roseli S. M. , Pedalini Maria Elisabete B. , Zerati Fabio , Yoshinari Natalino H. , Bento Ricardo F. 
Published: November 2003

AbstractObjectives/Hypothesis Otolaryngological manifestations are common in Lyme disease, affecting up to 75% of patients. One of these symptoms is sudden deafness. Hearing loss has been frequently described in Lyme disease; on the other hand, titers seropositive for Borrelia burgdorferi, the causal agent of this disease, have been found in almost 20% of cases of sudden deafness. No consensual information exists on the outcome of Borrelia‐seropositive patients or on the importance of determining Borrelia antibody titers. The present study aimed to determine the prevalence of seropositivity for Borrelia in sudden deafness, describing clinical characteristics and outcomes.Study Design This was a prospective observational study.Methods Forty‐seven consecutive patients with sudden deafness were enrolled in the study. Demographic data, the presence of tinnitus and vertigo, and low‐ and high‐frequency pure‐tone averages were recorded. The percentage of hearing recovery was determined. Data obtained from Borrelia‐seropositive patients were described and compared with those from the seronegative group.Results Titers positive for B burgdorferi antibodies were present in 21.3% of the cases. Seropositive and seronegative groups of patients were homogeneous concerning age, sex distribution, the presence of tinnitus and vertigo, and high‐ and low‐frequency hearing thresholds. Hearing outcome was not significantly different between the groups of patients.Conclusions No distinctive clinical characteristic was found between seropositive and seronegative subjects. The hearing outcome of treated Borrelia‐seropositive patients was similar to that of the seronegative group.
Hearing Impairment and Tinnitus Pitch in Patients With Unilateral Tinnitus: Comparison of Sudden Hearing Loss and Chronic Tinnitus
Authors: Ochi Kentaro , Ohashi Toru , Kenmochi Mutsumi 
Published: November 2003

AbstractObjectives The objectives were to analyze the results of pitch‐matching and loudness‐balance testing in patients with unilateral tinnitus and to evaluate the relationship between audiological findings based on the tinnitus‐affected and tinnitus‐unaffected threshold differences and tinnitus pitch by using linear interpolation methods. In addition, the effects of the duration of the tinnitus on this relationship were investigated. Sudden sensorineural hearing loss with tinnitus was selected for the “acute tinnitus” group, and unilateral tinnitus with unknown disease and a duration of more than 3 months was selected for the “chronic tinnitus” group.Study Design Retrospective study of the clinical records of patients.Methods One hundred thirty‐two patients with unilateral tinnitus (comprising 68 female [51.5%] and 64 male [48.5%] patients) were investigated as subjects. Their mean age was 50.4 years (SD = 15.8 y). All patients underwent otoneurological testing, including the pure‐tone audiogram and pitch‐matching and loudness‐balance tests.Results The mean difference in the hearing threshold between the tinnitus‐affected ear and the tinnitus‐unaffected ear was largest near the tinnitus pitch in both the acute and the chronic tinnitus groups. However, the relationship between hearing impairments and tinnitus pitch was somewhat different in the two groups: It exhibited a single smooth peak in the acute tinnitus group but a bimodal peak in the chronic tinnitus group.Conclusion The results suggest that tinnitus is related to hearing impairment in the same frequency region in patients with sudden sensorineural hearing loss with tinnitus or in patients with chronic tinnitus, whereas some instances of chronic tinnitus are caused by reorganization in cortical cells.
Management of Cholesteatoma: Status of the Canal Wall
Authors: Syms Mark J. , Luxford William M. 
Published: November 2003

AbstractObjective/Hypothesis Management of chronic otitis media with cholesteatoma remains controversial. The purpose of the study is to examine factors associated with the surgical approach to manage cholesteatoma.Study Design A retrospective review.Methods A retrospective review was made of all primary cases of mastoid surgery for cholesteatoma performed at an otological center between 1995 and 2000. During the study period, 486 ears underwent surgery for cholesteatoma. Data included procedures performed, location and extent of the disease, residual and recurrent disease, complications, reasons for staging the surgery, and duration of follow‐up.Results The canal wall remained intact in 68.5% of ears. The majority of the remainder of the patients underwent a canal wall down technique with mastoid obliteration. Residual cholesteatoma was found in 26.9% of second procedures and in 2.7% of third procedures.Conclusions The majority of patients with cholesteatoma can be adequately managed with a canal intact tympanomastoidectomy with staging. Otolaryngologists should consider a two‐staged procedure as a viable management approach for chronic otitis media with cholesteatoma.
Intratympanic Gentamicin for Intractable Meniere's Disease
Authors: Perez Nicolas , Martín Eduardo , García‐Tapia Rafael 
Published: November 2003

AbstractObjective The study aimed to analyze the results of the intratympanic injection of gentamicin as a treatment option for patients with unilateral Meniere's disease who were refractory to medical treatment.Study Design Prospective study in the setting of a tertiary care medical center.Methods Seventy‐one patients with unilateral Meniere's disease according to 1995 American Academy of Otolaryngology—Head and Neck Surgery 1995 guidelines who had been unresponsive to medical therapy for at least 1 year were studied. Intratympanic injections of a prepared concentration of 27 mg/mL gentamicin were performed at weekly intervals until the development of symptoms and signs indicative of vestibular hypofunction in the treated ear. As the main outcome measure, the 1995 American Academy of Otolaryngology—Head and Neck Surgery criteria for reporting treatment outcome in Meniere's disease were used. The results of treatment were expressed in terms of control of vertigo, disability status (functional level and degree of overall impairment evaluated by the Dizziness Handicap Inventory and the University of California Los Angeles Dizziness Questionnaire), hearing level, and quantitative measurement of vestibular function.Results Vertigo was controlled in 83.1% of the 71 patients. Recurrence of vertigo spells after initially complete control was noted in 17 patients. In 13 of these patients, this was cured by another course of intratympanic injections of gentamicin. Functional level and measures of self‐reported handicap were significantly and promptly lowered after treatment in the patients who attained control of vertigo. Hearing level as pure‐tone average was unchanged 2 years after treatment, but hearing loss as a result of gentamicin injections occurred in 23 patients at the end of treatment and in 9 and 11 patients at 3 months and 2 years after the treatment, respectively. Vestibular function was kept normal or reduced in 49.3% of the patients, whereas in the rest of the patients vestibular areflexia was observed. Control of vertigo did not depend on the amount of vestibular damage.Conclusions Ending weekly intratympanic injections when clinical signs of vestibular deafferentation appear can control vertigo in the majority of patients, and it is a useful alternative, together with other surgical options, for the treatment of patients with Meniere's disease who do not respond to medical treatment.
Development of the First Force‐Controlled Robot for Otoneurosurgery
Authors: Federspil Philipp A. , Geisthoff Urban W. , Henrich Dominik , Plinkert Peter K. 
Published: November 2003

AbstractObjective In some surgical specialties (eg, orthopedics), robots are already used in the operating room for bony milling work. Otological surgery and otoneurosurgery may also greatly benefit from the enhanced precision of robotics.Study Design Experimental study on robotic milling of oak wood and human temporal bone specimen.Methods A standard industrial robot with a six‐degrees‐of‐freedom serial kinematics was used, with force feedback to proportionally control the robot speed. Different milling modes and characteristic path parameters were evaluated to generate milling paths based on computer‐aided design (CAD) geometry data of a cochlear implant and an implantable hearing system.Results The best‐suited strategy proved to be the spiral horizontal milling mode with the burr held perpendicular to the temporal bone surface. To reduce groove height, the distance between paths should equal half the radius of the cutting burr head. Because of the vibration of the robot's own motors, a high oscillation of the SD of forces was encountered. This oscillation dropped drastically to nearly 0 Newton (N) when the burr head made contact with the dura mater, because of its damping characteristics. The cutting burr could be kept in contact with the dura mater for an extended period without damaging it, because of the burr's blunt head form. The robot moved the burr smoothly according to the encountered resistances.Conclusion The study reports the first development of a functional robotic milling procedure for otoneurosurgery with force‐based speed control. Future plans include implementation of ultrasound‐based local navigation and performance of robotic mastoidectomy.
Cochlear Implantation Concurrent With Translabyrinthine Acoustic Neuroma Resection
Authors: Ahsan Syed , Telischi Fred , Hodges Annelle , Balkany Thomas 
Published: November 2003

AbstractObjectives/Hypothesis Cochlear implants provide successful auditory rehabilitation for patients with profound sensorineural hearing loss who do not derive at least marginal benefit from conventional hearing aids. Patients with neurofibromatosis type 2 can present with bilateral profound sensorineural hearing loss caused by bilateral vestibular schwannomas. Auditory rehabilitation in these patients can be challenging. We present the case of one such patient who underwent a concurrent translabyrinthine vestibular schwannoma resection and cochlear implantation in the same ear.Study Design A case report and review of the literature.Methods Review the patient's medical record and MEDLINE literature search.Results The patient presented with a relatively small tumor that was situated in the fundus of the internal auditory canal with intralabyrinthine extension. Postoperative performance with implant stimulation was in the higher range of that for other cochlear implant patients.Conclusions To the best of our knowledge, this is the first case reported of simultaneous cochlear implant and translabyrinthine acoustic neuroma resection in the same ear of a patient with neurofibromatosis type 2.
Endoscopic and Transconjunctival Orbital Decompression for Thyroid‐Related Orbital Apex Compression
Authors: Schaefer Steven D. , Soliemanzadeh Peyman , Della Rocca David A. , Yoo Gu‐Pei , Maher Elizabeth A. , Milite James P. , Della Rocca Robert C. 
Published: November 2003

AbstractObjective To evaluate the efficacy and safety of a combined endoscopic and transconjunctival orbital decompression in patients with thyroid‐related orbitopathy with orbital apex compression.Study Design Retrospective review.Methods A sequential series of patients with thyroid‐related orbitopathy presenting with orbital apex compressive myopathy with and without optic neuropathy who were undergoing combined endoscopic and transconjunctival decompression by the same surgeons from 1992 to 2001 was reviewed. Patients were regularly evaluated preoperatively and postoperatively over a 3‐ to 55‐month period to record the effects of this approach on visual acuity, Hertel exophthalmometry, and diplopia. Complications and secondary ophthalmological procedures were reviewed.Results Between 1992 and 2001, 72 combined endoscopic and transconjunctival decompressions were performed on 41 patients with orbital apex compression. Visual acuity improved in 89.3% of the patients with compressive optic neuropathy (P <.0005) and in 34.1% of those without neuropathy. Proptosis was reduced by 3.65 mm, on average. There was one case of transient intraoperative cerebrospinal fluid extravasation at the site of the optic nerve decompression, and one patient developed epistaxis.Conclusions The study supports the treatment of thyroid‐related orbital apex compression with and without compressive optic neuropathy by a combined transconjunctival and endoscopic approach. This approach offers short hospital stays, excellent visual recovery, and minimal complications in patients with thyroid‐related orbital apex compressive myopathy and related compressive optic neuropathy. The beneficial effects observed in the patients with visual loss continued to improve over time and were significant (P <.001).
Distribution of Respiratory Mucin Proteins in Human Nasal Mucosa
Authors: Groneberg David A. , Peiser Christian , Dinh Q. Thai , Matthias John , Eynott Paul R. , Heppt Werner , Carlstedt Ingemar , Witt Christian , Fischer Axel , Chung K. Fan 
Published: November 2003

AbstractObjectives/Hypothesis The upper respiratory tract is involved in many acute and chronic respiratory tract diseases that present with the symptom of mucus hypersecretion. Mucin genes that encode for the backbone of glycoproteins contribute to the viscoelastic property of airway mucus. We examined the cellular expression and distribution of two major respiratory mucus‐forming glycoproteins, MUC5AC and MUC5B, in normal human nasal tissues.Methods Immunohistochemical analysis using polyclonal antibodies against the mucins MUC5AC and MUC5B was performed in normal human nasal tissues.Results An abundant staining of submucosal mucus gland and epithelial goblet cells for MUC5B was found. Immunohistochemical analysis of MUC5AC showed staining of surface epithelium goblet cells, whereas there was no staining of glandular cells. Comparison of the expression to lower airways revealed a similar pattern of expression of both mucins.Conclusions The data in the present study demonstrated the localization of the two major respiratory mucin proteins in human nasal mucosa with a similar distribution of expression of MUC5AC and MUC5B in normal upper and lower airways. Mucin protein expression parallels that of mucin messenger RNA expression.
Highlights in the Evolution of Diagnosis and Treatment of Laryngeal Cancer
Authors: Assimakopoulos Dimitrios , Patrikakos George , Lascaratos John 
Published: November 2003

AbstractObjectives To present selected highlights from the evolution of diagnosis of laryngeal disease and treatment of laryngeal cancer from ancient Greece until the 20th century.Study Design Historical study of diagnosis of laryngeal disease and treatment of laryngeal cancer from the ancient Greek medical scriptures until the most recent evolutional steps in the 20th century.Methods Original Greek‐language texts of ancient and Byzantine medical writers were studied and literature on history of medicine was investigated to reveal early knowledge of diagnostic and therapeutic techniques for laryngeal disease and cancer of the larynx.Results Diseases of the upper aerodigestive tract were known and treated by ancient Greek physicians, and, later, Byzantine doctors, apart from preserving ancient medical concepts, contributed their own ideas, mainly about surgery and postoperative care. The initial therapeutic approach for the disorders caused by laryngeal tumors was either tracheotomy or endotracheal intubation in an attempt to prevent suffocation. In more recent times, construction of the laryngoscope and other modern examination instruments, as well as the final acceptance of histological diagnosis based on tissue biopsy, has allowed for accurate diagnosis and successful treatment of laryngeal lesions. Preoperational biopsy, application of pharyngoesophageal speech and advanced vocal devices for the laryngectomees, and invention of antibiotic and anesthetic agents had led, by the middle of the 20th century, to the establishment of extended and radical surgical techniques as optional treatment for laryngeal cancer. In addition, the discovery of x‐rays and radium introduced radiotherapy as an alternative in the treatment procedure for cancer of the larynx.Conclusion Progress in the evolution of laryngological diagnosis and practice demanded efforts by many daring and courageous investigators and surgeons, contributing new ideas and techniques in the development of modern laryn‐ gology.