bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune Dysfunction in Refractory Sinusitis in a Tertiary Care Setting
Authors: Chee Lincoln , Graham Scott M. , Carothers Daniel G. , Ballas Zuhair K. 
Published: November 2003

AbstractObjective To examine the contribution of the primary immunodeficiency states, which are uncommon in the general population, to refractory sinusitis.Study Design We retrospectively reviewed the charts of 316 patients with sinusitis who were referred to the Allergy and Immunology Clinic for immunological evaluation from 1991 to 1997.Methods Of the 316 patients, 79 were selected for further study. Inclusion criteria included at least one sinus surgery and/or sinusitis diagnosed by endoscopy and/or computed tomography (CT) scan at least three times in the previous year. Patients with human immunodeficiency virus (HIV), allergic fungal sinusitis, cystic fibrosis, and primary ciliary dyskinesia were excluded. The results of their immunological evaluation for atopy, T‐lymphocyte function, and immunoglobulin levels were examined.Results The average age of these 79 patients was 44 years (± 14.5 standard deviation [SD]). They had, on average, 2.94 (± 2.19 SD) previous operations and had mean sinus CT scores (Lund‐McKay) of 11.2 (± 5.0 SD). Forty of 79 (50.6%) patients had at least one positive result on skin test to an aeroallergen. Delayed hypersensitivity skin testing revealed that 22 of 55 patients (40%) were anergic. Of the 60 patients with in vitro T‐lymphocyte function testing, 54.8% showed abnormal proliferation in response to recall antigens, 11.3% had decreased response to alloantigen, and 26.3% demonstrated decreased response to T‐cell mitogens. Determination of quantitative immunoglobulins showed low immunoglobulin G in 14 of 78 patients (17.9%), low immunoglobulin A in 13 of 78 (16.7%), and low immunoglobulin M in 4 of 78 (5.1%). Common variable immunodeficiency (CVID) was diagnosed in 9.9% of patients, and selective IgA deficiency was found in 6.2%.Conclusions This retrospective review reveals an unexpectedly high incidence of immune dysfunction. These results suggest that immunological testing should be an integral part of the evaluation of patients with refractory sinusitis.
Quantitative Analysis of Mucin and Lectin in Maxillary Sinus Fluids in Patients With Acute and Chronic Sinusitis
Authors: Shinogi Jun , Harada Teruhiko , Nonoyama Tsutomu , Kishioka Chikako , Sakakura Yasuo , Majima Yuichi 
Published: November 2003

AbstractObjectives Sinusitis is characterized by quantitative and qualitative changes in mucus biosynthesis that contribute to sinus disease. In general, patients with acute sinusitis complain of purulent rhinorrhea, whereas those with chronic sinusitis complain of mucoid or mucopurulent rhinorrhea. Locally produced mucin largely contributes to the high viscoelasticity of mucus in sinusitis. In this study, the authors attempt to quantify the concentrations of mucin and lectin in the maxillary sinus fluids from these patients.Study Design To assess the concentrations of mucin and lectin in aspirates of 11 acutely and 11 chronically inflamed maxillary sinuses, the concentration of mucin was measured by enzyme‐linked immunosorbent assay (ELISA) and that of lectin by sandwiched enzyme‐linked lectin assay (ELLA).Results The concentrations of mucin and lectin that were measured using monoclonal antibodies (HCS 4, HCS 14, and HCS 18) and Ulex europaeus agglutinin‐1 (UEA‐1) in chronic sinusitis were higher than those in acute sinusitis. The concentration of total protein in chronic sinusitis was lower than that in acute sinusitis. Each mucin and lectin versus total protein ratio in chronic sinusitis was higher than that in acute sinusitis.Conclusions These data suggest that hypersecretion in chronic sinusitis may result from locally increased mucin production. Comprehension of this mechanism may be a strategy to prevent the viscous cycle of paranasal sinus fluids in chronic sinusitis.
Specificity of Parotid Sialendoscopy
Authors: Marchal Francis , Dulguerov Pavel , Becker Minerva , Barki Gerard , Disant François , Lehmann Willy 
Published: November 2003

AbstractObjective To present our initial experience with sialendoscopy of the parotid duct.Study Design: Methods Diagnostic and interventional sialendoscopy procedures were performed in 79 and 55 cases, respectively. Diagnostic sialendoscopy was used to classify ductal lesions into sialolithiasis, stenosis, sialodochitis, and polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolithiasis fragmentation and/or extraction device used, the total number of procedures, the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables. The outcome variable was the endoscopic clearing of the ductal tree and resolution of symptoms.Results Diagnostic sialendoscopy was possible in all cases, with an average duration of 26 ± 14 minutes and no complications. Interventional sialendoscopy was successful in 85% of cases, with an average duration of 73 ± 43 minutes (± standard deviation). Multiple procedures were performed in 45% of cases, general anesthesia was used in 24%, and parotidectomy in 2%. Multiple sialoliths were found in 58% of ducts and associated with more procedures under general anesthesia and longer operations. The average size of sialoliths was 3.2 ± 1.3 mm; larger stones were associated with more procedures under general anesthesia, longer and multiple procedures, use of fragmentation, and sialendoscopy failures. Sialolithiasis fragmentation was required in 10% of cases, with a success rate of 70%. Semirigid sialendoscopes performed better than flexible ones. Complications were mostly minor but were encountered in 12% of cases.Conclusions Diagnostic sialendoscopy is a new technique for evaluating salivary duct disease, a technique which is associated with low morbidity. Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision.
The Anatomical Basis of the Abbé Flap
Authors: Schulte Douglas L. , Sherris David A. , Kasperbauer Jan L. 
Published: November 2003

AbstractObjectives Objective of the study were 1) to determine the course, including specific relationship to the vermilion border, free margin of the lip, and orbicularis oris and number of the superior and inferior labial arteries, and 2) to discuss the relevance of this anatomy to design of the Abbé flap.Study Design Detailed anatomical dissections of the mid and lower face of injected cadaver heads.Methods Sixteen superior labial arteries and 15 inferior labial arteries in 9 adult cadaver heads ranging in age from 41 to 90 years were studied.Results The superior labial artery was a single vessel in all cases. At the oral commissure the vessel was superior to the vermilion border in 94% of the dissections. At the midline the vessel was within the vermilion border in 75% of dissections. The vessel was found within the orbicularis oris in 19% of dissections and between the mucosa and the orbicularis oris in 81% of dissections. The inferior labial artery was a single vessel in all dissections. Its course was variable in position relative to the vermilion border and to its take‐off from the facial artery. In the central portion of the lip the vessel was found within the orbicularis oris in 13% of dissections and between the mucosa and the orbicularis oris in 87% of dissections.Conclusions The superior labial artery is found within 10 mm of the free margin of the upper lip. The inferior labial artery is variable in its course, varying up to 15 mm from the free margin of the lower lip.
The Predictive Value of Serum Interleukins in Recurrent Respiratory Papillomatosis: A Preliminary Study
Authors: Snowden R. Todd , Thompson Jerome , Horwitz Edwin , Stocks Rose Mary 
Published: November 2003

AbstractObjective IL‐2 is the primary interleukin responsible for activation of the cell‐mediated (Th1) arm of the immune response. Our objective was to determine whether a correlation existed between circulating levels of interleukin‐2 as well as its soluble receptor (sIL‐2R) and the clinical course of recurrent respiratory papillomatosis.Methods and Materials Fifteen children with a histological diagnosis of RRP were recruited. Age at the time of study, time since first diagnosis, and number of surgical interventions were recorded. The number of surgically treated recurrences per year was then calculated. We obtained serum samples from each of these 15 children and from 10 normal control subjects. We then performed in vitro determination of serum IL‐2 and soluble IL‐2 receptor levels using enzyme‐linked immunosorbent assay (ELISA) techniques.Results IL‐2 was significantly lower (136.6 vs. 199.9 pg/mL, P = .035) in papilloma patients than in control subjects. IL‐2R was also lower in papilloma patients (531.7 vs. 785.8 U/mL, P = .025). There was no statistical age difference between the papilloma and control groups. Among patients with papillomatosis, IL‐2 and sIL‐2R levels were significantly higher in those with aggressive disease (>4 surgically treated recurrences per year) versus non‐aggressive disease (179.2 vs. 99.2 pg/mL, P = .024; and 697 vs. 387 U/mL, P = .022). Age was also significantly lower in the aggressive papilloma group (P = .002).Conclusions Levels of interleukin‐2 and IL‐2 receptor were significantly lower in patients with recurrent respiratory papillomatosis compared with normal children. These data support the presence of an aberrant cell‐mediated immune response in children with recurrent respiratory papillomatosis.
Computed Tomographic and Anatomical Analysis of the Basal Lamellas in the Ethmoid Sinus
Authors: Kim Sung‐Shik , Lee Jeung‐Gweon , Kim Kyung‐Su , Kim Hyun Ung , Chung In Hyuk , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives To investigate the exact anatomical structure of the lamellas in the ethmoid sinus by computed tomography (CT) and anatomical analysis.Study Design Cadaver dissections and CT scans were used to compare lamellar structures and their radiological images.Methods Anatomical microdissection of 100 midsagittal sections from adult cadaver head specimens were examined and compared with those of sagittal CT scans at 1‐mm intervals.Results The posteroinferior end of the uncinate process attaching to the inferior turbinate divided the fontanelle into the anterior and posterior portions in the majority of cases. The basal lamellas of the bulla ethmoidalis were subdivided into three major types. The posteroinferior portion of its basal lamella was connected to the lower horizontal portion of the third basal lamella in all cases. The anterior indentation of the third lamella was identified in nine cases, but there was no indentation in the posterior direction. The basal lamella of the superior turbinate was attached to the skull base superiorly either separately or fused to the third lamella, and its posteroinferior portion was attached to the lowest portion of the anterior wall of the sphenoid sinus. The supreme turbinate existed in 50 cases; however, its basal lamella was identified in only 15 cases.Conclusions Our results indicate that the lamellas of the ethmoid sinus have relatively uniform patterns, although there is variability in shape. It is hoped that this study will provide surgeons with a more detailed structure of the basal lamellas for better surgical results and lower complication rates.
Frequency and Localization of the Putative Vomeronasal Organ in Humans in Relation to Age and Gender
Authors: Knecht Michael , Kühnau Dorit , Hüttenbrink Karl‐Bernd , Witt Martin , Hummel Thomas 
Published: November 2003

AbstractObjectives/Hypotheses In many species the vomeronasal organ (VNO) serves as a chemosensory organ in addition to the olfactory system. The present investigation was undertaken to study 1) the frequency of monolateral or bilateral detection of the putative VNO (pVNO) in humans, 2) its localization in humans, and 3) whether detectability of the pVNO varies with age or gender.Study Design Prospective.Methods A total of 173 subjects participated in this study (88 women and 85 men; age range, 2–91 y). Inspection of the nose was performed with a speculum and a 30° endoscope. The exact localization of the VNO was measured with custom‐built rulers.Results The study revealed the following major results: 1) A pVNO is detectable in approximately two‐thirds of the population and bilateral pVNOs are present in approximately 40% of investigated subjects, 2) its localization on the left and right nasal septum is almost symmetrical, and 3) and detectability of the pVNO is not related to age or gender.Conclusions The present data indicated that the pVNO is present in approximately two‐thirds of the population. This value may be biased by methodological or biological factors; nevertheless, it indicates that the pVNO is not observed in all humans regardless of age and gender. Thus, considering its variability in shape and immunohistochemical characteristics and the missing nerval connections between the peripheral “organ” and the central nervous system, the present results are not suited to argue for a functional significance of the pVNO in humans.
Modulation of Myosin Heavy Chains in Rat Laryngeal Muscle
Authors: Shiotani Akihiro , Nakagawa Hideki , Flint Paul W. 
Published: November 2003

AbstractObjectives To test the hypothesis that myosin heavy chain (MHC) composition is a biological marker indicative of appropriate and functional reinnervation.Study Design Age‐matched adult rats were randomized for prospective study under three experimental conditions.Methods In adult rats, three e‐perimental conditions were surgically created, including transient recurrent laryngeal nerve (RLN) crush injury, RLN transection and repair, and cricoarytenoid joint fi‐ation with intact RLN. Animals were survived for 30, 90, and 180 days. At each interval, vocal fold mobility was assessed by rigid microlaryngoscopy. Laryngeal electromyography (EMG) was performed before euthanasia. The thyroarytenoid and posterior cricoarytenoid muscles were then e‐cised, each muscle was processed for sodium dodecyl sulfate–polyacrylamide gel electrophoresis, and MHC composition was determined.Results Thirty days after nerve crush injury, three of six animals regained vocal fold mobility and normal MHC composition. Impaired vocal fold motion in three of six animals was associated with MHC composition characteristic of denervation. At 90 and 180 days, normal vocal fold motion and normal MHC composition were observed in all animals. Following nerve transection and repair, impaired vocal fold motion and MHC composition characteristic of denervation were observed in all animals, despite evidence of reinnervation on EMG. Following joint fixation, alteration in MHC composition consistent with denervation was observed only at 30 days, as was evident in the nerve crush model.Conclusion Temporary injury and vocal fold immobilization result in transient shifts in MHC composition. Nerve transection and repair result in persistent alteration of MHC composition and vocal fold dysfunction. The expression of normal MHC composition is dependent on the condition of appropriate neural contact and functional reinnervation.
A Prospective Study on Pros and Cons of Electrodissection Tonsillectomy
Authors: Blomgren Karin , Qvarnberg Yrjö H. , Valtonen Hannu J. 
Published: November 2003

AbstractObjective Hemorrhages are main complications after tonsillectomy, whatever technique is used. This prospective study aimed at revealing pros and cons associated with monopolar electrodissection tonsillectomy.Study Design A prospective study.Methods A prospective study on all patients undergoing tonsillectomy or adenotonsillectomy in Central Hospital of Central Finland in 1997. Operation time and bleeding, as well as perioperative and postoperative complications, were recorded.Results Inpatient tonsillectomy was performed in 440 patients (mean age, 17.9 y). Primary post‐tonsillectomy hemorrhage (within 24 h) occurred in 2.3%. A total of 15.9% of patients searched for medical help because of secondary post‐tonsillectomy hemorrhage, 7.7% receiving active treatment and 8.2% not. Post‐tonsillectomy hemorrhages proved to be most common in older patients and when peritonsillar abscess was in patient history.Conclusions Monopolar electrodissection tonsillectomy was fast and resulted in little intraoperative bleeding. However, postoperative hemorrhages were common, and the mean use of analgesics was for more than 10 days. Preoperative counseling must be thorough and realistic. Our results indicate that better methods for tonsillectomy still need to be developed.
Endoscopic and Endoscopic‐Assisted Surgery for Juvenile Angiofibroma
Authors: Carrau Ricardo L. , Snyderman Carl H. , Kassam Amin B. , Jungreis Charles A. 
Published: November 2003

AbstractObjectives/Hypothesis The mainstay treatment for juvenile angiofibromas is surgery. Endoscopic techniques have been applied to the resection of juvenile angiofibromas. The aim of the study is to establish the efficacy of endoscopic and endoscopic‐assisted techniques for the removal of juvenile angiofibromas.Study Design Retrospective review.Methods Retrospective review was made of all patients with juvenile angiofibromas who were treated with endoscopic and endoscopic‐assisted surgery from January 1994 to July 1999.Results Fifteen tumors in 13 patients were removed using endoscopic or endoscopic‐assisted surgeries. In 11 patients, endoscopic surgery or endoscopic‐assisted surgery (or both) was successful and the patients remained without evidence of disease at a median follow‐up of 34 months. In two patients tumor persisted, which was detected during routine follow‐up less than 6 months after the initial surgery. These tumors were managed with a second endoscopic or endoscopic‐assisted surgery, and patients remained without evidence of disease. We encountered one postoperative complication, a progressive optic neuropathy that was successfully managed with endoscopic decompression.Conclusions Endoscopic and endoscopic‐assisted surgery is a feasible alternative or adjunct to traditional techniques.
Evaluation of Eardrum Laser Doppler Interferometry as a Diagnostic Tool
Authors: Huber Alexander M. , Schwab Christoph , Linder Thomas , Stoeckli Sandro J. , Ferrazzini Mattia , Dillier Norbert , Fisch Ugo 
Published: November 2003

AbstractObjectives Laser Doppler interferometry (LDI) of the eardrum allows noncontact optical analysis of its vibrations in response to sound. Although LDI has been widely used in research, it has not yet been introduced into clinical practice as an adjunctive test for otological workup. The aim of this study was to evaluate LDI as a diagnostic tool in the clinical sphere.Study Design Prospective.Methods A measurement system was developed based on a commercially available scanning He‐Ne laser Doppler interferometer. The study included 129 eardrums of 79 subjects that were divided into 3 groups: 1) normal subjects and 2) patients with sensorineural and 3) conductive hearing loss (HL). All the patients suffering from conductive HL underwent ossiculoplasty, which allowed confirmation of the final diagnosis, and patients were assigned accordingly to the subgroups malleus fixation, incus luxation, and stapes fixation.Results The modified LDI system allowed bilateral evaluation of a subject within 30 minutes. No significant difference between normal subjects and patients having sensorineural HL were found. However, it was possible to distinguish between normal subjects and patients with conductive HL. Furthermore, the system had the ability to differentiate between various middle ear diseases. These groups differed statistically significantly in terms of manubrium vibration amplitude and resonance frequency. In malleus fixation significant differences in tympanic membrane movement patterns were found.Conclusions Our LDI is applicable in clinical otological practice and serves as a valuable addition to the routine audiological investigations for preoperative evaluation of the mobility and integrity of the ossicular chain.
Second Malignant Neoplasms in Patients Under 40 Years of Age With Laryngeal Cancer
Authors: Albright James T. , Karpati Ronit , Topham Allan K. , Spiegel Joseph R. , Sataloff Robert T. 
Published: November 2003

AbstractObjectives/Hypothesis To determine the incidence of second malignant neoplasms (SMN) in patients under 40 years of age with invasive squamous cell carcinoma (SCC) of the larynx.Study Design Retrospective.Methods Using a National Cancer Institute tumor registry database encompassing 1973–1996, the incidence of SMN in patients under 40 years of age with laryngeal cancer was determined and compared with that of the registry's older, more traditional laryngeal cancer population. Median follow‐up was 136 months.Results Among the 364 patients under the age of 40 years with laryngeal cancer, 30 (8.2%) had developed a secondary malignancy to date. In comparison, 4876 (21.4%) of 22,786 patients 40 years or older with laryngeal cancer were affected by an SMN. Kaplan‐Meier analysis of the younger cohort projected 3.0%, 6.8%, and 10.7% relative risk of developing a SMN at any site over 5‐, 10‐, and 15‐year periods, respectively, after index tumor diagnosis. Similar results for the older cohort were 14.2%, 28.1%, and 39.4% at 5, 10, and 15 years, respectively. Further Kaplan‐Meier analysis demonstrated at least a fourfold increased risk for the development of secondary upper aerodigestive tract malignancies among older compared with younger patients.Conclusion Patients under 40 years of age with invasive SCC of the larynx are significantly less likely to develop a second malignancy than their older counterparts.
Endoscopy‐Negative, Computed Tomography‐Negative Facial Pain in a Nasal Clinic
Authors: West Brian , Jones Nick S. 
Published: November 2003

AbstractObjectives To establish the etiology of facial pain in individuals attending the nasal clinic of the Department of Otorhinolaryngology, University Hospital, Nottingham, U.K., with normal nasal endoscopy and computed tomography of the paranasal sinuses.Study Design A retrospective analysis of a cohort of 973 patients consecutively presenting to the nasal clinic with symptoms of rhinosinusitis and/or facial pain.Methods We reviewed the case notes of 973 consecutive patients who presented to the nasal clinic with either symptoms of rhinosinusitis or facial pain, and in particular 101 who had facial pain without any objective evidence of nasal disease as detected by nasal endoscopy or computed tomography. The diagnosis was based on the outcome and response to treatment after a mean of 2 years 2 months.Results One hundred one patients had pain as a predominant symptom with normal nasal endoscopy and computed tomography of the paranasal sinuses. None of these patients responded to either medical or surgical treatment for what some workers have hypothesized could be “occult” sinonasal disease. A neurological diagnosis was made in 99 patients. Eighty patients received successful medical treatment for “neurological” diagnoses, 8 patients experienced spontaneous resolution of their symptoms, 7 failed to respond to any treatment modality, 2 were lost to follow‐up, and 2 refused any treatment.Conclusion The majority of patients presenting to a rhinologic clinic with facial pain and no objective evidence of sinus disease, as detected by endoscopy and computed tomography, responded well to neurological treatment and surgical intervention was unnecessary. These patients should receive a trial of medical therapy, such as low‐dose amitriptyline for 6 weeks in the first instance, before any surgical intervention is considered.