bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frozen Section in a Cytological Diagnosis of Thyroid Follicular Neoplasm
Authors: Alonso Núria , Lucas Anna , Salinas Isabel , Castella Eva , Sanmartí Anna 
Published: November 2003

AbstractObjective/Hypothesis Fine‐needle aspiration biopsy is the most accurate diagnostic test for thyroid nodules, its only limitation being the diagnosis of follicular neoplasm that does not distinguish between benign and malignant follicular lesions.Study Design To determine the utility of intraoperative frozen‐section analysis in cases of a cytological diagnosis of follicular neoplasm, a retrospective review of 66 patients with a solitary thyroid nodule and follicular neoplasm who underwent thyroid surgery was carried out.Methods Fine‐needle aspiration was classified following the Papanicolaou Society of Cytopathology Classification, and frozen section was defined as malignant or “deferred.” If a malignant diagnosis was made by frozen‐section analysis, a total thyroidectomy was carried out. The extension of thyroid surgery in the deferred cases was based on the definitive histological diagnosis.Results Sixty‐four cases were classified as deferred, and two as suspect for malignancy. Among the 64 deferred cases, 15 were malignant in the final pathological findings, and 49 were benign. The two suspect cases were papillary carcinoma. Frozen‐section analysis classified 2 of 17 (11.7%) cases as follicular variant of papillary carcinoma that could not be diagnosed by cytological study. However, these two cases had a strong clinical evidence of malignancy.Conclusion The routine use of frozen‐section analysis is useless in cases of cytological diagnosis of follicular neoplasm on fine‐needle aspiration biopsy, because of the low probability of achieving the diagnosis of follicular carcinoma and the inability to provide additional information apart from the clinical and the cytological data.
Empiric Esomeprazole in the Treatment of Laryngopharyngeal Reflux
Authors: DelGaudio John M. , Waring J. Patrick 
Published: November 2003

AbstractObjective Objectives were to determine the efficacy of empiric treatment with esomeprazole for patients diagnosed with laryngopharyngeal reflux and to determine a treatment paradigm for this patient population.Study Design Prospective study.Methods Patients were treated with a once‐daily dose of 40 mg esomeprazole for 8 weeks. All patients completed a subjective symptom scale (rating laryngeal symptoms and esophageal symptoms) and scoring of flexible fiberoptic examination before treatment and at 4 and 8 weeks of treatment. Nonresponders (<50% reduction in symptom score) were recommended to undergo 24‐hour dual‐probe pH study while on a regimen of 40 mg esomeprazole once a day, to evaluate for the adequacy of acid suppression.Results Thirty patients completed the course of therapy. After 4 weeks of treatment, only 8 of 30 patients had significant improvement of their overall symptoms (8 of 30 improved on laryngeal score, and 11 of 18 improved on esophageal score). At 8 weeks of treatment, 19 of 30 patients had significant improvement on their overall symptoms (18 of 30 on laryngeal score, and 13 of 18 on their esophageal score). Five of seven nonresponders who agreed to be tested had positive findings on pH studies (on medication regimen) at 1 cm above the upper esophageal sphincter. Four of 10 nonresponders improved further after increasing their dosage to 40 mg twice a day. Laryngeal examination scores were statistically improved in responders after 8 weeks of treatment.Conclusions Laryngopharyngeal reflux symptoms require at least 8 weeks of treatment for significant improvement in the majority of patients. Esophageal symptoms improve sooner. Nonresponders at a daily dose of 40 mg should be treated with a dosage of 40 mg twice daily, and pH study on medication reserved for nonresponders at this higher dose. Laryngeal examination scores showed mild but statistically significant improvement at 8 weeks of therapy in responders.
Squamous Cell Carcinoma of the Head and Neck in Ontario, Canada, and in Southeastern Norway
Authors: Hall Stephen F. , Boysen Morten , Groome Patti A. , Mackillop William 
Published: November 2003

AbstractObjectives/Hypothesis Reports comparing case mix, treatments, and outcomes between different countries are uncommon in head and neck oncology. Prospective databases of unselected patients from regional cancer centers in southeastern Ontario, Canada, and southeastern Norway were compared.Study Design Retrospective comparative study of two prospective databases.Methods The case mix, treatments, and disease‐specific mortality were compared using frequency tables, Kaplan‐Meier survival curves, and the log rank test.Results The case mix, except for differences in oral cavity, oropharynx, and the recorded tumor (T) category, was similar, and the treatments were different. There was no statistical difference in overall survival for all patients, as well as for some sites.Conclusions The results of treatments, based on different overall treatment polices, for all patients were similar. The differences in recorded T category with no statistical difference in overall survival suggest a difference in staging assignment and raises a question about the reliability of the TNM staging process.
Tuberculosis of the Nasopharynx: A Rare Entity Revisited
Authors: Tse Gary M. K. , Ma Tony K. F. , Chan Amy B. W. , Ho Fiona N. Y. , King Ann D. , Fung Kitty S. C. , Ahuja Anil T. 
Published: November 2003

AbstractObjectives Tuberculosis of the nasopharynx is uncommon. A large series of 17 cases is reported, and the clinical and pathological features are discussed.Study Design A retrospective review.Methods Seventeen archived cases of biopsy‐proven nasopharyngeal tuberculosis were reviewed for patient age and sex, presenting complaint and duration, systemic symptoms, cervical lymphadenopathy, and chest x‐ray findings. These findings were compared with a compilation of 40 cases reported in the English literature.Results There was a female predominance (13 women and 4 men), with age range of 20 to 74 years (mean age, 38 y). The most common presentation was enlargement of the cervical lymph nodes (53%), followed by hearing loss (12%), tinnitus, otalgia, nasal obstruction, and postnasal drip (6% each). The duration of the presenting symptoms ranged from 1 week to 1 year (mean duration, 16 wk). Ten patients (59%) had cervical lymphadenopathy, two (12%) had systemic symptoms (fever, weight loss, night sweats), and one patient (6%) had miliary pulmonary tuberculosis. Direct endoscopic examination showed nasopharyngeal mucosal irregularity or mass in the majority of patients (12 patients [70%]). These features were similar to those reported in the literature.Conclusions Nasopharyngeal tuberculosis is uncommon, usually occurring without pulmonary or systemic involvement. Cervical lymphadenopathy occurs in more than half of the patients and is the most common presenting complaint; this, together with the nasopharyngeal findings of mass or mucosal irregularity, makes differentiation from carcinoma on clinical examination difficult, necessitating histological evaluation.
Endoscopic Surgery for Juvenile Angiofibroma: When and How
Authors: Nicolai Piero , Berlucchi Marco , Tomenzoli Davide , Cappiello Johnny , Trimarchi Matteo , Maroldi Roberto , Battaglia Giuseppe , Antonelli Antonino R. 
Published: November 2003

AbstractObjectives/Hypothesis In recent years, the indications for endoscopic surgery of the sinonasal tract, originally introduced for the treatment of inflammatory diseases, have been expanded to include selected cases of benign and malignant neoplastic lesions. The aim of the present study was to establish the efficacy of endoscopic surgery in the management of small and intermediate‐sized juvenile angiofibromas.Study Design Retrospective study.Methods We reviewed the clinical records and the preoperative and postoperative imaging studies of 15 patients with juvenile angiofibroma who were treated with an endoscopic approach after embolization in the period from January 1994 to April 2000. All patients were prospectively followed by endoscopic and magnetic resonance imaging evaluations performed at regular intervals (every 4 months during the first year and, subsequently, every 6 months).Results According to a staging system reported in 1989, there were two patients with a type I, nine with a type II, three with a type IIIA, and one with a type IIIB juvenile angiofibroma. Angiography demonstrated that the vascular supply was strictly unilateral in 11 patients and bilateral in 4. Intraoperative blood loss ranged from 80 to 600 mL (mean blood loss, 372 mL). During follow‐up (range, 24–93 mo; mean follow‐up, 50 mo [SD ± 19.9 mo]), only one patient presented a residual lesion on magnetic resonance imaging, which was 16 mm in diameter and was detected 24 months after surgery.Conclusions The endoscopic approach is a safe and effective technique that allows removal of small and intermediate‐sized juvenile angiofibromas (without extensive involvement of the infratemporal fossa and cavernous sinus) with a low morbidity. Advanced lesions are more appropriately treated by external approaches.
Branching of Spiral Ganglion Neurites Is Induced by Focal Application of Fibroblast Growth Factor‐1
Authors: Aletsee Christoph , Brors Dominik , Mlynski Robert , Ryan Allen F. , Dazert Stefan 
Published: November 2003

AbstractObjectives/Hypothesis During the terminal innervation of the developing organ of Corti, fibroblast growth factor‐1 (FGF‐1) messenger RNA has been shown to be transiently expressed in the sensory epithelium of the rat, suggesting that this growth factor may contribute to developmental processes such as innervation and synaptogenesis of the inner and outer hair cells. In a previous study it has been demonstrated that exogenous FGF‐1 supports rat spiral ganglion neurite extension in vitro, whereas a secreted form of FGF‐1 produced by transfected fibrocytes induces neurite branching and targeting.Study Design Response of spiral ganglion neurites to FGF‐1–coupled beads was compared with the response to noncoupled control beads.Methods Effects of multiple focal sources of FGF‐1 to outgrowing spiral ganglion neurites were investigated on explants from postnatal day 4 rat spiral ganglion samples that were cultured in the presence of FGF‐1 covalently coupled to polybead microspheres. After fixation and immunocytochemical labeling of the explants the growth patterns of the extending neuronal processes were evaluated.Results When spiral ganglion neurites were observed near clusters of FGF‐1 beads, they formed a plexus‐like network characterized by significantly higher branching in the vicinity of the beads. However, fibers did not appear to terminate on the beads. Plexus‐like formations were not seen at a distance from FGF‐1 coupled beads or in the vicinity of control beads lacking FGF‐1 on their surface.Conclusion The results of the study indicate that spiral ganglion neurites branch in response to focal sources of FGF‐1, suggesting an important role of this growth factor for hair cell innervation during the terminal development of the sensory epithelium.
Clinical Associations of Serum Antiendothelial Cell Antibodies in Patients With Sudden Sensorineural Hearing Loss
Authors: Cadoni Gabriella , Agostino Stefania , Manna Raffaele , De Santis Antonella , Fetoni Anna Rita , Vulpiani Paola , Ottaviani Fabrizio 
Published: November 2003

AbstractObjectives/Hypothesis The role of antiendothelial cell antibodies in systemic vasculitis has been reported. The aim of the study was to define the clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss.Study Design A prospective study in patients with sudden sensorineural hearing loss.Methods Serum samples were taken from 59 consecutive patients with sudden sensorineural hearing loss at time of presentation and from 28 normal control subjects. Indirect immunofluorescence assay was used to detect antiendothelial cell antibodies.Results The prevalence of antiendothelial cell antibody detection was 54% (32 of 59 patients), with a statistically significant difference between patients and control subjects (P = .0004). Antiendothelial cell antibody positivity was significantly associated with absent recovery of hearing loss (P = .0020).Conclusions The cytotoxicity to endothelial cells of the inner ear by antiendothelial cell antibody–positive sera might play a role in causing the stria vascularis damage in immune‐mediated sudden sensorineural deafness. The appearance of antiendothelial cell antibody is related to the poor outcome of hearing loss, and its detection could be helpful in the selection of particular patients with sensorineural hearing loss for specific immunosuppressive treatments.
A Randomized Trial of the Canalith Repositioning Procedure
Authors: Yimtae Kwanchanok , Srirompotong Somchai , Srirompotong Supaporn , Sae‐seaw Patchareeporn 
Published: November 2003

AbstractObjective To compare the effectiveness and complications of our adaptation of the canalith repositioning procedure (CRP) with the expectation treatment for benign paroxysmal positional vertigo.Study Design A randomized, controlled trial in the setting of a neurotological clinic in Thailand.Methods Fifty‐eight patients with posterior benign paroxysmal positional vertigo were randomly assigned to treatment and control groups using a block of four. The treatment group was treated with the modified CRP technique until the nystagmus disappeared. A mastoid oscillator was not used, nor were any instructions given for patients after the maneuver. Both groups recorded the daily grading of symptoms and the amount of anti‐vertiginous drugs (cinnarizine) taken. Objective and subjective assessments were made weekly until the nystagmus disappeared or until 4 weeks had passed since treatment began.Results The rates of effectiveness of CRP treatment and the control treatment for benign paroxysmal positional vertigo were 75.9% and 48.2%, respectively. There was a significant difference in the treatment outcomes of the CRP and control groups (P = .03). The CRP group used significantly fewer drugs than the control group (P = .001). Complications in the CRP group, such as lateral canalithiasis and fainting, were observed in 13.8% of the patients.Conclusions The CRP was more effective than the expectation treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery and required less dependence on medication. Complications of CRP were limited to 13.8% of patients.
Autograft Ossiculoplasty in Cholesteatoma Surgery: Is It Feasible?
Authors: Ng Siu Kwan , Yip William W. L. , Suen Michael , Abdullah Victor J. , van Hasselt C. Andrew 
Published: November 2003

AbstractObjective To investigate whether autologous ossicles can be safely used in ossicular reconstruction in cholesteatoma surgery after attempting cholesteatoma removal under the operating microscope.Study Design A prospective fine‐section histological study of formalin‐stored ossicles, harvested from cholesteatomatous ears, to evaluate for existence of residual cholesteatoma after surface disease clearance under the operating microscope.Methods One hundred four ossicles were harvested from 76 patients with cholesteatoma for the study. These malleus heads and incudes were categorized into three groups: group 1, ossicles with retained shape and useful bulk, treated by microscopic stripping alone; group 2, ossicles with retained shape and useful bulk, treated by microscopic stripping and drilling; and group 3, badly eroded ossicles, treated by microscopic stripping alone. These treated ossicles were then subjected to 4‐μm histopathological study.Results Residual disease was identified in 6 of the 104 ossicles. Residual disease was found only in badly eroded ossicles that are not suitable for reconstruction. All the usable ossicles were free of disease.Conclusions Autologous ossicles that have retained body and bulk are safe to use for reconstruction after surface stripping under the operating microscope. Additional burring probably adds a further margin of safety.
Ventricular Dysphonia: Clinical Aspects and Therapeutic Options
Authors: Maryn Youri , De Bodt Marc S. , Van Cauwenberge Paul 
Published: November 2003

AbstractObjective/Hypothesis Ventricular dysphonia, also known as dysphonia plica ventricularis, refers to the pathological interference of the false vocal folds during phonation. Despite its low incidence and prevalence, Vd is a well‐known phenomenon in voice clinics. The present report reviews symptoms, etiology, diagnosis, and therapeutic options regarding this voice disorder.Study Design Literature review and case studies.Methods The literature pertaining to all clinical aspects of VD was reviewed to define diagnostic and therapeutic clinical decision making.Results Ventricular dysphonia is characterized by a typical rough, low‐pitched voice quality resulting from false vocal fold vibration. Ventricular dysphonia may be compensatory when true vocal folds are affected (resection, paralysis). Noncompensatory types may be of habitual, psychoemotional, or idiopathic origin. Because perceptual symptoms may vary considerably, diagnosis should rely on a meticulous voice assessment, including laryngeal videostroboscopic, perceptual, aerodynamic, and acoustic evaluation. Various therapeutic approaches for the noncompensatory type of ventricular dysphonia may be considered: voice therapy, psychotherapy, anesthetic or botulinum toxin injections, or surgery.Conclusion The study presents the state of the art with respect to ventricular dysphonia and may be helpful in diagnosis and therapeutic decision‐making.
Functional Outcomes After Primary Oropharyngeal Cancer Resection and Reconstruction With the Radial Forearm Free Flap
Authors: Seikaly Hadi , Rieger Jana , Wolfaardt John , Moysa Gerald , Harris Jeffery , Jha Naresh 
Published: November 2003

AbstractObjective To report prospectively collected aeromechanical, acoustical, and perceptual speech outcomes, as well as preliminary swallowing data, in patients having reconstruction with radial forearm free flaps after primary resection for oropharyngeal cancer.Study Design Prospective cohort study.Methods Acoustical, aeromechanical, and perceptual speech data and swallowing data were gathered at three evaluation times (preoperatively and before and after radiation therapy) for patients treated for oropharyngeal cancer by means of primary resection and reconstruction with a radial forearm free flap. Degree of involvement of the soft palate and base of tongue, along with reconstructive techniques, were entered as between‐group factors in the analysis.Results There were no significant differences in speech intelligibility between the patient groups based on the degree of palate and tongue resected. However, patients with resections of half or more than half of the soft palate had significantly higher nasalance values and larger velopharyngeal orifice areas than individuals who had less than half of the soft palate resected. Significant within‐subject differences were revealed across evaluation times for the dependent variables nasalance, velopharyngeal orifice area, and word intelligibility. Ninety‐four percent of the patients were able to resume a normal or soft diet. There was a 6% incidence of aspiration in 128 swallows that were analyzed. The amount of base of tongue resected did not significantly affect any of the speech or swallowing parameters.Conclusions Radial forearm free flaps are a good reconstructive option after oropharyngeal cancer extirpation. Our acoustic and aeromechanical results indicated that issues related to quality of the speech signal require further study for resections of half or more than half of the soft palate.
Association of Systematic Head and Neck Physical Examination With Severity of Obstructive Sleep Apnea—Hypopnea Syndrome
Authors: Zonato Adriane I. , Bittencourt Lia Rita , Martinho Fernanda Louise , Júnior João Ferreira Santos , Gregório Luiz Carlos , Tufik Sergio 
Published: November 2003

AbstractObjectives/Hypothesis To identify upper airway and craniofacial abnormalities is the principal goal of clinical examination in patients with obstructive sleep apnea–hypopnea syndrome. The aim was to identify anatomical abnormalities that could be seen during a simple physical examination and determine their correlation with apnea–hypopnea index (AHI).Study Design Consecutive patients with obstructive sleep apnea–hypopnea syndrome who were evaluated in a public otorhinolaryngology center were studied.Methods Adult patients evaluated previously with polysomnography met the inclusion criteria. All subjects underwent clinical history and otolaryngological examination and filled out a sleepiness scale. Physical examination included evaluation of pharyngeal soft tissue, facial skeletal development, and anterior rhinoscopy.Results Two hundred twenty‐three patients (142 men and 81 women) were included (mean age, 48 ± 12 y; body mass index, 29 ± 5 kg/m2; AHI, 23.8 ± 24.8 events per hour). Patients were distributed into two groups according to the AHI: snorers (18.4%) and patients with sleep apnea (81.7%). Sleepiness and nasal obstruction were reported by approximately half of patients, but the most common complaint was snoring. There was a statistically significant correlation between AHI and body mass index (P <.000), modified Mallampati classification (P = .002), and ogivale–palate (P <.001). The retrognathia was not correlated to AHI, but the presence of this anatomical alteration was much more frequent in patients with severe apnea when compared with the snorers (P = .05). Other correlations with AHI were performed considering multiple factors divided into two groups of anatomical abnormalities: pharyngeal (three or more) and craniofacial (two or more) abnormalities. There was a statistically significant correlation between pharyngeal landmarks and AHI (correlation coefficient [r] = 0.147, P = .027), but not between craniofacial landmarks and AHI. The combination of pharyngeal anatomical abnormalities, modified Mallampati classification, and body mass index were also predictive of apnea severity.Conclusions Systematic physical examination that was used in the present study indicated that, in combination, body mass index, modified Mallampati classification, and pharyngeal anatomical abnormalities are related to both presence and severity of obstructive sleep apnea–hypopnea syndrome. Hypertrophied tonsils were observed in only a small portion of the patients. The frequency of symptoms of nasal obstruction was high in sleep apnea patients. Further studies are needed to find the best combination of anatomical and other clinical landmarks that are related to obstructive sleep apnea.