bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Internal Auditory Canal with Virtual Endoscopy
Authors: Vrabec Jeffrey T. , Briggs Russell D. , Rodriguez Sarah C. , Johnson Raleigh F. 
Published: February 2003

OBJECTIVEThree‐dimensional imaging can improve the understanding and comprehension of complex anatomy. Recent advances in software development allow the construction of a virtual endoscopic view of anatomic structures. This report applies virtual endoscopic capabilities to imaging of the internal auditory canal.STUDY DESIGN, SETTING, AND PATIENTSWe conducted a retrospective case review at a tertiary referral center of patients with abnormal internal auditory canal anatomy on computed tomography.INTERVENTIONSComputed tomography images were obtained using conventional clinical algorithms involving multiple, 1‐mm‐thick slices through the temporal bone. Three‐dimensional reconstructions were made using General Electric Advantage Windows Navigator software. The virtual endoscopic image‐processing algorithm used selected image intensity threshold levels to visualize internal auditory canal anatomy from an endoscopic perspective.RESULTSEleven cases of abnormalities of the internal auditory canal were retrospectively identified. Clinical applications using the virtual endoscopic images are presented. The virtual endoscopic images supported prior clinical decision making in 6 of the 11 cases evaluated.CONCLUSIONThis technique shows promise for the diagnosis, surgical planning, and teaching of temporal bone anatomy. Usefulness is dependent on acquisition parameters and clinical indications for examination.
Hepatocyte Growth Factor/Scatter Factor Stimulates Mitogenesis and Migration of a Head and Neck Squamous Cell Carcinoma Cell Line
Authors: Fleigel Jeffery , Sedwick Jack , Kornberg Lori J. 
Published: February 2003

OBJECTIVEWe sought to assess the effect of extracellular matrix and hepatocyte growth factor/scatter factor (HGF/SF) on the growth and motility of cultured squamous cell carcinoma of the head and neck (SCCHN) cells.METHODSCultured cells were incubated in the presence of HGF/SF. The effect of HFG/SF on cell growth, motility, and phosphorylation of the signaling proteins FAK and Erk was determined.RESULTSHGF/SF is both mitogenic and motogenic to the human SCCHN cell line FaDu. Incubation of FaDu cells in the presence of HGF/SF led to a rapid increase in phosphorylation of both FAK and the growth‐promoting kinase Erk. HGF/SF‐induced phosphorylation of FAK and Erk was observed in both detached and attached SCCHN cells. However, phosphorylation was much greater in attached cells.CONCLUSIONS AND SIGNIFICANCEThe mitogenic and motogenic activities of HGF/SF may contribute to the pathogenesis of SCCHN in vivo.
Sinus Tympani Endoscopic Anatomy
Authors: Baki Fatthi Abdel , Dine Mohammed Badr El , Saiid Ibrahim El , Bakry Moustafa 
Published: February 2003

OBJECTIVEThe sinus tympani has been the focus of clinical interest because of its tendency to be invaded by cholesteatoma, its visual obscurity, and the lack of a straightforward surgical approach by which it can be addressed. This study was undertaken to describe the microscopic as well as the endoscopic anatomy of the sinus tympani.STUDY DESIGN AND SETTINGThirty temporal bones harvested from cadavers were dissected using an operating microscope and telescopes with different angles and 2.7‐ and 4‐mm diameters, fitted with a videocamera. Images were transmitted to a computer screen. Precise measurements were made after scaling the distances with the digital image processing.RESULTSMarked variation in size and shape was the rule. It was found that the sinus tympani is bounded laterally by a constant ledge of bone anterior to the facial nerve. It was deep, extending posterior to the facial nerve in 6 specimens. The telescopes (30° to 70°) enabled the surgeon to see this region clearly because the orifice plane was more or less perpendicular to the axis of the external auditory canal.CONCLUSIONThe study emphasizes the importance of removal of this lateral lip of bone to expose the orifice of the sinus tympani. This should be complemented with the use of a 30° endoscope (1.7 mm in canal‐up and 4.0 mm in canal‐down technique) for better visualization and cleaning of this hidden area.
Community‐Based Treatment of Acute Uncomplicated Bacterial Rhinosinusitis with Gatifloxacin
Authors: Sher Lawrence D. , Poole Michael D. , Von Seggern Kristen , Wikler Matthew A. , Nicholson Susan C. , Pankey George A. 
Published: February 2003

OBJECTIVEWe sought to evaluate gatifloxacin in adults with acute uncomplicated bacterial rhinosinusitis.STUDY DESIGNTeqCES was an open‐label, multicenter, noncomparative study of the safety and efficacy of gatifloxacin. More than 11,000 adult patients with acute uncomplicated rhinosinusitis received gatifloxacin 400 mg once daily for 10 days.RESULTSMoraxella catarrhalis (91% β‐lactamase producers), Haemophilus influenzae (28% β‐lactamase producers), Streptococcus pneumoniae (18% intermediately resistant and 14% fully resistant to penicillin), and Staphylococcus aureus were the predominant pathogens isolated from purulent nasal discharge. More than 99% of rhinosinusitis pathogens isolated from the nasopharynx of patients meeting the clinical criteria for rhinosinusitis were susceptible to gatifloxacin. Among 10,353 patients whose clinical response could be determined, 91.6% were cured. Clinical cure rates exceeded 90% for the major pathogens. Gatifloxacin was well tolerated; drug‐related adverse events that occurred in 1% or more of patients were nausea (4.4%), dizziness (1.8%), diarrhea (1.4%), and headache (1.0%).CONCLUSIONGatifloxacin is effective for patients with acute bacterial rhinosinusitis in the community.!
Long‐Term Results of Endoscopic Stapling Diverticulotomy for Pharyngeal Pouches
Authors: Raut Vivek V. , Primrose William J. 
Published: February 2003

OBJECTIVEThe aim of the present study was to evaluate the long‐term success of endoscopic stapling as a primary procedure for the treatment of pharyngeal pouches.METHODSThis study is a retrospective case review of 25 patients with pharyngeal pouches treated by endoscopic stapling (23 stapled, 2 abandoned) over a 4‐year period (1994 to 1998) at a University teaching hospital in the United Kingdom. Outcomemeasures used were relief of symptoms over a long‐term follow‐up of 2 to 5 years.RESULTSOf the 25 patients analyzed, 12 patients (48%) have remained asymptomatic after their initial stapling. Eight patients (32%) were relieved of their symptoms after revision stapling. The overall long‐term success rate for endoscopic stapling was 80% (20 of 25 patients)CONCLUSIONReduced morbidity and few complications in the elderly make endoscopic stapling a favored primary technique of treating pharyngeal pouches. Open surgery is recommended only in healthy patients with very large pouches.
Laser Therapy for Refractory Myringitis in Children
Authors: Fechner Frank P. , Cunningham Michael J. , Eavey Roland D. 
Published: February 2003

OBJECTIVEWe present the application and initial results of a CO2 laser technique for the treatment of medically refractory chronic granular myringitis (CGM).STUDY DESIGN AND SETTINGRetrospective case series of 15 treated ears in 13 consecutive patients between the ages of 6 and 14 years (median age, 9.0 years) cared for in a tertiary care specialty hospital.RESULTSEleven of 15 treated ears had total resolution of CGM and associated symptoms; median follow‐up time was 10 months. Three ears were improved, and 1 ear remained unchanged. Three of 5 preoperative tympanic membrane perforations healed after laser treatment; 1 patient developed a postoperative, dry perforation. Hearing was not impaired in any patient tested.CONCLUSIONPreliminary results suggest that CGM, when refractory to medical treatment, can often be treated effectively by a single laser treatment.
Predicting Calcium Status Post Thyroidectomy with Early Calcium Levels
Authors: Husein Murad , Hier Michael P. , Al‐Abdulhadi Khaled , Black Martin 
Published: February 2003

OBJECTIVEThe study goals were to predict postoperative normocalcemia and hypocalcemia after total thyroidectomy using calcium levels and to assess the value of a standardized protocol in managing the total thyroidectomy patient.STUDY DESIGNWe conducted a prospective study encompassing 68 patients undergoing a total thyroidectomy using a standardized protocol. Blood to measure postoperative calcium levels was drawn at 6, 12, and 20 hours and then twice daily thereafter. Calcium slope was calculated from the 6‐ and 12‐hour serum corrected calcium levels.RESULTSLogistic regression analysis allowed the comparison of the 6‐ and 12‐hour calcium slope versus proportion of normocalcemic patients postoperatively. A slope of +0.02 had a 97% chance of remaining normocalcemic (p = 0.0007).CONCLUSIONSuccessful prediction of calcium status post total thyroidectomy can be achieved using the slope of the 6‐ and 12‐hour calcium levels. The risk of developing severe hypocalcemia can also be predicted with these slope values. Implementation of the protocol resulted in a significant reduction in the duration of hospital stay for patients who remain normocalcemic.
Cost‐Effective Diagnosis of Acoustic Neuromas: A Philosophical, Macroeconomic, and Technological Decision
Authors: Murphy Mark R. , Selesnick Samuel H. 
Published: February 2003

OBJECTIVEOur goals were to define the most sensitive techniques of acoustic neuroma diagnosis, to examine their relative costs, and to propose diagnostic modality selection given the rarity of acoustic neuroma incidence and given the other costs that society faces in more commonly encountered diseases.METHODSWe conducted a MEDLINE search of the English language from 1966 to 2001 using the following keywords: acoustic neuroma, acoustic tumor, vestibular schwannoma, diagnosis, cost effectiveness, MRI, auditory brainstem response, brainstem audiometric evoked response, incidence, and prevalence.RESULTSAlthough magnetic resonance imaging with gadolinium remains the most sensitive diagnostic modality in the discovery of acoustic neuromas, its cost may be prohibitive for some societies.CONCLUSIONWhich modality to use in acoustic neuroma diagnosis is just as much a philosophical and macroeconomic question as a technological one.CLINICAL SIGNIFICANCEThe cost of a timely diagnosis of acoustic neuromas must be weighed against using resources for other, more pressing, health concerns.
Thyroidectomy using the Harmonic Scalpel: Analysis of 105 Consecutive Cases
Authors: Shemen Larry 
Published: February 2003

OBJECTIVEThe purpose of this report was to evaluate the technical benefits, if any, of thyroidectomy using the harmonic scalpel versus conventional thyroidectomy.STUDY DESIGNOne hundred five consecutive patients underwent thyroidectomy over 1 year with use of the harmonic scalpel. They were compared with a group of 20 patients who underwent thyroidectomy 1 year earlier using conventional techniques.RESULTSThe incision length for those undergoing thyroidectomy with the harmonic knife averaged 4.5 cm compared with 5.5 cm for the conventional thyroidectomy group. The operating time for a hemithyroidectomy averaged 50 minutes for the harmonic scalpel group versus 80 minutes for the conventional technique. The operating time for a total thyroidectomy averaged 80 minutes for the harmonic scalpel group versus 120 minutes for the conventional thyroidectomy group.CONCLUSIONThe use of the harmonic scalpel in thyroid surgery offers several advantages over the conventional technique. The incision length is shorter and the operating time is reduced. Bleeding is negligible and complications are few.SIGNIFICANCEThe harmonic scalpel, whose use was pioneered in laparoscopic surgery, offers the thyroid surgeon the ability to safely and expeditiously control the feeding vessels through a limited field.
A Comparison of Tonsillectomy with the Harmonic Scalpel versus Electrocautery
Authors: Morgenstein Stuart A. , Jacobs H. Kurt , Brusca Peter A. , Consiglio Angelo R. , Donzelli Joseph , Jakubiec James A. , Donat Terry L. 
Published: February 2003

OBJECTIVEWe sought to test whether the use of the harmonic scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of electrocautery.DESIGN AND SETTINGIn a private practice community hospital, we conducted a prospective nonrandomized comparison of 156 pediatric tonsillectomy cases. Local anesthetic infiltrations and steroids were used at the discretion of the surgeon. Outcome variables consisted primarily of immediate‐and mid‐term pain, pain medications required, time to eating, morbidities and charges.RESULTSThere were no differences between the groups on an intention‐to‐treat basis except for costs, which were higher in the harmonic scalpel group. When rescue use of electrocautery was required to control bleeding in the in the harmonic scalpel patients, more pain and longer times to taking food were noted.CONCLUSIONSUsed with discretion the harmonic scalpel is equivalent to electrocautery for tonsillectomy.SIGNIFICANCEThe harmonic scalpel does not provide a major benefit over more conventional methods of tonsillectomy.
Comparison of Methods for Determining Cricopharyngeal Intrabolus Pressure in Normal Patients as Possible Indicator for Cricopharyngeal Myotomy
Authors: Bammer Tanja , Salassa John R. , Klingler Paul J. 
Published: February 2003

OBJECTIVEWe sought to compare methods for determining intrabolus cricopharyngeal pressure as a possible indicator for cricopharyngeal myotomy.STUDY DESIGNWe determined multiple intrabolus pressures in the cricopharyngeal region of 20 normal volunteers, of whom 12 were 20 to 35 years old and 8 were older than 75 years. Data were collected using a commercially available manofluorography system and a 6‐sensor unidirectional solid‐state 2‐ x 4‐mm catheter. Each subject underwent 5 5‐mL and 5 10‐mL liquid barium swallows. Data were analyzed, and young subjects were compared with old subjects.RESULTSThe mean mid‐bolus pressures in young subjects were 5.2 ± 4.9 mm Hg and 7.2 ± 6.5 mm Hg for the 5‐mL and 10‐mL swallows, respectively, and in older subjects, 10.8 ± 8.8 mm Hg and 12.3 ± 7.4 mm Hg. The mean gradient pressures across the 3‐cm cricopharyngeal region in young subjects were 2.02 ± 5.0 mm Hg, and −0.91 ± 4.8 mm Hg for the 5‐mL and 10‐mL swallows, respectively, and for older subjects, 4.38 ± 3.1 mm Hg and 2.82 ± 3.4 mm Hg.CONCLUSIONSCricopharyngeal intrabolus pressures were lower in young than in older subjects. The mid‐bolus pressure and the gradient pressure across the cricopharyngeal region appeared to be the most consistent methods for evaluating intrabolus pressures.SIGNIFICANCEIntrabolus pressure anomalies in the cricopharyngeal region have been proposed as an indicator for selecting patients who would benefit from cricopharyngeal myotomy. The methods of determining intrabolus pressures vary, with resulting variations in recommendations.
Histopathologic Changes in the Vestibule after Cochlear Implantation
Authors: Tien Hui‐Chi , Linthicum Fred H. 
Published: February 2003

OBJECTIVEThe study goal was to determine the histopathologic changes of the vestibular end organs after cochlear implantation and to relate them to clinical performance.STUDY DESIGNTo differentiate the effect of implantation from the disease process that originally destroyed the hearing, 11 pairs of temporal bones from unilateral implantees were studied with light microscopy to compare the vestibular damage in the implanted ears with that in the nonimplanted ears.RESULTSSignificant histopathologic damage of the vestibular end organs was noted in 6 patients (54.5%). The major histopathologic findings were fibrosis in the vestibule, saccule membrane distortion, new bone formation, and reactive neuromas. The scala vestibuli involvement, as a result of damage to the osseous spiral lamina or basilar membrane in cochlear basal turn, was highly correlated with vestibular damage (75%).CONCLUSIONSAlthough the clinical incidence of balance disturbance after cochlear implantation is low, damage of the vestibular end organs may occur and be asymptomatic. Keeping the electrode array in the scala tympani will minimize vestibular damage.
Hypocalcemia Complicating Total Thyroidectomy in Patients with Coexisting Celiac Sprue
Authors: Agrama Mark T. , Pribitkin Edmund A. , O'Hara Brian J. , Rosen David , Miller Jeffrey L. , Keane William M. 
Published: February 2003

Patients with either an autoimmune thyroid disease or thyroid nodules exhibit an increased incidence of celiac sprue.1 Total thyroidectomy in the setting of celiac sprue poses an increased risk of postoperative hypocalcemia because of a characteristic malabsorption of calcium and magnesium.2 Hypocalcemia secondary to celiac sprue is independent of the well‐described risk of hypoparathyroidism after total thyroidectomy.3Celiac sprue is a chronic condition in which there is a characteristic mucosal lesion of the small intestine that impairs nutrient absorption by the involved bowel.4,5 Intestinal absorption and associated symptoms normalize with the adoption of a gluten‐free diet. Nonetheless, chronic calcium and magnesium malabsorption coupled with an associated vitamin D insensitivity may exacerbate postoperative hypocalcemia after total thyroidectomy despite dietary precautions and normal parathyroid function.2,6We present an illustrative case of total thyroidectomy for papillary thyroid carcinoma in a patient with Hashimoto's thyroiditis and celiac sprue. Total thyroidectomy in this setting must be undertaken with heightened attention to the risk of postoperative hypocalcemia because of chronic malabsorption of calcium and magnesium.
Incidence of Complications for Subtotal Ionized Field Ablation of the Tonsils
Authors: Lee Kelvin C. , Altenau Mark M. , Barnes David R. , Bernstein Joseph M. , Bikhazi Nadim B. , Brettscheider Frank A. , Caplan Charles H. , Ditkowsky William A. , Ingber Craig F. , Klausner Lee M. , Moghaddassi Maseih M. 
Published: February 2003

OBJECTIVEIonized field ablation, or coblation‐assisted subtotal tonsillectomy, has been described as a new alternative technique for the management of tonsillar disease. This study was designed to review the incidence of complications in patients undergoing this procedure.STUDY DESIGNA 10‐surgeon retrospective chart review of the intraoperative and postoperative complications of patients undergoing ionized field ablation subtotal removal of tonsils was performed. Postoperative pain, dietary restrictions, and activity level were not reviewed.RESULTSOf the 528 patients who underwent ionized field ablation of their tonsils, the incidence of intraoperative and postoperative complications compared favorably with those reported in retrospective studies in the literature for traditional subcapsular tonsillectomy. Significant postoperative bleeding occurred in less than 1%, and only 1 patient required surgical control of bleeding in the operating room. No patients required transfusions of any blood products.CONCLUSIONSIonized field ablation subtotal tonsillectomy may offer an alternative to traditional subcapsular tonsillar surgery with a decreased incidence of postoperative complications. Further study is necessary to establish the complication rate of this technique.
Natural History of Allergic Fungal Rhinosinusitis: A 4‐ to 10‐Year Follow‐Up
Authors: Marple Bradley , Newcomer Mark , Schwade Nathan , Mabry Richard 
Published: February 2003

BACKGROUNDNumerous studies have noted the high rate of recidivism after the initial treatment of allergic fungal rhinosinusitis (AFS). Short–term studies have revealed varying recurrence rates based on therapy; however, little is currently known about the long–term natural history of the disease.OBJECTIVEOur goal was to address the question of long–term outcomes in AFS patients and make observations about the natural history of the disease.PATIENTS AND METHODSSeventeen patients with follow–up ranging from 46 to 138 months were examined and interviewed, and their charts were reviewed. A quality–of–life survey was completed, and blood was drawn to measure immunoglobulin levels.RESULTSAll patients initially underwent treatment with a combination of surgery, systemic and/or topical corticosteroids, and immunotherapy to pertinent fungal and nonfungal antigens. Normalization of sinonasal mucosa (Kupferberg stage 0) was seen in 5 (29%) of 17 patients, whereas 76% demonstrated either normal or slight mucosal edema (Kupferberg stage 0 or 1). Serologic testing revealed fungus‐specific IgE significantly elevated in all 17 patients.CONCLUSIONThe initial choice of therapy did not appear to affect the long–term outcome, and patients tended to be doing well overall. These results suggest that after successful initial treatment and control of AFS, many patients can achieve a quiescent disease state.
Localized Laryngeal Amyloidosis
Authors: Friedman Aaron D. , Bhayani Rajendra , Memeo Lorenzo , Kuriloff Daniel B. 
Published: February 2003

A 54‐year‐old female schoolteacher presented with 1‐month of hoarseness and a foreign body sensation in the back of her throat that was not associated with symptoms or signs of infection. Direct laryngoscopy showed bilateral, yellow, hyperemic masses on the false vocal folds and laryngeal ventricles Fig 1. Both true vocal folds were mobile. An excisional biopsy of the mass revealed an amorphous, eosinophilic hyaline material Fig 2 that exhibited apple‐green birefringence when stained with Congo red and viewed under polarized light Fig 3, consistent with amyloidosis. There was no evidence of neoplasm. The work‐up for systemic amyloidosis and multiple myeloma was negative.The patient did well over the next several years, but recurrence of the laryngeal amyloid tumor necessitated 2 additional conservative endoscopic CO2 laser excisions. Since her last surgery, the patient has remained asymptomatic.
The Transmastoid Retrolabyrinthine Approach in Vestibular Schwannoma Surgery
Authors: Ferreira Bento Ricardo , Vuono de Brito Rubens , Sanchez Tanit Ganz , Miniti Aroldo 
Published: February 2003

OBJECTIVEWe conducted a prospective analysis of 22 patients with small vestibular schwannoma and useful hearing who were operated on via a transmastoid retrolabyrinthine approach between January 1994 and March 1999.PATIENTS AND METHODSThe average age was 35 years, and there were 14 females and 8 males. All patients had unilateral tumors, with 10 of them occurring in the right ear and 12 occurring in the left ear. The following parameters were included in our protocol: total removal of the tumor, intraoperative difficulties or complications, immediate postoperative complications, facial score 10 days and 3 months after the surgery, and audiologic evaluation 90 days after the surgery.RESULTSA good exposure of the internal auditory canal was possible in 19 cases. In 3 patients we had to change the approach to a translabyrinthine one to achieve total removal of the tumor in all patients. Hearing was preserved at the same preoperative levels in 31% of the cases.CONCLUSIONSThe retrolabyrinthine approach offered security to the facial nerve, no morbidity, and good percentage of hearing preservation. It is also easily changeable to a translabyrinthine approach when more exposure is necessary.