bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acoustic Tensor Tympani Response and Vestibular‐Evoked Myogenic Potential
Authors: Ochi Kentaro , Ohashi Toru , Kinoshita Hirotsugu 
Published: November 2003

AbstractObjective To investigate the acoustic response properties and the vestibular‐evoked myogenic potential (VEMP) in various lesions.Study Design Retrospective study of the clinical records of patients.Methods Neurotological tests including acoustic response and VEMP were performed and analyzed in 62 patients with facial palsy, otosclerosis, ossicular chain interruption, sensorineural hearing loss, or acoustic tumor.Results Inverted acoustic responses were observed in 25 of 38 (65.8%) patients with facial palsy, in 5 of 6 (83.3%) patients with acoustic tumor, and in all patients with otosclerosis, ossicular chain interruption, or sensorineural hearing loss. These inverted responses were obtained only when ipsilateral stimulation was used. The thresholds of the inverted responses were statistically significantly higher than those of the normal response.Conclusions The vibration of the eardrum is thought to stimulate the ipsilateral trigeminal nerve, leading to contraction of the tensor tympani muscle. The stapedius response had an inhibitory effect on the inverted response. Vibration of the stapes footplate (which requires a normal middle ear conduction system) is necessary to induce the VEMP, whereas the functioning of the facial and cochlear nerves is independent of the VEMP response.
Quality of Life, Functional Outcome, and Costs of Early Glottic Cancer
Authors: Smith Jonathan C. , Johnson Jonas T. , Cognetti David M. , Landsittel Douglas P. , Gooding William E. , Cano Elmer R. , Myers Eugene N. 
Published: November 2003

AbstractObjective To analyze quality of life, functional outcome, and hidden costs by primary treatment with surgery or radiation therapy in patients with early glottic cancer.Study Design Retrospective study in a tertiary care facility.Methods A group of 101 patients with carcinoma in situ and T1 invasive squamous cell carcinoma treated primarily with either surgery or radiation, between January 1990 and December 2000, were identified from searching our tumor registry. Patients completed two previously validated questionnaires and one local questionnaire. Statistical significance was assessed with the rank sum test, χ2 test, or Fisher's Exact test.Results Questionnaires were completed in 59% (44 of 74) of the surgical cohort and 41% (11 of 27) of the radiation therapy cohort. The primary surgical treatments were endoscopic excision (86%), hemilaryngectomy (12%), and total laryngectomy (1%). Patient‐reported problems with swallowing, chewing, speech, taste, saliva, pain, activity, recreation, and appearance showed no difference between the endoscopic excision or radiation therapy cohorts. Comparing endoscopic excision versus radiation therapy, respectively, median number of treatments (2 vs. 35), total median travel distance (150 vs. 660 miles), total median travel time (180 vs. 1440 min), and total median number of hours of work missed (76 vs. 24) all differed significantly (P <.01).Conclusions Almost all patients with early glottic cancer, whether treated with surgery or radiation therapy, reported excellent quality of life outcomes and functional results. In addition to actual costs, the hidden costs for radiation therapy versus endoscopic excision were all greater in terms of total number of hours of work missed, total travel time, and total travel distance.
Antigenic as Well as Nonantigenic Stimuli Induce Similar Middle Ear Responses in the Rat
Authors: Tonnaer Edith L. G. M. , Ingels Koen J. A. O. , Rijkers Ger T. , Curfs Jo H. A. J. 
Published: November 2003

AbstractObjectives/Hypothesis The observation that during otitis media many different types of micro‐organisms have been cultured from effusions indicate that, once present in the middle ear cavity, most types of micro‐organisms are able to trigger an inflammatory reaction leading to otitis media. The present study was designed to determine the middle ear response after injection of different substances into the middle ear cavity.Study Design To determine whether and to what extent an inflammatory response of the middle ear depends on the entering agent, the response in the tympanic cavity was studied by otomicroscopy and histological examination after inoculation of various substances.Methods Lewis rats were inoculated in transtympanic fashion either with live or heat‐killed bacteria (pathogenic and nonpathogenic), Keyhole limpet hemocyanin, active charcoal, or saline. The mucosal response of the challenged middle ears was studied histologically.Results Irrespective of the inoculated substance, no essential differences in the mucosal response were found. The intensity of the inflammatory response was greater when live bacteria were inoculated.Conclusions The present study demonstrates that any substance reaching the middle ear cavity is likely to induce otitis media. These observations emphasize the role of the eustachian tube as “porte d'entrée” in the pathogenesis of this disorder. Determination of specific aspects of the eustachian tube involved in protection or in facilitating bacterial translocation will be important for the understanding of the pathogenesis of otitis media and the subsequent development of new therapeutic strategies. In addition, elucidation of bacterial factors involved in the process of colonization and translocation will be of equal importance.
Duplicate Publications in the Otolaryngology Literature
Authors: Rosenthal Eben L. , Masdon Jimmy Lee , Buckman Christy , Hawn Mary 
Published: November 2003

AbstractObjective/Hypothesis A duplicate publication duplicates other published work by the same author(s). The purpose of the study was to define the extent of this problem within the otolaryngology literature.Study Design Retrospective review of the literature.Methods Original articles published in Archives of Otolaryngology—Head and Neck Surgery and Laryngoscope in 1999 were reviewed using the OVID search engine. Titles and abstracts from English articles written by the same first, second, or last author were analyzed, and suspected publications were evaluated. Duplicate publications were classified as dual (identical data set and conclusions) or suspected dual (nearly identical data set and conclusions) publications.Results Of the 492 articles evaluated, 40 index articles were identified. These led to a total of 42 (8.5%) duplicate articles of which 27 were classified as dual and 15 as suspected dual publications. Approximately half of the duplicate publications were published by authors in the United States (55%). Duplicate articles usually appeared within 12 months of the each other (74%) and failed to cross‐reference the earlier publication (83%).Conclusions Journal editors have become aware of an increase in the number of duplicate publications in the medical literature. The incidence of duplicate publications in the otolaryngology literature appears to be similar to that in other specialties.
Delivery of an Adenoviral Vector to the Crushed Recurrent Laryngeal Nerve
Authors: Rubin Adam , Mobley Bret , Hogikyan Norman , Bell Kimberly , Sullivan Kelli , Boulis Nicholas , Feldman Eva 
Published: November 2003

AbstractObjectives Objectives were to create a model of recurrent laryngeal nerve injury for testing the efficacy of potential therapeutic viral gene therapy vectors and to demonstrate that remote injection of a viral vector does not cause significant additional neuronal injury.Study Design Animal model.Methods Rats were randomly assigned to three groups of 10 animals each. In group I, the recurrent laryngeal nerve was crushed. In group II, the nerve was crushed and then injected with an adenoviral vector containing no transgene. In group III, the nerve was identified but was not crushed. Rats were killed at 1 week, and their larynges and brainstems were cryosectioned in 15‐μm sections. Laryngeal cryosections were processed for acetylcholine histochemical analysis (motor endplates) followed by neurofilament immunoperoxidase (nerve fibers). Percentage of nerve–endplate contact was determined and compared between groups. Fluorescent in situ hybridization was performed on brainstem sections from rats in group II to confirm the presence of virus.Results No significant difference in percentage of nerve–endplate contact exists between the two crushed‐nerve groups (groups I and II) (P = .88). The difference between both crushed‐nerve groups and the group with noncrushed nerves (group III) was highly significant (P <.0001). The presence of virus was confirmed in group II rats.Conclusions Crush provides a significant measurable injury to the recurrent laryngeal nerve and may be used as a model to explore therapeutic interventions for nerve injury. The remote injection of viral vector did not cause significant additional neuronal injury. Remote delivery of viral vectors to the central nervous system holds promise in the treatment of recurrent laryngeal nerve injury and central nervous system diseases.
Effects of Pituitary Adenylate Cyclase—Activating Polypeptide on Facial Nerve Recovery in the Guinea Pig
Authors: Kimura Hiromoto , Kawatani Masahito , Ito Eiko , Ishikawa Kazuo 
Published: November 2003

AbstractObjectives/Hypothesis Pituitary adenylate cyclase–activating polypeptide (PACAP) has neurotrophic effects of neural regeneration and gives protection to the nervous system. We investigated whether PACAP had a neurotrophic effect on peripheral motoneurons and whether PACAP could facilitate glial cell line–derived neurotrophic factor (GDNF), a neurotrophin, in nerve regeneration. The presence and distribution of PACAP receptors following facial nerve transection were also investigated.Study Design Animal experiment.Methods Unilateral transection of the facial nerve was performed in male Hartley guinea pigs, and PACAP was injected at the site. Saline was substituted as a control. Compound muscle action potentials were recorded to measure the changes of latency. Glial cell line–derived neurotrophic factor (GDNF) content in facial target muscle was measured using enzyme‐linked immunosorbent assay. The regenerating site was taken for histological studies.Results Pituitary adenylate cyclase–activating polypeptide hastened the appearance of compound muscle action potentials and shortened the latency. Pituitary adenylate cyclase–activating polypeptide increased and prolonged the nerve transection‐induced GDNF increase in the facial muscles. The number of myelinated fibers at 1 to 4 weeks after the transection was increased. PAC1 receptor or VPAC1 receptor or both were identified in the injury area at 2 to 4 weeks.Conclusions Pituitary adenylate cyclase–activating polypeptide facilitated the recovery of latency of compound muscle action potentials or the number of myelinated axons, or both. Pituitary adenylate cyclase–activating polypeptide prolonged the GDNF levels in target organs. These data indicated that PACAP promoted regeneration of the facial nerve.
Pitch‐Raising Surgery in Fourteen Male‐to‐Female Transsexuals
Authors: Wagner Isabelle , Fugain Claude , Monneron‐Girard Lucile , Cordier Bernard , Chabolle Frédéric 
Published: November 2003

AbstractObjective To evaluate the indications and results of pitch‐raising surgery in male‐to‐female transsexual patients.Study Design Retrospective study of male‐to‐female transsexual patients who underwent pitch‐raising surgery between 1994 and 2001 at a single institution.Methods The 14 patients had inadequate improvements after speech therapy alone. After anterior commissure advancement (n = 2), cricothyroid approximation (n = 9), or both (n = 3), results were evaluated subjectively by the patients and speech therapists and objectively by electroglottographic measurement of fundamental frequencies (usual, maximal, and minimal), postoperative gain in usual fundamental frequency, and the percentage of irregularities.Results Cricothyropexy disruption occurred in two patients. Median follow‐up was 6.5 months. Subjective success rates were 78.5% and 71.5% according to the patients and speech therapists, respectively. Usual, maximal, and minimal frequencies increased significantly; median postoperative gain in usual fundamental frequency was 11 Hz. Three of the four patients with a poor objective result continued to smoke after surgery.Conclusion Pitch‐raising surgery induces subjective and objective improvements but should be reserved for patients in whom speech therapy is not sufficiently effective.
Medial and Lateral Orbital Wall Surgery for Balanced Decompression in Thyroid Eye Disease
Authors: Graham Scott M. , Brown Christopher L. , Carter Keith D. , Song Alice , Nerad Jeffrey A. 
Published: November 2003

AbstractObjectives/Hypothesis Diplopia remains a major potential complication of orbital decompression performed for thyroid eye disease. We sought to examine the effect of medial and lateral wall surgery with sparing of the orbital floor on the incidence of postoperative diplopia.Study Design Retrospective review.Methods A retrospective review was made of 63 consecutive medial and lateral orbital wall surgeries (40 patients) performed between December 1996 and May 2002 for orbital decompression of thyroid eye disease.Results The average patient age was 50.9 years of age (age range, 14–83 y). The studied group was predominantly female (sex ratio, 36:4). Indications were compressive optic neuropathy (34), exposure keratopathy (25), and aesthetic concerns (4). The mean time since surgery was 31.5 months (range, 3–69 mo). The medial wall was approached by a transcaruncular (59) or endoscopic (4) technique. Two patients had fat removal. The average improvement in exophthalmos was 4.1 mm (range, 0–10 mm). The average palpebral fissure improvement was 2.0 mm (range, 0–7 mm). Two patients had cerebrospinal fluid leaks during excavation of the sphenoid bone. These were diagnosed and repaired primarily without complication. New‐onset diplopia occurred in four patients. Two of these patients required strabismus surgery.Conclusion A 10% new‐onset diplopia rate compares favorably with other surgical series. Medial and lateral wall surgery only, sparing the floor, may reduce diplopia after surgery for orbital decompression in thyroid eye disease.
Expiratory Pharyngeal Airway Obstruction During Sleep: A Multiple Element Model
Authors: Woodson B. Tucker 
Published: November 2003

AbstractObjective/Hypothesis In patients with obstructive sleep apnea and snoring, airway obstruction during sleep is not limited to inspiration but may also occur with expiration. The aim of this study was to assess the segmental mechanics of expiratory obstruction.Design Experimental study of a convenience sample of 20 patients with snoring and mild obstructive sleep apnea.Methods During sedated sleep, airflow, airway pressure measurements (supraglottic, oropharyngeal, nasopharyngeal, and nasal mask), and either supraglottic/retroglossal or retropalatal areas were simultaneously measured. Nasal continuous positive airway pressures were experimentally adjusted during single breath tests (SBTs) to modify upper airway size. Airway mechanics were evaluated during pressure drops on expiration.Results The predominant level of expiratory obstruction was supraglottic/retroglossal level alone (65%) or combined supraglottic/retroglossal and retropalatal (17.6%). In nonobstructed SBTs, compliance curves derived from supraglottic/retroglossal and retropalatal pressures were similar but diverged in obstructed breaths. Compliance during expiration was greater in the supraglottic/retroglossal segment compared to the retropalatal segment. Retropalatal cross‐sectional size was smaller during early and late expiration on obstructed than on nonobstructed breaths independent of airway pressure measures. The rate of expiratory collapse was increased at all time points measured (P < .005) in the retropalatal segment on obstructed as compared with nonobstructed breaths.Conclusions During expiration, the supraglottic/retroglossal level is obstructed more frequently and has greater compliance than the retropalatal segment. Failure of upstream pressures to describe pharyngeal obstruction supports a multi‐element model of collapse. Segments interact during expiration, with increased retropalatal collapse on obstructed as compared with nonobstructed breaths. Increased collapse on expiration provides a mechanism for increased obstruction on subsequent inspiratory breaths.
Safe tracheostomy for patients with severe acute respiratory syndrome
Authors: Wei William I. , Tuen Henry H. , Ng Raymond W. M. , Lam Lai Kun 
Published: November 2003

AbstractObjectives/Hypothesis: Severe acute respiratory syndrome (SARS) caused by coronavirus has become an epidemic affecting many regions worldwide. Fourteen percent to 20% of patients require endotracheal intubation and ventilator support. Some of these patients may require tracheostomy subsequently. This procedure, when performed without protection, may lead to infection of the medical and nursing staff taking care of the patient. Study Design: Based on clinical information of three patients. Methods: The authors carried out an emergency tracheostomy and changed the tracheostomy tube for one patient and performed elective tracheostomy in another two patients. Results: No medical or nursing staff member was infected after carrying out the procedure while taking all the precautions and wearing the appropriate protective apparel. Conclusion: The authors have prepared guidelines for performing a safe tracheostomy under both elective and emergency conditions. Surgeons who might be involved in performing the tracheostomy should become familiar with these guidelines and the appropriate protective apparel.
External auditory canal foreign body removal: Management practices and outcomes
Authors: Thompson Scott K. , Wein Richard O. , Dutcher Paul O. 
Published: November 2003

AbstractObjectives/Hypothesis: The purpose of the study was to evaluate the effectiveness of external auditory canal foreign body removal attempts by health care practitioners and to explore outcomes of patients with unsuccessful initial removal attempts. Study Design: Retrospective case series. Methods: A case series of patients presenting with external auditory canal foreign body to the emergency department of the authors' institution (Strong Memorial Hospital, University of Rochester Medical Center) over a 3‐year period was studied retrospectively. Medical records were reviewed, and information including age at presentation, type of foreign body, side of presentation, length of time in place, signs and symptoms at presentation, management practices, and outcomes was recorded. Results: One hundred sixty‐two patients with a diagnosis of external auditory canal foreign body were identified. Emergency personnel successfully managed 67% of patients using direct visualization techniques, and 33% required otolaryngological consultation. Otolaryngologists used otomicroscopy with standard otological instruments as their mainstay of management. Analysis of successfully managed emergency department cases revealed that 82% of foreign bodies were irregularly shaped objects with soft, graspable parts. Conversely, 72% of foreign bodies in otolaryngology referrals were firm, rounded objects such as beads and beans. Analysis of patients referred to otolaryngologists revealed a requirement for removal under anesthesia of 19%. Patients with a history of one or more removal attempts before emergency department evaluation universally failed further direct visualization techniques. A disproportionate number of these patients eventually required operative intervention and/or had tympanic membrane perforation. Patients with a history of previous removal attempt(s) who were referred directly to otolaryngologists were more likely to be successfully managed without general anesthesia. Conclusion: Emergency room personnel successfully manage the majority of patients with foreign bodies of the external auditory canal. For patients with firm, rounded objects, direct otolaryngology consultation without further manipulation should be strongly considered. Patients who have had previous removal attempts should not undergo further manipulation in the emergency department but rather should be referred directly to an otolaryngologist.
The accuracy of the modified Evan's blue dye test in predicting aspiration
Authors: Belafsky Peter C. , Blumenfeld Liza , Lepage Amanda , Nahrstedt Kristen 
Published: November 2003

AbstractObjectives/Hypothesis: The modified Evan's blue dye test (MEBDT) is a relatively simple, inexpensive bedside procedure for the assessment of aspiration in the tracheotomized patient. Recent investigations have questioned its diagnostic accuracy. The purpose of the study was to evaluate the accuracy of the MEBDT in predicting aspiration among tracheotomized patients. Study Design: Prospective observational study. Methods: In the setting of a long‐term acute care hospital, all persons with a tracheotomy tube undergoing a bedside swallowing evaluation between October 1, 2001, and March 31, 2002, were prospectively evaluated. All individuals underwent a MEBDT and a subsequent fiberoptic endoscopic evaluation of swallowing (FEES) using a standardized protocol. The sensitivity and specificity of the MEBDT in predicting aspiration were determined. Results: Thirty persons were evaluated. The mean age of the cohort was 65 years (SD ± 11 y). Sixty percent (18 of 30) were men. The sensitivity and specificity of the MEBDT for the entire cohort were 82% and 38%, respectively. The sensitivity of the MEBDT for patients receiving mechanical ventilation was 100% compared with 76% for individuals not receiving mechanical ventilation. The specificity of the MEBDT remained low, regardless of ventilator status (33%–40%). Conclusion: The sensitivity of the MEBDT in predicting aspiration among individuals in our cohort was 82%. The sensitivity was even higher (100%) when performed on persons receiving mechanical ventilation. These results support the use of the MEBDT as a screening tool for persons with a tracheotomy tube. The specific technique of performing the MEBDT is imperative, and the results of the study must be differentiated from other reports evaluating the MEBDT that use a different test protocol.