bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cochlear Implantation With Large Vestibular Aqueduct Syndrome
Authors: Miyamoto Richard T. , Bichey Bradford G. , Wynne Michael K. , Kirk Karen I. 
Published: November 2003

AbstractObjectives In this investigation, we report the outcomes of 14 adults (age >18 y) and 9 children (age <18 y) with radiographically proven large vestibular aqueduct syndrome (LVAS) who received cochlear implants at Indiana University School of Medicine.Study Design This is a retrospective case‐control study detailing the outcomes of 23 patients with LVAS and 46 control patients implanted with Nucleus (Cochlear Corp., Englewood, CO), Clarion (Advanced Bionics Corp., Sylmar, CA), or Med‐El (MED‐EL Corp., Innsbruck, Austria) cochlear implants.Methods Performance data on pure‐tone averages, speech detection thresholds, and a variety of auditory and speech recognition tasks from these patients with LVAS were compared with performance data obtained from a matched group of 46 cochlear implant users who did not have LVAS. Specific patient characteristics used in matching included the age of the patient, the age at implant of the patient, and whether the patient was pre‐ or postlingually deafened. Data for the adult group was analyzed using the Student t test, and data for the pediatric patient group was compared using a χ2 test.Results The results indicated positive outcomes for both pediatric and adult groups. With both adult and pediatric groups, auditory and speech recognition performance did not differ significantly between those patients with LVAS and control subjects.Conclusions This study adds further support for the use of cochlear implantation in patients with LVAS. Cochlear implantation is beneficial and can be offered as an eventual treatment of LVAS if hearing loss progresses to profound levels in these patients.
The Superior Turbinate as a Source of Functional Human Olfactory Receptor Neurons
Authors: Lane Andrew P. , Gomez George , Dankulich Tatyana , Wang Hongyan , Bolger William E. , Rawson Nancy E. 
Published: November 2003

AbstractObjectives The function of human olfactory receptor neurons (ORNs) remains incompletely understood, in part because of the difficulty of obtaining viable olfactory tissue for study. During endoscopic sphenoidotomy, a portion of the superior turbinate is often removed to achieve wide and safe access to the sphenoid sinus. The purpose of this study was to determine whether functional olfactory mucosa could be obtained from such superior turbinate tissue.Study Design/Methods Superior turbinate tissue was resected from 4 patients undergoing transnasal endoscopic approaches to the sphenoid sinus. The gross appearance of the turbinate mucosa was normal at the time of surgery. The specimens were placed directly into cold cell culture media and transferred to the laboratory. A portion of the mucosa was fixed and embedded for histology and immunohistochemistry. The remaining tissue was enzymatically dissociated, and the resulting cell suspension was either prepared for immediate calcium imaging or placed into cell culture. Cultured ORNs underwent calcium imaging after several weeks to assess their ability to respond to odorants.Results Histologic analysis of superior turbinate tissue revealed the presence of patchy olfactory neuroepithelium staining positive for olfactory marker protein. Acutely dissociated ORNs were capable of generating calcium responses to odorant mixtures. ORNs could be maintained in mixed culture and retained their ability to respond to odorants.Conclusions Superior turbinate tissue removed during endoscopic sphenoidotomy can provide a valuable source of human olfactory neuroepithelium for functional or histologic study. Superior turbinate tissue yields stem cells and immature neurons capable of differentiating into ORNs that retain many of their functional characteristics even after growth in culture.
Presence of Cysteinyl Leukotrienes in Asthmatic Patients With Chronic Sinusitis
Authors: Arango Pablo , Kountakis Stilianos E. 
Published: November 2003

AbstractIntroduction The association between asthma and sinusitis has long been recognized. Numerous studies point to a complex, yet undeniable relationship between asthma and chronic sinusitis and rhinitis. There have also been extensive attempts to characterize the inflammatory mechanisms of both disorders. Increasingly, the cysteinyl leukotrienes, a potent group of inflammatory mediators, have gained attention as important contributors to the manifestation of both disorders. Leukotriene production has been shown to be upregulated in the bronchial tissue of asthmatics. Our study sought to determine if leukotriene production was increased in the sinus mucosa of asthmatics with chronic sinusitis.Study Design Prospective study.Methods Nasal polyp tissue was evaluated from 27 consecutive patients undergoing elective polypectomy. The presence of asthma was determined by patient history, their medical record, and use of asthma medication. Sinus tissue was extracted during the course of endoscopic surgery. Cysteinyl leukotrienes (CysLT) were quantified by a sensitive competitive enzyme immunoassay, and the levels of CysLT were compared in the group with and without asthma.Results Cysteinyl leukotrienes were detected in 23 of 27 patients. The average level of LTC4 in non‐asthmatic patients was 25.6 picograms (pg)/g. The average amount of LTC4 in asthmatic patients with sinusitis was 19.2 pg/g. There was no significant difference between the two groups (P = .64).Conclusions The presence of asthma does not correlate with increased levels of leukotrienes in the sinus mucosa of patients with chronic sinusitis.
Inverted Papilloma of the Sphenoid Sinus Presenting With Auditory Symptoms: A Report of Two Cases
Authors: Eisen Marc D. , Buchmann Luke , Litman Richard S. , Kennedy David W. 
Published: November 2003

AbstractObjectives The report aims to inform the reader of cases of inverted papilloma involving the sphenoid sinus presenting with auditory symptoms.Study Design Case series.Methods A retrospective medical record analysis was carried out to identify patients with inverted papilloma involving the sphenoid sinus that presented with a primary complaint of hearing loss or tinnitus, or both. Clinical records, including initial history and physical examination, audiologic and radiologic studies, and operative and histopathologic reports, were carefully examined. A complete literature review for relevant studies was performed to explore possible pathophysiologic factors and similar cases.Results Two patients with inverted papilloma presenting with primary auditory complaints were identified. One patient had roaring tinnitus and sensorineural hearing loss demonstrated with audiologic assessment, whereas the other had pulsatile tinnitus. Both patients had biopsy‐proven inverted papilloma involving the sphenoid sinus, and both patients underwent endoscopic resection of the disease. No other cause or origin of their auditory symptoms was confirmed. The auditory symptoms of both patients improved markedly after excision of their inverted papillomas.Conclusions Tinnitus with or without hearing loss is an unusual presentation of inverted papilloma of the sphenoid sinus. Sphenoid tumors should be considered in the workup of these symptoms.
Evaluation of Endotracheal Tube Safety for CO2 Laser Resurfacing
Authors: Ferguson John C. , Carr Rebecca T. , Chang Edward W. , Farrior Edward H. 
Published: November 2003

AbstractObjectives The new generation carbon dioxide lasers have become popular as a result of their ease of use and consistent results. Their use is becoming widespread with both the experienced laser surgery clinician and those just venturing into the realm of laser resurfacing. The purpose of this study was to evaluate the safety of the common PVC endotracheal and one designed for laser procedures if contacted by the CO2 laser during resurfacing. In addition, the cost and efficacy of a simple covering to the PVC tube was assessed.Study Design Endotracheal tubes were subjected to multiple passes of the Coherent Ultrapulse laser system while recording tube effect and intraluminal temperature.Method With the highest energy densities used in our practice, multiple passes were made over both PVC and Xomed Laser‐Shield II endotracheal tubes with 100% intraluminal oxygen. Thermocouplers recorded both inflow and outflow temperatures. The procedure was repeated with PVC endotracheal tubes covered with saline‐soaked sponges held in place with netting.Results Charring of the PVC tube occurred after 1 pass, and intraluminal smoke was present after 21.6 passes. The Laser‐Shield II and the wrapped PVC tube did not show significant charring or tube lumen breach after up to 200 passes. The prepared PVC tube was $105.14 less than the commercial tube.Conclusions Our method of PVC endotracheal tube preparation provides a safe, inexpensive, reliable airway during CO2 laser resurfacing.
Argon Plasma Coagulation (APC) in Palliative Surgery of Head and Neck Malignancies
Authors: Hauser Ulrich , Hoffmann Thomas K. , Balló Hilmar , Bier Henning 
Published: November 2003

AbstractObjectives Surgical reduction of bulky disease is an important treatment option in patients with incurable head and neck malignancies. In general, conventional tumor ablation is associated with significant hemorrhage, and the resulting tumorous wound surface entails aftercare problems. Argon plasma coagulation (APC) represents a novel technique providing effective hemostasis and wound sealing. Thus, APC features requirements of particular interest in palliative surgery of the head and neck.Study Design Using APC, we performed 18 palliative tumor resections in a series of 8 consecutive patients with recurrent head and neck lesions. Five patients received repeated APC treatment up to five times.Methods APC as non‐contact, high‐frequency electrosurgery under inert argon plasma atmosphere allows dissection, hemostasis, and desiccation of tumor tissue in a one‐step procedure. In consideration of the limited and heterogeneous group of patients, results are interpreted descriptively.Results In every case of palliative surgery, APC caused efficient hemostasis, which helped significantly to reduce both time exposure of the operation and intraoperative loss of blood. Only one APC‐unrelated complication occurred (transient rhino‐liquorrhea), and none of the patients developed postoperative hemorrhage. Finally, APC produced dry and clean wound surfaces facilitating surgical aftercare. The achieved esthetic and functional improvements strengthened the patient's autonomy and social acceptance.Conclusion APC is highly recommended for palliative surgery of head and neck malignancies.
Immune Reactivity Does Not Predict Chemotherapy Response, Organ Preservation, or Survival in Advanced Laryngeal Cancer
Authors: Wolf Gregory T. , Bradford Carol R. , Urba Susan , Smith Allison , Eisbruch Avraham , Chepeha Douglas B. , Teknos Theodoros N. , Worden Frank , Dawson Laura , Terrell Jeffrey E. , Hogikyan Norman D. 
Published: November 2003

AbstractObjective To determine whether pretreatment lymphocyte subpopulations correlate with tumor response to induction chemotherapy as part of an organ preservation treatment approach in patients with advanced laryngeal cancer.Study Design A prospective clinical trial in patients with advanced laryngeal cancer was undertaken to determine whether the frequency of late salvage laryngectomy and overall survival could be improved using one cycle of neoadjuvant chemotherapy to select patients for organ preservation. Pretreatment peripheral blood lymphocyte subpopulations for CD3, CD4, CD8, NK, and B cells were correlated with tumor response to induction chemotherapy, larynx preservation, and survival, to determine whether immune parameters could be useful in patient selection.Methods The study setting was a tertiary referral academic health center. Studied were 53 patients with stage III (42%) or IV (57%) larynx cancer. Most patients had supraglottic cancers (73%) and positive clinical nodes (51%). Sixty‐eight percent had greater than 50% tumor response after one cycle of induction chemotherapy and then received concurrent chemoradiation and two cycles of adjuvant chemotherapy. Lymphocyte subpopulations were measured in 39 patients. Mean follow‐up was 23.3 months (range, 5–61 mo).Results A total of 18 (34%) patients underwent laryngectomy. Only 4 cases were late salvage resections (13–35 mo after treatment). Fourteen cases were planned surgery after initial chemotherapy. Of the lymphocyte subpopulations measured, CD8 levels were significantly lower in stage IV patients and tended to be lower in patients with successful organ preservation. However, no significant differences in lymphocyte subpopulations were found among responders and nonresponders to chemotherapy. Overall survival was 88%.Conclusions One cycle of neoadjuvant chemotherapy was effective in selecting patients for organ preservation. The regimen of definitive concurrent and adjuvant chemotherapy was associated with an unexpectedly high 2‐year survival rate. Lymphocyte subsets were not significant predictors of responding patients or survival. Further study of other biological markers useful in selecting patients for organ preservation are needed.
High‐Dose‐Rate Brachytherapy in the Treatment of Recurrent and Residual Head and Neck Cancer
Authors: Glatzel Michael , Büntzel Jens , Schröder Dirk , Küttner Klaus , Fröhlich Dietmar 
Published: November 2003

AbstractObjectives/Hypothesis Interstitial and endocavitary brachytherapy are well‐accepted kinds of radiotherapy that are commonly used in recurrent head and neck cancer. Most reports about brachytherapy in the successful treatment of head and neck tumors used low‐dose‐rate brachytherapy. There are only a few reports about high‐dose‐rate brachytherapy (HDRBT) in head and neck cancer patients.Methods After 10 years of experience with HDRBT with Ir 192, we have analyzed the results regarding response rates, survival time, and side effects. Between 1991 and 2000, 90 consecutive patients (68 men, 22 women) were treated with interstitial (68 patients) or intracavitary (22 patients) HDRBT in the head and neck area. Primary tumor locations were as follows: oropharynx (n = 26), tongue/floor of mouth (n = 22), nasopharynx (n = 10), nose/paranasal sinuses (n = 9), salivary glands (n = 5), hypopharynx (n = 5), CUP syndrome (n = 5), and others (n = 8). High‐dose‐rate brachytherapy was administered in 51 patients with recurrent disease and in 32 patients with residual tumor after primary radiochemotherapy. Seven patients were given exclusive HDRBT in a primary palliative situation. The single dose per fraction ranged from 1.5 to 7.5 Gy (median value, 5 Gy), and the total HDRBT dose ranged from 4.0 to 42.0 Gy (median value, 17.5 Gy).Results The overall remission rate was 81% with a 46% rate of complete remissions. We observed no change in or progression of tumor in 17 cases (19%). The rate of complete remissions (and median overall survival time) was different in the three therapy groups: in case of recurrent disease, 28% (6 mo); in case of residual tumor, 84% (25 mo); and in primary palliative brachytherapy, 0% (1 mo). Late toxicities III and IV (radiation treatment oncology group score) occurred in 6 of 90 (6.7%) patients.Conclusions High‐dose‐rate brachytherapy proved to be an effective treatment modality in locoregional recurrent head and neck cancer. In cases with persistent or residual tumor after primary radiochemotherapy a local boost with brachytherapy can improve the chance of cure of tumor disease.
Congenital Tracheocutaneous Fistulas
Authors: Oxford Lance , Ducic Yadranko 
Published: November 2003

AbstractObjective To outline two cases of congenital tracheocutaneous fistula and discuss the potential pathogenesis of this previously unreported developmental abnormality.Methods Two cases of tracheocutaneous fistula evaluated at John Peter Smith Hospital (Fort Worth, TX) from May to October 2001 were reviewed. The surgical treatment of one infant is described.Results Two infants were evaluated with a congenital fistula extending from the suprasternal region of the neck dorsally to the trachea in the midline. The infants were otherwise developmentally normal with unremarkable prenatal histories. Primary surgical closure of a fistula was accomplished without complication.Conclusions Congenital tracheocutaneous fistula appears to be an isolated developmental abnormality not associated with the same degree of morbidity as acquired tracheocutaneous fistula. The development of a congenital tracheocutaneous fistula may be the result of abnormal epidermal migration secondary to a localized midline mesodermal defect. Congenital tracheocutaneous fistula may be successfully treated with primary closure. Observation and close follow‐up of asymptomatic fistulas may be reasonable.
Laryngeal Prostatic Cancer Metastases: An Underestimated Route of Metastases?
Authors: Prescher Andreas , Schick Bernhard , Stütz Arndt , Brors Dominik 
Published: November 2003

AbstractObjective Despite the high rate of metastases in advanced prostatic cancer, only 12 reports with 13 cases of laryngeal metastases in prostatic cancer have been given in the literature since the first description by Schmorl in 1908. A histopathological study was undertaken to clarify the obvious controversial clinical experience of multiple metastases in prostatic cancer but rare observations of laryngeal involvement.Study Design Postmortem laryngeal examination in advanced prostatic cancer.Methods Six patients with prostatic cancer and tumor spread to different organs but without clinical symptoms of laryngeal involvement were available for postmortem analysis. Gross anatomical inspection of the inner and outer surfaces of the removed larynx, horizontal slices of the larynx, and subsequent histological investigations including immunohistochemical analysis were used to search for metastases.Results Macroscopic evaluation of the whole‐larynx specimens did not lead to suspicion of laryngeal metastases. Interestingly, in all six larynx specimens of patients with metastatic prostatic cancer, laryngeal tumor infiltration was detected by macroscopic inspection of horizontal slices and proven histologically. Tumor infiltration ranged from focal micrometastases in the hematopoietic tissue of the ossified laryngeal skeleton to partial destruction of the external and/or internal osseous or cartilaginous lamina of the laryngeal skeleton.Conclusions The larynx is more often affected in metastatic prostatic cancer disease than is suggested by clinical experience. Because prostatic cancer metastasis starts in the hematopoietic areas of the ossified laryngeal skeleton, macroscopic evaluation of the whole larynx fails to detect metastases. Detecting laryngeal involvement requires horizontal slices and histological analysis.
Intermittent Pressure Therapy of Intractable Ménière's Disease Using the Meniett Device: A Preliminary Report
Authors: Gates George A. , Green J. Douglas 
Published: November 2003

AbstractHypothesis Treatment with the Meniett device, which applies intermittent micropressure pulses to the inner ear through a tympanostomy tube, is effective in controlling vertigo in people with intractable Ménière's disease.Study Design Short‐term, preliminary descriptive report.Methods Ten patients with intractable vertigo despite adequate medical therapy elected to use the Meniett device. After placement of a standard tympanostomy tube, the patient self‐administers the Meniett device three times daily.Results The follow‐up ranged from 3 to 11 months with an average of 8 months. All 10 patients responded to the therapy with vertigo control in 9 of 10 and a 50% reduction in the 10th case. There was a mean hearing gain of 6 dB, which was statistically significant. There were no major complications. Two subjects required tube reinsertion during the 8 months of follow‐up.Conclusions Use of the Meniett device is an effective and safe option for people with intractable vertigo from Ménière's disease.
Measurement of Facial Muscle Strength in Normal Subjects
Authors: Neely J. Gail , Pomerantz Rebecca G. 
Published: November 2003

AbstractObjectives Muscle strength is a fundamental measure of function for neuromuscular systems; however, mimetic facial muscle strength has never been recorded. The objective of the present feasibility project was to measure facial muscle strength.Study Design The study design was a prospective experimental trial in 10 normal subjects. Descriptive statistics, t tests, and analysis of variance were used to summarize and compare data.Methods Subjects were selected by convenience following submission and approval of a prospectively designed protocol and consent form to the Human Studies Committee. Application of a force transducer to the central eyebrow and commissure during eyebrow raising, eyelid closing, smiling, and puckering was performed by two methods: surface adhesion method (n = 5) and direct probe application method (n = 5). Data were recorded in pounds. Three repetitions of each movement were made.Results Rank order of muscle strengths (in pounds) by the surface adhesion technique was as follows: brow, 0.758; eye, 0.549; pucker, 0.387; and smile, 0.307. By direct probe application the rank order of muscle strengths was as follows: eye, 0.880; brow, 0.773; and smile, 0.730.Conclusions Objective measures of facial motion are crucial for quantitative investigations of preventative, therapeutic, reconstructive, and rehabilitative interventions for facial nerve and muscle lesions. Until the present, objective measures required cross‐correlations with current standards that were subjective. This is the first time an actual physical measure of facial muscle function has been performed. The purpose of presenting this preliminary work is to stimulate advancement along this line of research.
The Treatment of Facial Verrucae With the Pulsed Dye Laser
Authors: Vargas Hannah , Hove Christopher R. , Dupree Marsha L. , Williams Edwin F. 
Published: November 2003

AbstractObjectives/Hypothesis To evaluate the treatment of facial verrucae with the pulsed dye laser.Study Design A prospective, nonrandomized, nonblinded pilot study evaluating the treatment of facial verrucae with the pulsed dye laser.Methods Twelve patients with facial verrucae (four recalcitrant) were identified and followed in the study in the setting of a tertiary referral center. The treatment consisted of the flash‐lamp pumped pulsed dye laser (585 mn) with a spot size of 5 mm at fluences between 9.0 and 13 J/cm2. Each lesion received one or two pulses with 2 mm of surrounding normal skin included in the treatment. One patient had paring prior to pulse treatment. The patients were examined 3 to 4 weeks after each procedure, and clinical assessment of the lesion was documented.Results Patient ages ranged from 18 to 47 years. Four patients had refractory lesions, and eight patients had never undergone previous treatment. All 12 patients had full resolution of their facial warts after one to three treatment sessions. No complications such as scarring, alopecia, or recurrence were encountered. Follow‐up ranged from 10 to 33 months.Conclusions Pulsed dye laser therapy is highly effective and safe therapy for facial verrucae. This method appears to selectively destroy warts without damaging surrounding skin.