bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumor Growth and Audiometric Change in Vestibular Schwannomas Managed Conservatively
Authors: Massick Douglas D. , Welling D. Bradley , Dodson Edward E. , Scholfield Minka , Nagaraja Haikady N. , Schmalbrock Petra , Chakeres Donald W. 
Published: November 2003

AbstractObjective To prospectively define the correlation between changes in tumor volume and audiometric function in vestibular schwannomas managed conservatively.Study Design Prospective longitudinal study.Methods Twenty‐one patients (age range, 15–84 y; mean age, 63.3 y) with newly diagnosed vestibular schwannomas were enrolled between 1994 and 1999 in a protocol at The Ohio State University Hospital (Columbus, OH) to evaluate the correlation between tumor volume and audiometric change during a period of observation. Patients were evaluated yearly by clinical examination, a standardized internal auditory canal magnetic resonance imaging scan with gadolinium contrast for volumetric analysis, and audiometric function testing. Demographic data, historical features, neurofibromatosis type 2 (NF2) status, initial testing results, and serial testing results were recorded.Results An increase in tumor volume occurred in 14 of the 21 patients (66%). The pattern of volumetric change was found to be e‐tremely variable. Multiple regression analysis revealed significant correlations of changes in tumor volume with changes in pure‐tone average and speech discrimination score (P < .0001 and P = .0021, respectively). Change in tumor volume had greater effect on pure‐tone average and speech discrimination score in patients initially with class D audiometric function when compared with those initially in class A (P = .0083 and P = .0245, respectively). The presence of NF2 had an independent protective effect against deterioration of the pure‐tone average when compared with patients without NF2 (P = .0125).Conclusions This study demonstrated a significant correlation between a change in volume and auditory deterioration in vestibular schwannomas being managed with a trial of observation. A given change in tumor volume appeared to have a greater effect on pure‐tone average and speech discrimination score as initial auditory classification declined.
Developmental Expression of Aquaporin 2 in the Mouse Inner Ear
Authors: Merves Michele , Bobbitt Bradley , Parker Kenneth , Kishore Bellamkonda K. , Choo Daniel 
Published: November 2003

AbstractObjectives The maintenance of endolymph homeostasis is critical for the inner ear to perform its functions of hearing and maintaining balance. The identification and cloning of aquaporins (a family of water channel proteins) has allowed the study of a novel cellular mechanism potentially involved in endolymph homeostasis. The objective of the present study was to define the developmental temporal and spatial e‐pression pattern of aquaporin 2 (Aqp2) in the developing mouse inner ear.Study Design A systematic immunohistochemical study of Aqp2 protein e‐pression was performed on embryonic mouse inner ears ranging from embryonic day 10 (otocyst stage) to embryonic day 18 (just before birth).Methods Serial cryosections of embryonic mouse inner ears were used for immunohistochemical e‐periments. A rabbit polyclonal antisera raised against a synthetic Aqp2 peptide was used with a standard nickel intensified 3,3‐diaminobenzidine reaction protocol for immunolocalization of Aqp2 in tissue sections.Results Aquaporin 2 is e‐pressed diffusely in the early otocyst, then becomes progressively restricted as the inner ear matures. During early cochlear duct formation (embryonic days 12 and 13), e‐pression of Aqp2 is homogeneous; later, it becomes restricted to specific regions of the endolymphatic compartment (embryonic days 15 and 18). Similar restriction of e‐pression patterns could be noted for the vestibular structures. Endolymphatic duct and sac and stria vascularis e‐pression of Aqp2 was noted to occur fairly late during development but demonstrated a distinct pattern of immunolabeling.Conclusions Aquaporin 2 shows an early and specific pattern of e‐pression in the developing mouse inner ear, suggesting a significant role for this water channel protein in the development of endolymph homeostasis and meriting further functional studies of Aqp2 in the inner ear.
Biodegradable External Tracheal Stents and Their Use in a Rabbit Tracheal Reconstruction Model
Authors: Robey Thomas C. , Eiselt Petra M. , Murphy Hedwig S. , Mooney David J. , Weatherly Robert A. 
Published: November 2003

AbstractObjectives/Hypothesis To design and develop an e‐ternal biodegradable tracheal stent for use in airway reconstructive surgery.Study Design E‐perimental model.Methods Biodegradable e‐ternal tracheal stents were fabricated from polyglycolic acid and poly(D,L‐lactide‐co‐glycolide) (85:15). In vitro studies were performed to analyze the mechanical properties and degradative characteristics of these stents. Then the stents were tested in vivo in an anterior tracheal reconstruction model in New Zealand white rabbits.Results The average dry modulus for the e‐ternal stents was 1800 kilopascal (kPa). All of the e‐ternal stents cracked by 4 weeks in buffer solution. Significant mass loss was not appreciated until after 10 weeks in solution, but by 20 weeks the stents were nearly 100% degraded . In the in vivo portion of the study, the attrition rate for the control group was 23.1% versus 50% for the external stent group. The stridor rate was approximately 38% for both groups . Of the rabbits that survived the entire 3 months of the study, the stented group, when measured by a balloon catheter method, had more patent airways than the control group, with an average stenosis of 27.8% versus 47.2%, respectively (P < .05). However, more accurate postmortem cast measurements of the internal airways did not confirm this.Conclusions The e‐ternal biodegradable tracheal stent employed in this study degraded in a predictable fashion and may provide a new method to augment surgical reconstruction of the anterior tracheal wall.
Hearing Results After Primary Cartilage Tympanoplasty
Authors: Gerber Matthew J. , Mason John C. , Lambert Paul R. 
Published: November 2003

AbstractObjectives/Hypothesis Cartilage–perichondrium grafting of the tympanic membrane has been used in an effort to reduce recurrence or progression of middle ear disease. The rigidity of cartilage has obvious benefit in preventing tympanic membrane retraction, but concern has been raised regarding its sound conduction properties. Few studies in the literature address hearing results after cartilage tympanoplasty. The purpose of this study was to investigate the hearing results after primary cartilage tympanoplasty and compare them with results after primary tympanoplasty with temporalis fascia.Study Design A retrospective review of all ear surgeries using cartilage between 1994 and 1999 was performed.Methods Only primary cases in which the ossicular chain was intact and no mastoid surgery was performed were included. Indications for surgery included tympanic membrane perforation, retraction, and cholesteatoma. Pre‐ and postoperative speech reception thresholds and air–bone gaps at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz were compared.Results Eleven patients comprised the cartilage study group, and there were 11 age‐ and temporally matched control subjects. The mean improvement in speech reception threshold for both the study group and the control group was 10 dB. The majority of patients in both groups had ABG closure to within 10 dB at all frequencies examined. There were no statistically significant differences in speech reception threshold improvement or air–bone gap closures between the two groups.Conclusions These results demonstrate that hearing results after cartilage tympanoplasty are comparable to those after temporalis fascia tympanoplasty. Therefore, when indicated, a cartilage–perichondrium graft can be used for prevention of disease recurrence or progression without fear of impairing hearing.
Evaluating the Effects of Oral Prednisolone on Recovery After Tonsillectomy: A Prospective, Double‐Blind, Randomized Trial
Authors: Palme Carsten E. , Tomasevic Predrag , Pohl David V. 
Published: November 2003

AbstractObjectives To investigate the role of a 7‐day course of oral prednisolone on recovery from tonsillectomy.Study Design Double‐blind, randomized, placebo‐controlled trial of 50 consecutive patients, aged 5 years and older, who had no previous or known contraindications to steroid therapy.Method The patients were randomized at the time of surgery to either a 7‐day course of daily placebo or prednisolone (dosage: 10 mg per day in patients aged 5–11 y, 0.5 mg/kg in those aged 12 and older). Age, sex, weight, diagnosis, tonsil size (in cm2), additional adenoidectomy, performing surgeon, method of dissection, length of procedure, total blood loss, intraoperative fluid requirement, and length of hospitalization were documented for each patient. During the first postoperative day, morning pain score, paracetamol use, oral fluid intake, temperature, presence of nausea and vomiting, level of activity (low, moderate, or normal), and type of diet (liquid, soft, or normal) were recorded.Results The steroid group consisted of a greater number of diathermy dissection cases and had significantly less intraoperative blood loss (P value = .022 and .017, respectively). On postoperative days 4 to 7, the steroid group experienced less nausea and vomiting (P value = .01, .04, .04, and .04, respectively). Paracetamol use was less in the steroid group on days 2, 7, and 8 (P value = .03, .02, and .02, respectively). There was no difference between the two groups for the other data measured.Conclusion A 7‐day course of corticosteroids may play a limited role in patients' recovery from tonsillectomy.
Endoscopic Staple‐Assisted Esophagodiverticulostomy: An Excellent Treatment of Choice for Zenker's Diverticulum
Authors: Cook Raymond D. , Huang Patti C. , Richstmeier William J. , Scher Richard L. 
Published: November 2003

AbstractObjectives The objectives of the present study are to review the technique of endoscopic staple‐assisted esophagodiverticulostomy (ESED) for the treatment of Zenker's diverticulum and to describe our e‐perience and modifications with ESED and the advantages of ESED over previous treatments of Zenker's diverticulum.Study Design Retrospective review of 74 cases of ESED performed for the treatment of Zenker's diverticulum.Methods Patient's records were retrospectively reviewed and tabulated for age, se‐, size of diverticulum, symptoms, duration of symptoms, operative time, length of postoperative hospital stay, oral intake, complications, and relief of symptoms.Results The senior author (r.l.s.) previously reported results in 36 cases of ESED performed in 34 patients with Zenker's diverticulum. We have performed an additional 38 cases of ESED in 37 patients between March 1997 and August 1999. The rate of success of ESED was similar between the two series. The average perioperative time, time until oral intake, and length of postoperative hospital stay decreased in the second series. Overall, there were no mortalities and few complications with ESED. Compared with other forms of treatment of Zenker's diverticulum, such as Dohlman's procedure, diverticulectomy, and diverticulopexy, ESED has a similar rate of success, decreased perioperative time, decreased convalescence, and decreased mortality and complications.Conclusions Cost‐effectiveness, safety, and efficacy of ESED offer new advantages over previously used treatments for Zenker's diverticulum. These results continue to support the use of ESED as the initial treatment of choice for patients with Zenker's diverticulum.
Investigative Modalities of Mandibular Invasion by Squamous Cell Carcinoma
Authors: Acton Caroline H. C. , Layt Craig , Gwynne Ray , Cooke Robin , Seaton David 
Published: November 2003

AbstractObjectives/Hypothesis To compare preoperative investigations with histological findings in squamous cell carcinoma (SCC) of the oral mucosa that abuts the mandible. Both clinical and radiological examinations fail to predict accurately invasion of the mandible by intraoral SCC.Study Design This two‐part, prospective study is of a consecutive series of patients whose first malignancy of the upper aerodigestive tract abutted the lingual surface of the mandible.Methods All patients presented to the Queensland Radium Institute Head and Neck Clinic between 1993 and 1997 with a biopsy‐proven SCC that abutted the mandible. These tumors were investigated clinically, radiologically, and histologically. Sensitivity, specificity, and predictive values were calculated for various approaches. In the second part of the study, single photon emission computed tomography (SPECT) bone scans were included. Quantification ratios of bone scans compared the average counting statistics in visually identified mandibular abnormal uptake with normal cervical spine and jaw.Results Sixty‐seven patients were followed for 55 months and assessed with orthopantomogram (OPG), computed tomography (CT) scans, and, in the second part of the study, SPECT bone scans. Thirty‐six tumors showed histological evidence of bony invasion. Bony involvement was suggested by OPG in 36 and confirmed histologically in 27 patients. CT scans showed evidence of bone invasion in 22 cases, with 18 of these histologically confirmed. Technetium 99m methylene diphosphonate (MDP) bone scans with planar imaging and SPECT were performed in 24 patients, and histological appearance was suitable for analysis in 14. Three patients with tumor (cervical spine ratios greater than 1.5 predicting malignant involvement) had this confirmed histologically.Conclusions The first part of the study confirms our hypothesis that currently used investigations, as well as clinical assessment, fail to predict accurately invasion of the mandible by intraoral SCC. The second part suggests that SPECT scanning with high quantification ratios is promising in the prediction of tumor involvement.
The Relationship Between Microvessel Density, the Expression of Vascular Endothelial Growth Factor (VEGF), and the Extension of Nasopharyngeal Carcinoma
Authors: Guang‐Wu Huang , Sunagawa Masanori , Jie‐En Li , Shimada Seiji , Gang Zeng , Tokeshi Yoshihiro , Kosugi Tadayoshi 
Published: November 2003

AbstractObjective The present study was aimed at clarifying whether the microvessel density (MVD) and the e‐pression of vascular endothelial growth factor (VEGF) were related to the degree of local invasion and metastasis in nasopharyngeal carcinoma (NPC).Study Design We measured the MVD and examined whether VEGF was expressed in NPC tissue using histological study combined with immunohistochemistry.Methods MVD and VEGF expression was measured in 73 specimens of NPC, 15 benign tumors of nasopharyngeal region, and 20 nasopharyngeal tissue without tumor. MVD and VEGF expression in NPC was compared between a metastasis group (49 specimens) and a non‐metastasis group (24 specimens).Results Both MVD and VEGF expression were markedly increased in NPC tissue as compared with those in benign tumors of nasopharyngeal region. Both MVD and VEGF expression in NPC tissue with metastasis were statistically significantly increased as compared with those in NPC without metastasis. Therefore, the invasion and metastasis of NPC cells were closely related to MVD and the expression of VEGF in NPC tissue.Conclusion The metastatic potency of NPC tissue and the prognosis of the patients with NPC can be estimated by measuring MVD and the expression of VEGF in NPC tissue. Drugs that have inhibitory actions on angiogenesis could be useful to prevent metastasis of NPC cells in the patients.
Bone Involvement in Sinusitis: An Apparent Pathway for the Spread of Disease
Authors: Perloff Joel R. , Gannon Frank H. , Bolger William E. , Montone Kathleen T. , Orlandi Richard , Kennedy David W. 
Published: November 2003

AbstractObjectives/Hypothesis To study the effects of bone involvement in experimentally induced sinusitis and the effect of involved bone on the overlying mucosa.Study Design Animal study.Methods Sinusitis was induced unilaterally with Pseudomonas aeruginosa in the maxillary sinus of 19 New Zealand white rabbits. At 6 weeks, the pathogenic organism was confirmed by culture, and a segment of the bone from the medial wall of the sinus implanted in a submucosal pocket in the opposite sinus. The rabbits were killed at predetermined time intervals up to 13 weeks from sinusitis induction, and en bloc sinus sections were decalcified and stained.Results The implanted bone reabsorbed partially or totally in all specimens. However, the study revealed clear histological evidence of bone involvement adjacent to the infected sinuses and the bony changes extended to the noninfected side in all specimens. The histological findings were identical to those seen in chronic osteomyelitis.Conclusions This study demonstrates the ability for pseudomonal sinusitis, at least in the presence of surgical intervention, to involve bone at a distance from the site of primary infection in the absence of intervening mucosal disease. If confirmed with additional organisms and models, these findings have significant implications for the therapeutic management of chronic sinus disease.
The Diagnosis of a Conductive Olfactory Loss
Authors: Seiden Allen M. , Duncan Heather J. 
Published: November 2003

AbstractObjectives/Hypothesis Two of the most common causes of olfactory loss include upper respiratory infection (URI) and nasal or sinus disease. The etiology of most URI‐related losses is thought to be viral and, as yet, there is no available treatment. In contrast, nasal or sinus disease produces an obstructive or conductive loss that often responds dramatically to appropriate therapy. Therefore, the distinction is important but in many cases may be difficult because such patients often present with no other nasal symptoms, and routine physical findings may be nonspecific. The purpose of this report is to characterize those aspects of the history and physical examination that will help to substantiate the diagnosis of a conductive olfactory loss.Study Design A retrospective, nonrandomized study of consecutive patients presenting with a primary complaint of olfactory loss.Methods This study reviewed 428 patients seen at a university‐based taste and smell clinic from July 1987 through December 1998. Of this total, 60 patients were determined to have a conductive olfactory loss. All patients were referred specifically because of a primary chemosensory complaint. The University of Pennsylvania Smell Identification Test (UPSIT; Sensonics, Inc., Haddon Heights, NJ) was administered in all cases.Results The most commonly diagnosed etiologies of olfactory loss were head injury (18%), upper respiratory infection (18%), and nasal or sinus disease (14%). Of the 60 patients with a conductive loss, only 30% complained of nasal obstruction, whereas 58% described a history of chronic sinusitis. Only 45% reported that their olfactory loss at times seemed to fluctuate in severity. Anterior rhinoscopy failed to diagnose pathology in 51% of cases, whereas nasal endoscopy missed the diagnosis in 9%. Systemic steroids elicited a temporary reversal of conductive olfactory loss in 83% of patients who received them, offering a useful diagnostic maneuver, whereas topical steroids did so in only 25%.Conclusions The etiology for olfactory loss can in many cases be difficult to determine, but it is important to establish prognosis and to predict response to therapy. Diagnosis requires a thorough history, appropriate chemosensory testing, and a physical examination that should include nasal endoscopy. A trial of systemic steroids may serve to verify that the loss is indeed conductive.
Local Vasodilator Response to Mobile Phones
Authors: Paredi Paolo , Kharitonov Sergei A. , Hanazawa Toyoyuki , Barnes Peter J. 
Published: November 2003

AbstractObjectives The use of mobile phones with the resulting generation of potentially harmful electromagnetic fields (EMF) is the focus of public interest. Heat generation and the activation of the inducible form of nitric oxide (NO) synthase may be possible causes of the biological effects of EMF exposure. We investigated if a mobile telephone conversation can modify skin temperature, NO, and nasal resistance.Methods We studied the effect of an EMF (900 MHz) generated by a commercially available cellular phone during a 30‐minute telephone conversation on skin temperature, nasal NO measured by chemiluminescence, and nasal minimal cross‐sectional area (MCA) measured by rhinometry. Eleven normal subjects (mean age ± standard error of mean [SEM], 32 ± 5 y; 10 male) were studied.Results There was a similar and significant increase in skin temperature of the nostril and occipital area on the same side as the telephone (maximal increase 2.3 ± 0.2°C at 6 min) as well as a tendency for higher nasal NO levels (maximal increase 12.9 ± 4.9% at 10 min), whereas the MCA was significantly reduced (maximal decrease ‐27 ± 6% at 15 min). Such changes were not recorded when an earpiece was used to avoid the direct exposure to the electromagnetic field. There were no changes in the skin temperature and nasal NO measured on the opposite side to the mobile phone, whereas the MCA was significantly increased (38 ± 10%).Conclusions Exposure to EMF produced by a mobile phone produces biological effects that can be easily measured. Microwaves may increase skin temperature and therefore cause vasodilation and reduce MCA. Further studies are needed to study the long‐term effects of mobile phone use and the relation among NO production, vasodilation, and temperature.
Botulinum Toxin: Basic Science and Clinical Uses in Otolaryngology
Authors: Blitzer Andrew , Sulica Lucian 
Published: November 2003

AbstractThe role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered. These effects are also graded according to dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm; vocal tics and stuttering; cricopharyngeal achalasia; various tremors and tics; hemifacial spasm; temporomandibular joint disorders; and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 years of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.