bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a Patient‐Graded Instrument for Facial Nerve Paralysis: The FaCE Scale
Authors: Kahn Jeffrey B. , Gliklich Richard E. , Boyev K. Paul , Stewart Michael G. , Metson Ralph B. , McKenna Michael J. 
Published: November 2003

AbstractObjective To develop and validate a patient‐based instrument to measure both facial impairment and disability, the Facial Clinimetric Evaluation (FaCE) Scale.Study Design Prospective instrument validation.Methods Eighty‐six patients with a documented history of facial paralysis completed a preliminary, 51‐item instrument (alpha FaCE Scale), as well as the previously developed Facial Disability Index (FDI) and the Medical Outcomes Study Short Form 36 Item Questionnaire (SF‐36). Two weeks after completing these instruments, 76 patients again completed the alpha FaCE Scale. Forty‐one of the patients were also evaluated using the House‐Brackmann Grading System (HBGS) and the Facial Grading System (FGS).Results Exploratory principal component factor analysis grouped 15 FaCE Scale items into 6 impairment and disability categories (domains), forming the beta FaCE Scale. Overall, the test‐retest reliability of the FaCE Scale was high (Spearman's correlation coefficient (r) = 0.88, P <.01), as were the reliability coefficients of the individual domains (r = 0.81–0.92, P <.01). The FaCE Scale domains showed appropriate correlation to global visual analogue scale questions posed on the original alpha FaCE Scale (r = 0.65–0.81, P <.01). Overall, the FaCE Scale showed significant correlation with HBGS and FGS scores (r = −0.55 and 0.57, respectively;P <.01). However, not all FaCE Scale domains correlated with the HBGS and FGS scores.Conclusions A reliable and valid patient‐based system to measure impairment and disability in facial paralysis has been developed. This system appears to be better than traditional, physician‐graded scales for evaluating quality‐of‐life issues affected by facial disability.
Olfaction and Its Alteration by Nasal Obstruction, Rhinitis, and Rhinosinusitis
Authors: Doty Richard L. , Mishra Anupam 
Published: November 2003

AbstractThe sense of smell has been largely ignored by otorhinolaryngologists, even though 1) its medical stewardship falls within their specialty's purview, 2) olfactory dysfunction is not uncommon in the general population, and 3) disorders of olfaction have significant quality of life, nutritional, and safety consequences. This report provides a succinct overview of the major intranasal neural systems present in humans (namely, cranial nerves O, I, and V, and the nonfunctional accessory [vomeronasal] organ system), along with a summary of notable findings resulting from the application of modern olfactory tests to patient populations, emphasizing diseases of the nose. Such tests have led to the discovery of significant influences of age, gender, smoking, toxic exposure, and genetics on the ability to smell. Within the field of otorhinolaryngology, they have revealed that 1) surgical and medical interventions in patients with rhinosinusitis do not, on average, lead to complete recovery of olfactory function, despite common beliefs to the contrary, and 2) associations are generally lacking between measures of airway patency and olfactory function in such cases. These findings have thrown into question the dogma that olfactory loss in rhinosinusitis is attributable primarily to blockage of airflow to the receptors and have led to histopathological studies demonstrating significant olfactory epithelial compromise in sinonasal syndromes.
Giant Ethmoid Osteoma With Orbital Extension, a Nasoendoscopic Approach Using an Intranasal Drill
Authors: Huang Hung‐Meng , Liu Chia‐Ming , Lin Kai‐Nan , Chen Hann‐Tsong 
Published: November 2003

AbstractObjective Ethmoid osteoma is a slow‐growing, benign, and encapsulated bony tumor. Symptoms occur earlier than with osteomas of the frontal sinus because of the small volume of the ethmoid sinus. Interestingly, orbital extension is uncommon. Treatment remains controversial, with open procedures typically being used. In this article, we present a less invasive yet safe and effective approach to treatment.Study Design A nasoendoscopic approach using a Stammberger‐Saches intranasal drill was developed for treatment of patients with ethmoid osteoma, with or without orbital extension. Between 1995 to 1999, seven patients underwent the new surgical procedure.Methods All procedures were performed under general anesthesia. Using 0° and 30° endoscopes, surface anesthesia of the nasal mucosa was performed, the anterior ethmoid cell was resected, and the whitish osteoma found. The osteoma was drilled out inferolaterally to superomedially. In the patient with orbital extension, a double‐ended blunt elevator was used to separate the remaining osteoma from the lamina papyracea and to push the residual osteoma medially toward the nasal septum. With alternate drilling and elevation, the osteoma was gently removed. The surgical site was then packed.Results The method successfully treated all patients. There were no major complications. The single patient with orbital extension had mild postoperative periorbital ecchymoses. Nasoendoscopy showed normal epithelialization 4 to 6 weeks after surgery. Computed tomography showed no residual tumors 6 months after surgery.Conclusion The 30° nasoendoscopic approach using an intranasal drill provides a good operative field and is a safe and effective technique, with the potential to become the treatment of choice in selected cases.
Autologous Transplantation of Fascia Into the Vocal Fold: Long‐Term Results of a New Phonosurgical Technique for Glottal Incompetence
Authors: Tsunoda Koichi , Baer Thomas , Niimi Seiji 
Published: November 2003

AbstractObjectives To study the long‐term results of autologous transplantation of fascia into the vocal fold, and to evaluate our use of autologous transplantation instead of bovine collagen injection in cases of glottal incompetence.Study Design Retrospective study of the patients who have undergone autologous fascia transplantation using our new technique.Methods Follow‐up studies were performed for at least 1 year (up to 3 y) on 9 autologous fascia transplant patients (6 cases with type 1 procedures and 3 cases with type 2 procedures). Clinical observations, including laryngeal stroboscopy, and measurement of maximum phonation time (MPT) were carried out.Results During 3 months after autologous fascia transplantation, MPT gradually increased and stroboscopy showed improved glottal closure. These improvements continued beyond 1 year in all cases of type 1 surgery and 2 of 3 cases of type 2 surgery.Conclusions Autologous transplantation of fascia into the vocal folds as a phonosurgical treatment for glottal incompetence yields excellent long‐term results. Temporal fascia appears to be a highly suitable tissue for transplantation in Reinke's space. However, the fascia is less suitable for transplantation in the muscle. We speculate that transplantation of temporal fascia leads to regeneration of vocal fold tissue, perhaps using a mechanism similar to stem cell transplantation in other organs.
Progressive Sensorineural Hearing Loss in Children With Mitochondrial Encephalomyopathies
Authors: Zwirner Petra , Wilichowski Ekkehard 
Published: November 2003

AbstractObjective Mitochondrial disorders are responsible for a variety of neurological syndromes. Specific mitochondrial DNA mutations have been identified recently in some of these rare disorders. Clinical symptoms may occur in different organs to various extent; often they are associated with progressive hearing loss. The aims of this study were to determine incidence, onset, and characteristics of hearing loss in children with mitochondrial encephalomyopathies and to investigate a possible correlation between the degree of hearing loss and neurological symptoms. In addition, we investigated the prognostic value of hearing loss as a predictor of the disease.Study Design From August 1992 to September 1998, 29 patients ranging in age from 5 to 23 years (mean years) were studied. These children were hospitalized for diagnostic purposes in the neuropediatric department.Methods The mitochondrial disorder was diagnosed by clinical and laboratory testings, including analysis of the mtDNA. Audiological evaluation consisted of measurements of pure‐tone and speech audiometry, tympanometry, and acoustic refle‐ threshold testing, auditory brainstem response, and evoked as well as distortion‐product otoacoustic emissions.Results A sensorineural hearing loss was identified in 12 children. Three of these were diagnosed as having classic Kearns‐Sayre syndrome; five as having multisystem KSS; two as having the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke‐like episodes (MELAS); one as having KSS‐MELAS overlap syndrome; and one as having Friedreich ataxia. Longitudinal testing was performed in seven children, and in all of them a progression of the hearing loss could be demonstrated. Audiological test results in all 12 children suggested cochlear as well as retrocochlear origin of the hearing loss presenting independently from the severity of hearing impairment. No correlation between the characteristics and degrees of hearing loss and the number and severity of clinical neurological symptoms could be found.Conclusions The present study demonstrated a high incidence (42%) of sensorineural hearing loss in children with mitochondrial encephalomyopathies. The progressive nature of the hearing impairment was confirmed by a significant correlation between the duration in years and severity of hearing loss in the children. The hearing loss does not have a prognostic value for the progression of the disorder. Based on our findings, we recommend regular audiometric examinations in patients with mitochondrial disorders.
A Prospective Comparison of Scalpel Versus Bipolar Scissors in the Elevation of Radial Forearm Fasciocutaneous Free Flaps
Authors: Wax Mark K. , Winslow Catherine , Desyatnikova Stella , Andersen Peter E. , Cohen James I. 
Published: November 2003

AbstractObjectives/Hypothesis The radial forearm fasciocutaneous free flap has become the workhorse for reconstruction of head and neck ablative defects. A location distal to the head and neck allows this flap to be elevated concurrent with the ablation. Most commonly, the flap is elevated under tourniquet control. This involves a primary ischemic insult with a certain amount of hemorrhage after the tourniquet is released. Bipolar scissors are a new method of dissection. They may allow for a speedier dissection with a concomitant decrease in ischemic time. Their hemostatic properties may control hemorrhage after use of the tourniquet.Study Design A prospective study of patients undergoing radial forearm free flaps over a 12‐month period at a tertiary care referral center was undertaken.Results Forty patients were entered into the study, flaps were elevated with scalpel (20) and with bipolar scissors (20). Mean time under tourniquet was 39 minutes (range, 30–56 min) with scalpel compared with 27 minutes (range, 21–31 min) with bipolar scissors (P <.001). Total mean time of elevation (including control of hemostasis and pedicle dissection) for scalpel elevation was 50 minutes (range, 35–61 min) compared with 32 minutes (range, 20–41 min) for bipolar scissors elevation (P <.001). Mean blood loss was 46 mL (range, 15–110 mL) in the scalpel elevation group compared with 14 mL (range, 0–50 mL) in the bipolar scissors elevation group (P <.001). Complications at the donor site were equal between groups.Conclusions Bipolar scissors are a safe, efficient method for elevating radial forearm free flaps.
Surgical Anatomy of the Nasofrontal Duct: Anatomical and Computed Tomographic Analysis
Authors: Kim Kyung Su , Kim Hyun Ung , Chung In Hyuk , Lee Jeung Gweon , Park In Yong , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives Although complete anatomical knowledge of the nasofrontal duct has been of great importance, little is known about it. The aim of this study is to examine the drainage site of the nasofrontal duct and to investigate the anatomical boundaries of the nasofrontal duct according to the drainage site.Study Design One hundred sagittally divided adult head specimens were analyzed by computed tomography and dissection under the surgical microscope.Methods Computed tomography scans of 50 adult cadaver heads were taken sagittally at 1‐mm intervals and coronally at 3‐mm intervals to find the nasofrontal duct. One hundred specimens, made up of sagittally divided adult cadaver heads, were dissected under the microscope to study the structure of the nasofrontal duct.Results We identified the anterior, posterior, medial, and lateral boundaries of the nasofrontal duct. In the most common type, the superior portion of the uncinate process formed the anterior border and the superior portion of the bulla ethmoidalis formed the posterior border of the nasofrontal duct. The conchal plate formed the medial border and the suprainfundibular plate formed the lateral border of the nasofrontal duct. Other variations are described in detail.Conclusions To widen the nasofrontal communication, removing the upper portion of the ground lamella of the ethmoid bulla, which is the posterior boundary of the nasofrontal duct, with cutting forceps seems to be a safe and easy method.
A Prospective Study of Quality of Life in Head and Neck Cancer Patients. Part I: At Diagnosis
Authors: Hammerlid Eva , Bjordal Kristin , Ahlner‐Elmqvist Marianne , Boysen Morten , Evensen Jan F. , Biörklund Anders , Jannert Magnus , Kaasa Stein , Sullivan Marianne , Westin Thomas 
Published: November 2003

AbstractPurpose A Swedish and Norwegian study was designed to examine health‐related quality of life (HQL) in patients with head and neck cancer (head and neck) at diagnosis and during treatment and rehabilitation. The overall aim was to examine the impact on HQL at diagnosis depending on tumor location, stage, sex, and age (part I) and to describe HQL longitudinally and determine for which patients and during which period HQL deteriorated most (part II). This article presents the results at diagnosis.Method Patients with head and neck cancer at five hospitals in Sweden and Norway were consecutively requested to participate. They were asked to answer the EORTC QLQ‐C30 and QLQ‐H&N35 (the European Organization for Research and Treatment of Cancer, Core 30 questionnaire and head and neck cancer module) repeatedly during 1 year. A total of 357 patients (mean age, 63 y; 72% males) were included.Results Patients with different tumor locations all had their special problems at diagnosis, for example, those with tumors in the larynx with communication, those with oral tumors with pain, and those with pharyngeal tumors with nutrition and pain. The patients with hypopharyngeal cancer reported the worst HQL. Stage appeared to have the strongest impact on HQL. Patients with a more advanced tumor stage reported significantly worse HQL scores for 24 of 32 variables reflecting functioning or problems. The females scored worse than the males for some areas, in particular, emotional functioning. The older patients scored significantly better for emotional and social functioning than patients <65 years but worse for physical functioning and various symptoms. The traditional way of grouping the tumor locations into oral, pharyngeal, laryngeal, and “other” tumors (salivary gland, sinus and nose, and unknown primary) was tested from a HQL point of view and found to be consistent.Conclusions The chosen questionnaires differentiated between different sites of head and neck cancer at diagnosis. Tumor stage had the most powerful impact on HQL score.
Pseudotumor of Infancy and Congenital Muscular Torticollis: 170 Cases
Authors: Wei Julie L. , Schwartz Kara M. , Weaver Amy L. , Orvidas Laura J. 
Published: November 2003

AbstractObjectives To review pseudotumor of infancy (POI) and congenital muscular torticollis (CMT) and to suggest an algorithm for treatment.Study Design Retrospective review of cases from 1962 to 1998 at a tertiary care center.Methods Patients included in this study were 81 boys and 89 girls who had a diagnosis of POI (n = 38) or CMT (n = 132) before 24 months of age.Results For all patients, the mean age at diagnosis was 4 months; 54.1% had the left side of the neck affected, over 90% had a head tilt, and 2.4% had feeding difficulty as a result of the disorder. Plagiocephaly was present in 39.5% of patients with POI and 63.6% of patients with CMT; a neck mass, in 63.2% and 18.2%, respectively; and facial asymmetry, in 7.9% and 15.9%, respectively. All patients had a complete physical examination; 54.1% had plain cervical radiography, 4.1%, computed tomography, and 2.9%, ultrasonography. Passive range of motion was the initial treatment recommended for 65.3% of patients. Conservative treatment failed for 16 patients; subsequently, they had surgical treatment. Follow‐up data were available for 159 patients; 85.5% experienced total resolution and 14.5% experienced subtotal resolution or long‐term abnormality.Conclusions Children diagnosed with POI or CMT should be treated and observed for at least 12 months or until symptoms resolve. If symptoms persist 1 year after diagnosis despite conservative therapy, surgical treatment should be considered. The majority of children with POI or CMT experience total resolution of symptoms.
Western Blot Analysis for Diagnosis of Lyme Disease in Acute Facial Palsy
Authors: Furuta Yasushi , Kawabata Hiroki , Ohtani Fumio , Watanabe Haruo 
Published: November 2003

AbstractBackground Lyme borreliosis has been implicated in the pathogenesis of acute peripheral facial palsy (APFP). Few studies, however, have used Western blot analyses to confirm the serological diagnosis.Purpose To analyze the prevalence of anti‐Borrelia antibodies in patients with APFP compared with healthy control subjects living in Hokkaido Island, Japan.Patients and Methods In total, 113 patients with APFP were analyzed. They included 32 patients with varicella zoster virus (VZV) reactivation (Ramsay Hunt syndrome and zoster sine herpete) and 81 patients with Bell's palsy. Fifty‐eight healthy control subjects were also included. IgM and IgG antibodies to Borrelia garinii and afzelii were tested by Western blot, and diagnoses were made according to the Centers for Disease Control and Prevention criteria.Results Five of 81 (6.2%) patients with Bell's palsy, 1 of 32 (3.1%) patients with VZV reactivation, and 1 of 58 control subjects (1.7%) were judged to have both IgM and IgG antibodies to Borrelia. This difference was not significant (P >.05, χ2 test). Patients with Bell's palsy who had herpes simplex virus type 1 (HSV‐1) reactivation at the onset of palsy had a higher IgM‐immunoreactivity to Borrelia afzelii.Conclusions Although it is one of the endemic areas of Lyme disease in Japan, the prevalence of APFP caused by Lyme borreliosis is low in Hokkaido Island. In addition, cross‐reactivity to B. afzelii in IgM blots is often observed in patients with HSV‐1 reactivation, suggesting that careful interpretation of Borrelia IgM immunoblot data are needed for accurate serological diagnosis.
The Study of Laryngeal Muscle Activity in Normal Human Subjects and in Patients With Laryngeal Dystonia Using Multiple Fine‐Wire Electromyography
Authors: Hillel Allen D. 
Published: November 2003

AbstractThe normal human larynx performs numerous complex tasks with nearly complete reliability. These tasks require precise timing of movements that are effected by the laryngeal muscles. The most specific method to examine these muscles is by electromyography. Although many studies on laryngeal electromyography have been reported using multichannel recordings, none has provided a detailed analysis of each laryngeal muscle's role during a variety of common tasks and the spectrum of normative values. Simultaneous eight‐channel, fine‐wire electromyographic recordings were made in 11 human subjects. The timing patterns of the laryngeal muscles during the coordinated efforts for phonation and other common glottic functions were examined. In addition, normative values for latencies and amplitudes of response were determined. During simple phonation, a “set pattern” for the thyroarytenoid, lateral cricoarytenoid, and interarytenoid muscles was found. The thyroarytenoid and lateral cricoarytenoid muscles demonstrated a burst at onset preceding phonation and then decreased activity, whereas the interarytenoid sustained glottic position during phonation. The coordination of the laryngeal muscles was similarly determined for connected speech, respiration, Valsalva maneuver, cough, throat‐clear task, and swallow. These patterns of response, the latencies for activities, and the amplitudes of response in normal subjects provided the basis to examine the abnormal laryngeal function in a group of 59 patients with four clinical varieties of laryngeal dystonia (adductor, tremor, abductor, and mixed). The findings include abnormal patterns of response, increased latencies, and increased amplitudes of recruitment in many tasks including nonphonatory tasks. Although specific distinctions were noted in each group, the responses were remarkably similar, indicating that all clinical varieties of laryngeal dystonia should be classified as mixed dystonia with a clinical preponderance for one or more types of behavior.
Distraction Osteogenesis of the Mandible for Airway Obstruction in Children
Authors: Sidman James D. , Sampson Daniel , Templeton Bruce 
Published: November 2003

AbstractObjectives Objectives of the study were to determine the effectiveness of distraction osteogenesis of the mandible to relieve airway obstruction in children with tongue‐base airway obstruction and to describe the new surgical techniques developed for use in infants and young children.Study Design Prospective, nonrandomized study.Methods Analysis of 11 children with severe airway obstruction secondary to tongue‐base obstruction was performed. Patients were between 2 weeks and 5.5 years of age. All patients underwent distraction osteogenesis of the mandible.Results Twelve distraction procedures in the 11 children in the study were accomplished; decannulation or extubation was successful in all children.Conclusion Distraction osteogenesis of the mandible can be used to treat tongue‐base airway obstruction in appropriately selected children.