bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thyroplasty for Adductor Spasmodic Dysphonia: Further Experiences
Authors: Isshiki Nobuhiko , Haji Tomoyuki , Yamamoto Yukiko , Mahieu Hans F. 
Published: November 2003

AbstractObjectives Two different surgical techniques for midline lateralization thyroplasty (type 2 thyroplasty) for adductor spasmodic dysphonia (SD) have been described, one using a composite graft and the other without. Indications and results for each method among different types of SD were compared, together with the theoretical background for the surgery.Study Design Retrospective.Methods The medical records of six patients with SD together with the fiberscopic video recording of laryngeal findings before, during, and after surgery were reviewed. The intraoperative video recordings of the surgical procedures were compared with the postoperative findings.Results The vocal features of SD, diverse preoperatively, disappeared postoperatively and a normal, or almost normal, voice was attained in 5 of 6 cases. The failure in one patient was attributed to combined focal dystonia of the neck muscles and difficulty in lateralization. Type 2 thyroplasty without a graft, which causes bowing of both vocal folds, is simple to perform and effective enough for most SD cases. No recurrence has been noted so far over postoperative periods ranging from 6 months to more than 3 years.Conclusion The results suggest that thyroplasty is an effective therapeutic approach for SD.
Juvenile Nasopharyngeal Angiofibroma: Management and Therapy
Authors: Scholtz Arne W. , Appenroth Elisabeth , Kammen‐Jolly Keren , Scholtz Lars U. , Thumfart Walter F. 
Published: November 2003

AbstractObjectiveTo conduct a review of contemporary approaches on the diagnostic‐preoperative, operative, and postoperative methods in the management of juvenile nasopharyngeal angiofibroma (JNA).Study DesignRetrospective study of 14 cases of JNA resection at the Department of Otorhinolaryngology, University of Innsbruck (Innsbruck, Austria) between 1987 and 1998.MethodsData was obtained for each patient regarding age, presenting symptoms, duration of symptoms, biopsy findings, tumor location, administration of preoperative angiography and embolization, and surgical approach. The follow‐up period ranged from 1 to 13 years.ResultsBased on the histological evaluation by the preoperative biopsy and the tumor location, several surgical approaches were applied. A transnasal endoscopic procedure was employed in seven cases. The preoperative embolization and the intranasal approach with the potassium titanyl phosphate laser minimized blood loss. The recurrence rate was at a low of 15%.ConclusionThe surgical approach should be determined by tumor location, tumor size, and effectiveness of tumor embolization. For patients with JNA with tumor extension involving the nasopharynx, the nasal cavity, the paranasal sinuses, and the pterygopalatine fossa, the transnasal endoscopic technique offers a minimally invasive resection of the entire tumor mass with minimal morphological disturbance.
The Role of Copper Suppression as an Antiangiogenic Strategy in Head and Neck Squamous Cell Carcinoma
Authors: Cox Claudell , Teknos Theodoros N. , Barrios Marty , Brewer George J. , Dick Robert D. , Merajver Sofia D. 
Published: November 2003

AbstractObjective To determine whether tetrathiomolybdate (TM), a powerful chelator of copper, is capable of lowering the body stores of copper and suppressing the growth of head and neck squamous cell carcinoma in an orthotopic murine model.Study Design In vivo, murine model.Methods Twelve 8‐week‐old male C3H/HeJ mice were assigned to either a TM treatment group (n = 7) or a control group (n = 5). Serum samples were obtained from a single mouse in each group to measure the level of ceruloplasmin as a surrogate marker of total body copper on days 0, 4, and 7. Mice in both groups received a floor‐of‐mouth injection of 1.5 × 105 SCC VII/SF cells. After 7 to 10 days of tumor growth the treatment group received fresh water daily, to which TM was added to achieve an oral intake of 50 mg per mouse. The control group received only fresh drinking water daily. Tumor volume measurements were obtained every other day. Microvessel density counts were assessed in the tumors by Factor VIII analysis.Results Measurable tumor growth was achieved in 100% of the mice by the tenth day. Total body copper was reduced by 28% from baseline levels in mice in the treatment group. The difference in mean tumor volume in the control group was 4.7 times greater than the TM‐treated group at the completion of treatment (3004 mm3 and 633mm3, respectively). This accounted for an overall suppression rate of 79% (P = .008; two‐tailed Student t test). In addition, microvessel density was reduced by 50% in the TM‐treated group.Conclusion In this initial study, the first of its kind in head and neck squamous cell carcinoma, we have demonstrated the ability of TM to significantly suppress both the growth of squamous cell carcinoma and tumor vascularity in this orthotopic murine model, suggesting its potential for efficacy in the treatment of this disease in humans.
Homologous Collagen Substances for Vocal Fold Augmentation
Authors: Courey Mark S. 
Published: November 2003

AbstractObjectives/Hypothesis Dysphonia resulting from failure of glottic closure during voicing is a difficult clinical problem. Recently developed homologous collagen compounds may be beneficial in treating this problem. The objectives of this thesis are to: 1) evaluate the potential site(s) of collagen graft placement in the human vocal fold, quantify the amount of graft material that can be injected into these sites, and determine how these sites are accessed by the currently available surgical tools for injection; 2) determine the effects of the superficial vocal fold implant on laryngeal vibratory patterns and characterize how the implant affects the forces required to bring vocal folds into an adducted position for vibration; and 3) evaluate the host response to two different forms of cadaveric collagen.Study Design Prospective laboratory.Methods Three separate experiments were undertaken: 1) Eight cadaver larynges were injected with collagen compounds through a 27‐gauge needle. The amount of substance required to medialize the vocal fold and potential positions for graft placement were evaluated. 2) Six cadaver larynges were mounted on a stabilizing stand while airflow, vocal fold length, adduction forces, and abduction forces on the vocal folds were manipulated. Vibratory patterns before and after the injection of the vocal folds with solubilized collagen were assessed. 3) A nude mouse model was used to study the host response to two different exogenous collagen compounds.Results Solubilized collagen compounds could be injected reliably into the superficial layer of the lamina propria (SLLP), medial portion of the thyroarytenoid muscle, or lateral portion of the thyroarytenoid muscle. When injected superficially, significantly less material was required to displace the medial edge of the vocal fold to midline (P = .0001). When graft material was placed into the medial portion of the thyroarytenoid (TA) muscle, the forces required to bring the vocal fold into a position suitable for vibration were significantly reduced (P = .0106) and the vibratory patterns of the vocal folds were not impaired. Both AlloDerm® and Dermalogen® solubilized preparations of human dermal tissue were well tolerated in the nude‐mouse model. Minimal inflammatory reaction occurred. Small amounts of graft material were identified histologically at the end of the 6‐month study period. The graft material appeared organized and had been infiltrated with fibroblasts of host origin.Conclusions Homologous collagen compounds can be reliably injected into the cadaveric human larynx. When the substances are injected into the medial portion of the TA muscle, immediately deep to the vocal ligament, they decrease the force of contraction needed to bring the vocal folds into a position adequate for phonation and have minimal affect on the vibratory patterns. These forms of homologous collagen are well tolerated. A small amount persists over a 6‐month interval. These materials warrant further clinical trials in human subjects.
Safety and Patient Experience With Transtympanic Electrocochleography
Authors: Ng Matthew , Srireddy Sharmila , Horlbeck Drew M. , Niparko John K. 
Published: November 2003

AbstractObjectives/Hypothesis Transtympanic electrocochleography (t‐ECOG) is a sensitive diagnostic instrument used for Meniere's disease. It is sensitive by virtue of the recording electrode's position on the promontory of the cochlea where the signals are generated. There is concern about the invasive nature of t‐ECOG in comparison to extratympanic recording techniques. The purpose of this study was to examine the safety issues, complications, and patient experience with t‐ECOG.Study Design Observational study utilizing retrospective chart review and patient survey.Methods The medical records of 205 patients who underwent t‐ECOG were reviewed for complications. Complications included persistent tympanic membrane perforation, hearing loss, otitis media, otitis externa, ear canal injury, hemotympanum, and pain. An additional 36 patients undergoing t‐ECOG were surveyed on subjective measures such as pain during topical anesthesia of the tympanic membrane, during transtympanic placement of the needle electrode, and during the test procedure and overall experience with t‐ECOG.Results There was one case of a nonhealed, persistent perforation in the setting of acute otitis media directly as a result of t‐ECOG. Two patients developed otitis media, and three patients had ear pain for up to 5 days. All 36 patients felt the procedure to be tolerable with minimal discomfort.Conclusions Transtympanic electrocochleography may be performed with good patient acceptance and infrequent complications.
Granulocyte‐Macrophage Colony‐Stimulating Factor in a Combination Gene Therapy Strategy for Head and Neck Cancer
Authors: Day Katherine V. , Li Daqing , Liu Shixi , Guo Ming , O'Malley Bert W. 
Published: November 2003

AbstractObjectives/Hypothesis Gene therapy offers a new approach for treatment of head and neck squamous cell carcinoma (HNSCC). This study examined the effectiveness of granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) in combination gene therapy strategy against HNSCC in an orthotopic mouse model.Study Design Experimental animal research.Methods Established tumors were treated with recombinant adenovirus constructs containing the genes for murine granulocyte‐macrophage colony‐stimulating factor (Ad‐mGM‐CSF), murine interleukin 2 (Ad‐mIL‐2), or herpes simplex virus thymidine kinase (Ad‐tk).Results The combination of Ad‐mGM‐CSF or Ad‐mIL‐2 and Ad‐tk resulted in significantly greater reduction in tumor size versus other treatment groups or control subjects. There was no statistical significance between the triple combination of Ad‐mGM‐CSF, Ad‐mIL‐2, and Ad‐tk versus Ad‐mIL‐2 and Ad‐tk at 1 to 2 weeks after treatment. There was no tumor reduction seen from Ad‐mGM‐CSF alone and no additional benefit seen from Ad‐mGM‐CSF combinations in long‐term follow‐up studies. The greatest cytotoxic T‐lymphocyte and natural killer cell activity occurred in the combination Ad‐mIL‐2 and Ad‐tk groups with and without Ad‐mGM‐CSF.Conclusion Results suggest that the additional mGM‐CSF did not enhance the immunogenicity of the HNSCC. Optimal activation of T lymphocytes may require additional co‐stimulatory molecules to stabilize the interaction of the T lymphocyte and antigen presenting cell. The presence of major histocompatibility complex Class II may increase CD4+ T‐cell mediated immunogenicity and augment therapeutic antitumor immune responses in combination with tk, mIL‐2, and mGM‐CSF.
Facial Nerve Monitoring in Middle Ear and Mastoid Surgery
Authors: Noss Roger S. , Lalwani Anil K. , Yingling Charles D. 
Published: November 2003

AbstractHypothesis Intraoperative electromyographic facial nerve monitoring, long accepted as the standard of care in surgery for acoustic neuroma and other cerebellopontine angle tumors, may be of aid in middle ear and mastoid surgery.Study Design Retrospective series of 262 cases of middle ear/mastoid surgery in which monitoring was performed by a neurophysiologist.Methods Neurophysiological monitoring events were classified as mechanical or electrical. The voltages producing facial nerve stimulation were compiled and compared with observed facial nerve dehiscence.Results The most common use of monitoring was localization of the facial nerve by electrical stimulation (60%) or identification of mechanically evoked activity (39%). In 57 cases (36%), the first electrical stimulation event evoked a facial nerve response at less than 1 V threshold, indicating little or no bony covering. The minimum stimulation threshold throughout each of these cases was less than 1 V in 88 of the 159 cases (55%) in which stimulation was attempted. In contrast, the facial nerve was visibly dehiscent in only 35 cases (13%). Neurophysiological monitoring confirmed aberrant facial nerve course through the temporal bone in four cases resulting in cancellation of surgical treatment in two cases. Postoperative facial nerve function was preserved in all cases when present preoperatively.Conclusions An electrical stimulation threshold of less than 1 V is a more useful criterion of dehiscence than observation under the operating microscope. The absence of monitoring events allows safe dissection. Monitoring can help locate the facial nerve, guide the dissection and drilling, and confirm its integrity, thereby allowing more definitive surgical treatment while preserving neural function.
Surgical Anatomy of the Anterior Ethmoidal Canal in Ethmoid Roof
Authors: Moon Hyoung‐Jin , Kim Hyun‐Ung , Lee Jeung‐Gweon , Chung In Hyuk , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives/Hypothesis This study was undertaken to examine three main relationships. First, the distance and angle from the anterior ethmoidal canal to the limen nasi and the sill were measured. Second, the location of the anterior ethmoidal canal was examined in relation to the lamellas and the skull base. Third, the existence of bony defects in the canal and the course of the canal through the anterior cranial fossa were studied.Study Design This study employed both sagittal computed tomography and cadaver dissection.Methods Seventy sagittally divided heads from randomly chosen Korean adult cadavers were used. Sagittal computed tomography was performed on all specimens. Then they were meticulously dissected under a surgical microscope.Results The mean distance and angle between the limen nasi and the anterior ethmoidal canal were 49.0 mm and 54.5°, respectively. The anterior ethmoidal canal was located between the second and third lamella in 61 of 70 cases. In 60 of 70 cases it was attached to the base of the skull, and in the remaining 10 cases it ran 2 to 3 mm below the skull base. When viewed from the superior side, the course of the anterior ethmoidal canal formed a diagonal line from the lateral to the medial side. Partial bony defects of the anterior ethmoidal canal were observed in eight cases, and complete bony defects in none.Conclusion This study provides surgeons with a better understanding of the anatomy of the anterior ethmoidal canal.
Intraoperative Gamma Probe Localization of Parathyroid Adenomas
Authors: Sullivan Daniel P. , Scharf Stephen C. , Komisar Arnold 
Published: November 2003

AbstractObjectives/Hypothesis In an effort to reduce operative time, improve diagnostic accuracy, and decrease perioperative morbidity, we combined preoperative technetium Tc 99m–sestamibi localization with the use of the gamma probe intraoperatively. This report examines our experience with the gamma probe for rapid intraoperative localization of parathyroid adenomas.Study Design A retrospective chart review was performed to identify all patients who underwent parathyroid exploration with the aid of the gamma probe at Lenox Hill Hospital (New York, NY).Methods Charts were reviewed for operative details, radiological findings, and pathological diagnoses.Results Between November 1, 1998, and June 30, 2000, 35 parathyroid explorations were performed with the aid of the gamma probe. The preoperative localization study was accurate in 34 of 35 cases. The gamma probe successfully identified the parathyroid adenoma in 33 of 35 cases. There were two false‐positive cases in which the gamma probe mistakenly identified a thyroid adenoma rather than a parathyroid adenoma. In 11 of 35 cases, the gamma probe was judged essential for rapid localization of the parathyroid adenoma. These cases included patients with multiple or ectopic adenomas and patients who had previous parathyroid surgery. Average operative time to remove parathyroid disease was 80 minutes (range, 45–140 min), which included 20 to 40 minutes waiting for frozen‐section results. All patients became normocalcemic, and there were no major complications in this series.Conclusion The gamma probe is a useful tool that complements a well‐performed localization study. It is most useful in patients who have multiple or ectopic adenomas or have had prior parathyroid surgery.
Osseous Tissue Engineering With Gene Therapy for Facial Bone Reconstruction
Authors: Lindsey William H. 
Published: November 2003

AbstractObjective Facial osseous defects remain a major functional and esthetic challenge for the head and neck surgeon. Tissue engineering may provide advantageous alternatives to conventional therapies. The objective of the study was to evaluate the efficacy of gene therapy in the repair of osseous facial defects.Study Design Blinded, controlled, prospective animal experiment.Methods Thirty adult athymic nude rats were divided into five groups of six animals. Three groups were used as control subjects. Two groups were treated with 3.75 × 108 viral particles containing recombinant type 5 adenoviral vectors. One group received viruses that coded for β‐galactosidase production, another received viruses that coded for bone morphogenetic protein (BMP‐2) production. After 120 days rats were examined at necropsy with precise planimetry, histological analysis of new bone growth, and radio‐densitometric analysis of bone thickness.Results Radio‐densitometric measurements showed that BMP‐2–treated nude athymic rats had significantly enhanced osseous repair compared with control subjects when evaluated by both radio‐densitometry and histological examination.Conclusion Gene therapy–treated, immunosuppressed rodents had an enhanced osteoinductive repair of a dorsal osseous nasal defect.
Laryngeal Angiosarcoma: A Clinicopathologic Study of Five Cases With a Review of the Literature
Authors: Loos Benjamin M. , Wieneke Jacqueline A. , Thompson Lester D. R. 
Published: November 2003

AbstractObjective Primary laryngeal angiosarcoma (LA) is rare without a reported series evaluating these tumors.Study Design/Methods Five patients with LA were retrospectively retrieved from the Otorhinolaryngic Registry of the Armed Forces Institute of Pathology.Results Three men and 2 women, aged 29 to 71 years, presented with hoarseness (n = 4) and hemoptysis (n = 1). Two patients had previous neck radiation. The tumors involved the supraglottis (n = 4) with a mean size of 3.1 cm. Histologically, all tumors had anastomosing vascular channels lined by remarkably atypical endothelial cells protruding into the lumen, frequent atypical mitotic figures, and hemorrhage. All cases tested (n = 4) demonstrated immunoreactivity with antibodies to Factor VIII‐RA and CD34. All patients had surgery followed by postoperative radiation (n = 3 patients). Three patients died with disease (mean, 17 mo), whereas one patient is alive with no evidence of disease at 18 years.Conclusions LA is a rare tumor, frequently associated with previous radiation, usually involving the supraglottis with characteristic histomorphologic and immunophenotypic features. LA has a poor prognosis, making appropriate separation from other conditions important.
Benign Paroxysmal Positional Vertigo After Stapedectomy
Authors: Atacan Erbil , Sennaroglu Levent , Genc Aydan , Kaya Sefa 
Published: November 2003

AbstractObjective To determine the incidence of benign paroxysmal positional vertigo (BPPV) following stapedectomy in a patient group and the efficacy of the Epley maneuver in this group.Study Design Prospective study in a university‐based tertiary referral system.Methods The patient group comprised 63 patients who had undergone stapedectomy; a control group consisted of normal healthy individuals with no otolaryngological complaints. All individuals underwent the Dix‐Hallpike maneuver for the diagnosis of BPPV. Patients who exhibited vertigo, torsional nystagmus (which reverses its direction on return to sitting position) preceded by a latent period, and the fatigability of these findings were considered to have BPPV. If the test result was positive, they underwent the Epley therapeutic maneuver.Results Four of the patients who had undergone a stapedectomy showed characteristic findings of BPPV. No individual in the control group had BPPV. All patients responded well to the Epley maneuver.Conclusions Stapedectomy may be regarded as an etiological factor in BPPV. Because the fenestra is located in the posterior part of the stapes footplate, the pathophysiology appears to be related to utricular rather than saccular trauma. Correct measurement of the distance between the incus and stapes footplate is essential in stapedectomy. An Internet survey of the relevant literature in English shows a scarcity of publications on the incidence of BPPV following stapedectomy. In the present study, 63 patients who had undergone a stapedectomy were investigated for the presence of BPPV; all had Dix‐Hallpike maneuvers performed for the diagnosis. Sixty‐three individuals with no otolaryngological complaints made up the control group. Four of the patients who had undergone stapedectomy showed characteristic findings of BPPV, and no individual in the control group had BPPV; the difference between the two groups was statistically significant. All four of the patients diagnosed with BPPV responded well to the Epley maneuver. The pathophysiology appears to be related to utricular trauma. Correct measurement of the distance between the incus and stapes footplate is essential in stapedectomy.
Surgical Treatment of Tracheostomal Stenosis
Authors: Giacomarra Vittorio , Russolo M. , Tirelli G. , Bonini P. 
Published: November 2003

AbstractHypothesis Stenosis of the tracheostome is a frequent complication following total laryngectomy; the problems created by tracheostomal stenosis are the result of reduced airflow and consequent turbulence. Many authors have studied etiological factors for the onset of stomal stenosis, and a number of procedures have been recommended for the surgical correction of such stenosis.Study Design A prospective analysis of 12 patients who underwent surgical correction of stomal stenosis is presented.Methods At the Institute of Clinical Otolaryngology we have recently defined a surgical technique for the correction of stomal stenosis that combines radial incisions, V‐shaped flaps, and interposing flaps. This technique enables us to correct all the types of stenosis, and we have treated 12 patients to date.Results To date, the average follow‐up has been 17 months (range, 3–36 mo), and the results are encouraging. Early stenosis of the tracheostoma reappeared in one patient, who had successful repeat surgery with the same technique.Conclusions Early results suggest the routine use of this surgical technique in the treatment of stomal stenosis.