bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypopharyngeal Cancer: Results of Treatment Based on Radiation Therapy and Salvage Surgery
Authors: Godballe Christian , Jørgensen Karsten , Hansen Olfred , Bastholt Lars 
Published: November 2003

AbstractObjectives The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with hypopharyngeal squamous cell carcinoma (HPC).Study Design A consecutively admitted series of 110 patients was analyzed retrospectively. The female:male ratio was 29:81. The sites of the tumors were: pyriform fossa (72%), postcricoid area (18%), and posterior pharyngeal wall (10%). T‐status was T1: 15%, T2: 26%, T3: 28%, and T4: 37%. N‐status was N0: 27%, N1: 33%, N2: 26%, and N3: 14%.Methods One hundred three patients (94%) were treated with curative intent. Two of these received primary surgery; the remaining 101 patients had primary radiotherapy. Seven patients (6%) received no or only palliative treatment.Results The 5‐ and 10‐year estimates for crude survival (CS) were 16% and 7% and disease‐specific survival (DSS) 28% and 23%, respectively. In the group of patients treated with curatively intended radiotherapy, 71 recurrences were observed at the time of analysis. The 5‐ and 10‐year RFS estimates were both 17%. The values for CS were 18% and 8% and the values for DSS were 31% and 26%, respectively. Univariate survival analyses of age, sex, T‐status, N‐status, and TNM staging did not show any significant influence on survival.Conclusions We conclude that the survival of patients with HPC treated with primary radiotherapy and salvage surgery is poor and that other treatment modalities have to be considered.
Intrasinus Administration of Topical Budesonide to Allergic Patients With Chronic Rhinosinusitis Following Surgery
Authors: Lavigne François , Cameron Lisa , Renzi Paolo M. , Planet Jean François , Christodoulopoulos Pota , Lamkioued Bouchaib , Hamid Qutayba 
Published: November 2003

AbstractObjective Whether instillation into the maxillary sinus of topical budesonide affected the immune response and improved allergic patients with chronic rhinosinusitis that had persistence of symptoms despite appropriate surgical intervention was assessed.Study Design Double‐blind placebo‐controlled.Methods Twenty‐six patients with allergy to house dust mites who had previously had surgery and who had persistent symptoms of disabling rhinorrhea or pressure‐pain resistant to oral antibiotics and intranasal corticosteroids were recruited. During the double‐blind study, patients instilled 256 μg budesonide daily or placebo through an intubation device (maxillary antrum sinusotomy tube) into one of the maxillary sinuses for 3 weeks before clinical assessment and a second biopsy.Results We found an improvement in the symptom scores in 11 of the 13 patients who received budesonide; we also found a decrease in CD‐3 (P = .02) and eosinophils (P = .002), and a decrease in the density of cells expressing interleukin‐4 (P = .0001) and interleukin‐5 messenger RNA (P = .006) after treatment.Conclusion Topical budesonide delivered through a maxillary antrum sinusotomy tube can control chronic rhinosinusitis that persists after surgery.
End‐to‐Side Neurorrhaphy and Lateral Axonal Sprouting in a Long Graft Rat Model
Authors: Goheen‐Robillard B. , Myckatyn T. M. , Mackinnon S. E. , Hunter D. A. 
Published: November 2003

AbstractObjective/Hypothesis Controversy exists regarding collateral axonal sprouting across an end‐to‐side neurorrhaphy to provide functional motor reinnervation of a target organ without compromise of the donor nerve. Rat models may be limited in the study of end‐to‐side repair given potential contamination from the proximal nerve stump of the recipient distal nerve and the use of antagonistic muscle groups for donor and recipient. The current study attempts to address these issues by using a rat model in which an end‐to‐side coaptation is performed with a long graft interposed between the intact donor tibial nerve and the divided, distal contralateral tibial nerve.Materials and Methods The graft used in proximal end‐to‐side coaptation consisted of both sciatic nerves in a donor syngeneic animal. The distal repair to the contralateral tibial nerve was done immediately or in a delayed fashion to allow potential motor axons to transverse the graft before division of the recipient tibial nerve.Results After 24 weeks, axons were noted to transverse the entire distance of the graft and into the contralateral distal posterior tibial nerve. A significant increase in axonal numbers was observed in the immediate repairs compared with the delayed. No animal recovered functional motor ability on the contralateral side as assessed by walking tracks.Conclusions These findings suggest the importance of immediate distal neurotrophic factors in encouraging nerve regeneration even in a long graft end‐to‐side repair. Our model is successful in demonstrating innervation through an end‐to‐side coaptation but questions its use given the lack of motor recovery.
Videomanofluorometric Study in Amyotrophic Lateral Sclerosis
Authors: Higo Ryuzaburo , Tayama Niro , Watanabe Takeshi , Nitou Takaharu 
Published: November 2003

AbstractObjective To elucidate the time‐course changes of swallowing function in amyotrophic lateral sclerosis (ALS) by videomanofluorometry.Study Design Videomanofluorometry was conducted on 21 patients with ALS, who were divided into five groups according to type of disease and according to the length of time following the appearance of bulbar symptoms.Methods Videomanofluorometry, which is videofluoroscopic and manometric study conducted simultaneously, was performed on patients in the five groups, and swallowing function in each group was evaluated. Some of the patients were followed up by videomanofluorometry performed several times, and their swallowing function changes over time were investigated.Results A decrease of swallowing pressure first appeared in the oropharynx, then the hypopharynx became involved. Oropharyngeal swallowing pressure had already decreased to approximately 50 mm Hg within 6 months after the appearance of bulbar symptoms; however, hypopharyngeal swallowing pressure was relatively maintained until 1 year after the onset of bulbar symptoms. Most of the patients with ALS maintained normal upper esophageal sphincter relaxation, but upper esophageal sphincter spasm was seen in some patients with ALS. Aspiration was seen in eight cases, five of which showed upper esophageal sphincter spasm.Conclusions Patients with ALS gradually face the danger of aspiration as decreases of oropharyngeal and hypopharyngeal swallowing pressure progress. Upper esophageal sphincter spasm occurs in some patients with ALS, and it is an important cause of aspiration. Both videofluoroscopic and manometric evaluation are necessary to assess these conditions, and they are quite useful for follow‐up of swallowing function in patients with ALS.
An Interpretation Method for Objective Assessment of Nasal Congestion With Acoustic Rhinometry
Authors: Mamikoglu Bulent , Houser Steven M. , Corey Jacquelynne P. 
Published: November 2003

AbstractObjectives Acoustic rhinometry is a relatively new modality for evaluating the status of the nose. It assesses the geometry of the nasal cavity by analyzing reflected sound waves. Despite its expanding use, there is no established interpretation method. Our aims in the present descriptive study were to develop and test a protocol as a possible method to read these graphs for clinical use.Study Design We formulated a reading protocol to grade the congestion state of the nasal cavity. The percentile difference of cross‐sectional area and volume values between the baseline and decongested states were classified into five categories based on normative values.Methods Fifty‐six patients with allergic rhinitis were used. All the acoustic rhinometry readings were performed in blinded fashion according to the protocol; later, the clinical information was paired with the interpretation of the graph.Results The mean percentile differences of baseline and decongestion values in patients with allergic rhinitis were in the mild to moderate range difference according to our reading system. The range of nasal congestion in patients with allergic rhinitis patients was increased with additional pathological conditions such as sleep apnea.Conclusion The percentile difference between the baseline values and values for maximally decongested state reflect mucosal congestion as a “congestion factor,” which can be graded as mild, moderate, severe, or markedly severe, for objective evaluation of nasal congestion.
Proliferation Potential in Recurrent Acoustic Schwannoma Following Gamma Knife Radiosurgery versus Microsurgery
Authors: Lee Frank , Linthicum Fred , Hung Gene 
Published: November 2003

AbstractObjective To evaluate the proliferation potential of recurrent acoustic schwannoma following gamma knife radiosurgery (GKR) versus microsurgery.Study Design Retrospective study.Methods A review of surgical records of the House Ear Clinic revealed 8 patients who had undergone GKR and 15 patients who had undergone microsurgery who had unilateral acoustic schwannoma recurrences. Immunohistochemical studies were performed to evaluate the expression of proliferating cell nuclear antigen (PCNA) on archival paraffin‐embedded blocks.Results All 8 GKR and 15 microsurgical tumors had positive staining for PCNA. The recurrent GKR tumors had significantly lower proliferation levels than in the microsurgical group (P = .03). Two GKR tumors had high proliferation levels.Conclusions Our study indicates that recurrent vestibular schwannomas treated with GKR have lower proliferation potential as assessed by PCNA compared with recurrences following microsurgery. Radiation‐induced apoptosis is thought to contribute to the lower tumor cell proliferation in GKR tumor. The two GKR tumors with high proliferation potential could be a result of radiation‐induced sporadic mutation, resulting in high tumor cell proliferation.
Immediate Reconstruction of Extruded Alloplastic Nasal Implants With Irradiated Homograft Costal Cartilage
Authors: Clark J. Madison , Cook Ted A. 
Published: November 2003

AbstractObjective To describe a novel surgical protocol for the management of patients presenting with extruded nasal implants.Study Design Retrospective chart review.Methods Analysis of consecutive patients presenting with extruded nasal implants from 1986 to 2000. Patients were selected from a large database of revision rhinoplasty cases. Inclusion criteria were: 1) at least one previous rhinoplasty procedure, 2) an extruded nasal implant that was documented preoperatively, 3) immediate reconstruction that was carried out with irradiated homograft costal cartilage (IHCC), and 4) at least 1 year of follow‐up recorded, including standard postoperative rhinoplasty photographs. A total of 18 patients met the inclusion criteria and form the basis of this study. Data gathered from the charts included date of surgery, last date of follow‐up, location of implant extrusion, alloplastic material, specific use of IHCC for reconstruction, percent of clinical IHCC resorption at last follow‐up, and presence of warping of the IHCC.Results All 18 patients were satisfied with the cosmetic outcomes of their nasal reconstructions. The most common extruded alloplast was Silastic, followed by Gore‐Tex (W.L. Gore & Associates, Inc., Flagstaff, AZ). There were no cases of extrusion or infection of the IHCC implant subsequent to immediate reconstruction of the extruded alloplast. Clinical resorption of the IHCC was minimal, with a mean follow‐up of 26 months. Only one patient had a complication, warpage, resulting in removal of the IHCC. In that patient, the IHCC still had carving markings on the implant after 2 years in vivo.Conclusions In this series of patients, a novel surgical protocol was used. The extruded implant was removed and immediate reconstruction with irradiated rib cartilage was done. All patients were evaluated for postoperative infection, graft extrusion, and satisfaction with cosmetic result. There was one major complication in this series of 18 patients, warping of the IHCC, which necessitated removal and replacement. This approach appears to be a reasonable method for reconstruction of extruded nasal alloplasts.
Identification of Upper Respiratory Bacterial Pathogens With the Electronic Nose
Authors: Lai Stephen Y. , Deffenderfer Olivia F. , Hanson William , Phillips Marguerite P. , Thaler Erica R. 
Published: November 2003

AbstractObjective To use an electronic nose to identify common upper respiratory bacterial pathogens.Study Design Controlled in vitro analysis.Methods Swabs of bacteria were obtained from in vitro samples. The specimens were vaporized and analyzed over the organic semiconductor‐based electronic nose (Cyranose 320). Data from the 32‐element sensor array were subjected to principal component analysis for depiction in two‐dimensional space and differences in odorant patterns were assessed by calculating Mahalanobis distances.Results The electronic nose was able to distinguish between control swabs and bacterial samples. Furthermore, calculation of the Mahalanobis distances among the various bacteria demonstrated distinct odorant classes (Mahalanobis distance ⩾3). This demonstrates that the electronic nose could differentiate among various common bacterial pathogens of the upper respiratory tract, including Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenza, and Pseudomonas aeruginosa.Conclusions The electronic nose represents a novel method to identify potential upper respiratory infections and to discriminate among common upper respiratory bacterial pathogens. This technology could provide a rapid means to identify organisms causing upper respiratory infections.
Management of Multiple Spontaneous Nasal Meningoencephaloceles
Authors: Schlosser Rodney J. , Bolger William E. 
Published: November 2003

AbstractObjectives/Hypothesis Multiple spontaneous nasal meningoencephaloceles in the same patient are rare lesions. Although many skull base defects occur after prior trauma or surgery, otolaryngologists must be aware of the potential for spontaneous encephaloceles. We present our experience with this unusual condition and discuss its pathophysiology and unique management issues.Study Design Retrospective.Methods Review of medical records, radiographic images, and cerebrospinal fluid pressures.Results We identified 5 patients with multiple, simultaneous, spontaneous encephaloceles: 4 patients with 2 encephaloceles and 1 patient with 3 encephaloceles (11 in all). Locations of the 11 encephaloceles were sphenoid lateral recess (6), frontal sinus with supraorbital ethmoid extension (2), ethmoid roof (1), frontal sinus (1), and central sphenoid (1). Three patients had bilateral sphenoid lateral recess encephaloceles, accounting for all six in that location. All four patients with available radiographic studies demonstrated empty sella turcica. Surgical approaches included endoscopic transpterygoid approach to the lateral sphenoid recess (3), endoscopic approach to ethmoid and central sphenoid (3), and osteoplastic flap with frontal sinus obliteration (2). We had 100% success at latest endoscopic follow‐up (mean period, 17 mo). Three patients had postoperative lumbar punctures with mean cerebrospinal fluid pressure of 28.3 cm water (range, 19–34 cm; normal range, 0–15 cm).Conclusions Multiple spontaneous encephaloceles can be managed safely and successfully using endoscopic and extracranial approaches. A high index of suspicion for this diagnosis must be maintained, especially in patients with radiographic evidence of laterally pneumatized sphenoid sinuses or empty sella. Spontaneous encephaloceles and cerebrospinal fluid leaks represent a form of intracranial hypertension.
The Transcaruncular Approach to the Medial Orbital Wall
Authors: Graham Scott M. , Thomas Robert D. , Carter Keith D. , Nerad Jeffrey A. 
Published: November 2003

AbstractObjectiveTo demonstrate the safety and use of the transcaruncular approach as a surgical technique that provides rapid exposure of the medial orbital wall and apex through a small cosmetic conjunctival incision.MethodsThe transcaruncular anterior orbitotomy incision is made through the conjunctiva, between the plica and caruncle, with dissection to a subperiorbital plane along the medial orbital wall. This technique was used in 49 patients (58 orbits) between July 1995 and December 2000. The patients' ages ranged from 5 to 89 years (mean, 50 y).ResultsThe transcaruncular anterior orbitotomy approach provided appropriate surgical exposure in all cases of orbital decompression for thyroid‐related orbitopathy (in 33 orbits [26 patients]); for biopsy of medial orbital or orbital apex masses in 12 patients; and for drainage of an orbital abscess or marsupialization of a mucocele in 7 orbits (6 patients). Five patients (6 orbits) underwent a transcaruncular approach for release of medial rectus entrapment after fracture. The single complication was 1 patient who required a revision procedure for treatment of medial fornix scarring with resolution of diplopia.ConclusionsThe transcaruncular approach provides a safe, rapid, and cosmetically pleasing surgical approach to the medial orbital wall and orbital apex. This technique can be used for a variety of indications.
Cystic Metastasis Versus Branchial Cleft Carcinoma: A Diagnostic Challenge
Authors: Briggs Russell D. , Pou Anna M. , Schnadig Vicki J. 
Published: November 2003

AbstractObjectives There is controversy regarding the existence of branchial cleft carcinomas. The objectives are to familiarize the clinician with the presentation and treatment of cystic metastases from head and neck primary sites and differentiate these from primary branchial cleft cyst carcinomas.Study Design Retrospective case study and literature review.Methods Published reports of branchial cleft carcinomas were reviewed in conjunction with a unique case presenting at the University of Texas Medical Branch (Galveston, TX).Results Most cases of branchial cleft carcinomas are probably cystic metastases from head and neck primary sites. Cutaneous involvement with primary branchial cleft carcinomas is rare but may occur in recurrent lesions.Conclusions The diagnosis of a primary branchial cleft cyst carcinoma requires the fulfillment of strict criteria. Cystic metastases from head and neck primaries can mimic branchial cleft carcinomas histologically. Correct diagnosis is important so that appropriate surgical and radiotherapeutic treatment can be delivered.
High‐Precision Measurement of the Vocal Fold Length and Vibratory Amplitudes
Authors: Schuberth Stefan , Hoppe Ulrich , Döllinger Michael , Lohscheller Jörg , Eysholdt Ulrich 
Published: November 2003

AbstractObjective/Hypothesis Standard laryngoscopy suffers from a lack of information about the actual size of the observed objects (i.e., vocal fold length and oscillating amplitudes). However, there is much interest in absolute measures for both clinical and research purposes. Therefore, a laser projection device has been developed that enables the precise determination of absolute units in endoscopic investigation during respiration and phonation.Study Design An experimental study in which 9 adults underwent high‐speed endoscopy combined with a laser projection device.Methods The projection system consists of two parallel laser beams with a distance of 3.8 mm. It is mounted on the tip of a rigid endoscope, which is attached to a digital high‐speed camera. During development and design, examination situations were taken into account. Two laser spots are projected onto the vocal folds and enable the definition of a metric scale within the endoscopic image. Knowledge‐based image processing algorithms were used for evaluation.Results First measurements of the vocal fold length during phonation were performed in a group of nine healthy male students. The determination of glottal length during phonation agrees with former results. Quantifying vocal fold velocities in absolute units makes it possible to estimate the initial collision forces.Conclusions The presented laser projection system allows the determination of absolute measures in the larynx. Because of the simple functional principle, the system is open for use without digital high‐speed recording as well. Absolute units may also be helpful in voice diagnosis and in monitoring during voice therapy.
Benign Paroxysmal Positional Vertigo in Patients With Ménière's Disease Treated With Intratympanic Gentamycin
Authors: Perez Nicolas , Martin Eduardo , Zubieta Jose Luis , Romero Maria Dolores , Garcia‐Tapia Rafael 
Published: November 2003

AbstractObjectives To analyze the incidence and characteristics of benign paroxysmal positional vertigo (BPPV) in patients with Ménière's disease who did not respond to medical treatment and to whom intratympanic gentamycin treatment was proposed.Study Design This is a retrospective analysis of the patients in our database. A complete otoneurologic bedside examination of each patient, including assessment of positional nystagmus, was performed at the time of diagnosis and during the follow‐up.Results Nine of 90 patients with Ménière's disease also had BPPV, which manifested in different ways. In 3 patients, BPPV preceded the onset of Ménière's symptomatology in the same ear; in 1, BPPV manifested after treatment for Ménière's disease had ended and the patient was in complete control of the spontaneous spells of vertigo; in 5 cases, recurrences of both Ménière's disease and the positioning symptomatology coincided. Treatment for each condition was conducted independently and favorable results were obtained after long‐term follow‐up when Ménière's disease and BPPV did not coincide simultaneously. In the group manifesting symptoms of both disorders at the same time, gentamycin treatment with the Canalith Repositioning Procedure and/or Semont maneuver partially resolved the symptoms.Conclusions In the context of Ménière's disease, the sequence of appearance of BPPV relative to the spontaneous episodes must be taken into account when planning the treatment for each of the disorders, which should be considered independently. This pattern could also influence the prognosis for each disorder.