bluuebunny/crossref_metadata_2025_split huggingface dataset:
Candidate's Thesis: Platelet‐Activating Factor–Induced Hearing Loss: Mediated by Nitric Oxide?
Authors: Rhee Chung‐Ku 
Published: December 2003

AbstractObjectives/Hypothesis Platelet‐activating factor (PAF)in middle ear effusion is thought to induce hearing loss. The purpose of this study is to investigate the role of nitric oxide (NO) in the mechanism of PAF‐induced hearing loss by studying the effects of PAF application on the round window membrane (RWM) with and without PAF‐antagonist NO‐blocker.Study Design Longitudinal study on randomized guinea pigs using PAF to induce hearing loss.Methods Guinea pigs were divided into four groups: PBS, PAF, PAF‐antagonist, and L‐NAME. The PBS group received phosphate buffered saline (PBS) and the PAF groups received 10, 20, and 40 μg of PAF soaked into gelfoam and placed on the RWM. PAF‐antagonist (WEB 2170) and NOS inhibitor NG‐nitro‐l‐arginine‐methylester (L‐NAME) were injected intraperitoneally prior to PAF 20 μg application on the RWM. The following three tests were performed on each animal group: Hearing was tested with an auditory brainstem response (ABR) test over 24 hours. At the end of 24 hours, cochlear hair cells were examined by scanning electron microscopy (SEM) and immunohistochemistry was carried out on the cochlea to test the expression of inducible nitric oxide synthase (iNOS).Results The PAF group developed significant elevation of ABR threshold and cochlear hair cell damage in the SEM group as compared with the PBS control group. The PAF‐antagonist (WEB 2170) and the L‐NAME groups did not show significant elevation of ABR threshold and cochlear hair cell damage compared with the group administered PAF 20 μg, but in the PAF‐antagonist group, the elevation of ABR threshold was significant compared with that of the PBS control group, whereas it was not significant compared with the PBS group in the L‐NAME group. Strong expression of iNOS on cochlea was observed in the PAF group and lighter expression was seen in PBS, WEB 2170, and L‐NAME groups.Conclusions This study demonstrated that PAF placed on the RWM induced hearing loss and cochlear hair cell damage. The PAF‐antagonists and L‐NAME prevented the PAF‐induced hearing loss and inhibited iNOS expression in the cochlea. These findings suggest that the PAF‐induced hearing loss caused by cochlear hair cell damage may have been mediated by NO. PAF‐antagonists and L‐NAME may have future therapeutic implications in preventing sensorineural hearing loss associated with chronic otitis media. The results of this study have significant potential clinical application.
A Method to Intraoperatively Assess Stapes Prostheses for Magnetic Attraction
Authors: White David W. 
Published: December 2003

AbstractObjective To present a technique used to assess metallic otologic protheses for magnetic susceptibility during surgery.Study Design Description of a surgical technique.Methods A sterile handheld pacemaker magnet is used to evaluate the prothesis prior to implantation. The magnet is placed over the prosthesis and the prosthesis is placed directly on the magnet. Any evidence of magnetic attraction and the prosthesis is rejected prior to implantation.Results None of the prostheses screened showed any magnetic attraction. As a control, steel wire was cut into pieces with dimensions similar to prostheses. These sections of wire were readily attracted to the magnet.Conclusions Intraoperative screening of metallic prostheses for magnetic susceptibility is possible using a sterile handheld pacemaker magnet.
Esthesioneuroblastoma: Endoscopic Nasal and Anterior Craniotomy Resection
Authors: Devaiah Anand K. , Larsen Christopher , Tawfik Ossama , O'Boynick Paul , Hoover Larry A. 
Published: December 2003

AbstractObjectives/Hypothesis The objective was to illustrate the use of endoscopic techniques as an evolving surgical modality in excision of esthesioneuroblastoma. The authors advocate this method with excision with anterior craniotomy for removal of cribriform plate or anterior cranial fossa tumor extension.Study Design A retrospective chart review of patients with esthesioneuroblastoma treated surgically at a tertiary care institution from 1991 to 2002 using this surgical paradigm.Methods Patients were excluded for nonsurgical treatment or nasal and sinus tumor excision by nonendoscopic techniques. Patient demographics, tumor histological findings, presenting signs and symptoms, staging (Kadish and Dulguerov), postoperative complications, adjunct therapy, and recurrence were examined.Results Seven of 13 patients with esthesioneuroblastoma met all inclusion criteria. The average patient age was 47 years, with a male‐to‐female distribution of 4 to 3. Patients were grouped by tumor stage using Kadish (stages A, B, and C included three, one, and three patients, respectively) and Dulguerov (stages T1, T2, and T4 included three, two, and two patients, respectively) methods. Average follow‐up was 62.3 months. All patients had an endoscopic excision of the nasal and sinus component with anterior craniotomy. The most common postoperative complication was temporary mental status change, which was seen in two patients. There were no postoperative deaths. All patients received radiation therapy, and one also received chemotherapy. Two of the seven patients had recurrences. At last follow‐up, six patients had no evidence of disease and one was alive with disease.Conclusion Endoscopic excision of the nasal and sinus component with anterior craniotomy for cribriform or anterior cranial fossa extension is an effective treatment of esthesioneuroblastoma.
Clinical Course of Thyroid Carcinoma After Neck Dissection
Authors: Shah Manish D. , Hall Francis T. , Eski Spiro J. , Witterick Ian J. , Walfish Paul G. , Freeman Jeremy L. 
Published: December 2003

AbstractObjectives/Hypothesis The objective was to compare the rate and site of recurrences in patients with well‐differentiated thyroid carcinoma who underwent a central compartment dissection, a posterolateral neck dissection, or a combination of both procedures.Study Design Retrospective chart review.Methods The charts of 522 consecutive patients with well‐differentiated thyroid carcinoma were reviewed, and 74 patients who had undergone a neck dissection were identified. The rates of recurrence in three sites were noted: the central compartment nodes (levels VI, superior mediastinum), posterolateral compartment neck nodes (levels II–V), and distant sites. These rates were compared in patients who underwent a central compartment dissection (level VI, superior mediastinum) and in patients who underwent a posterolateral neck dissection (levels II–V).Results Six patients underwent only a central compartment dissection, 47 patients had only a posterolateral neck dissection, and 21 patients had both a central compartment and a posterolateral neck dissection. In these three groups there were zero, two, and two central compartment node recurrences; two, nine, and seven posterolateral neck recurrences; and zero, two, and three distant recurrences, respectively. There were no significant differences in the rate of recurrence in any of the three sites examined between any of the three treatment groups (Fisher's Exact test, all P values > .20).Conclusion In patients with well‐differentiated thyroid carcinoma, dissection of only the central or posterolateral compartments of the neck with clinical or radiographic evidence of disease is advocated.
Topical Ciprofloxacin/Dexamethasone is Superior to Ciprofloxacin Alone in Pediatric Patients with Acute Otitis Media and Otorrhea through Tympanostomy Tubes
Authors: Roland Peter S. , Anon Jack B. , Moe Richard D. , Conroy Peter J. , Wall G. Michael , Dupre Sheryl J. , Krueger Kimberly A. , Potts Susan , Hogg Gail , Stroman David W. 
Published: December 2003

AbstractObjective To determine whether topical administration of a corticosteroid improves resolution of acute tympanostomy tube otorrhea when combined with topical antibiotic drops.Study Design Randomized, patient‐masked, parallel‐group, multicenter trial of topical otic ciprofloxacin/dexamethasone versus topical ciprofloxacin alone in 201 children aged 6 months to 12 years with acute otitis media with tympanostomy tubes (AOMT) of less than or equal to 3 weeks' duration and visible otorrhea.Methods Eligible patients were randomized to receive three drops of either ciprofloxacin 0.3%/dexamethasone 0.1% or ciprofloxacin 0.3% into the affected ear or ears twice daily for 7 days. Clinical signs and symptoms of AOMT were evaluated on days 1 (baseline), 3, 8 (end‐of‐therapy), and 14 (test‐of‐cure), and twice‐daily assessments of otorrhea were recorded in patient diaries.Results The mean time to cessation of otorrhea in the microbiologically culture‐positive patient population (n = 167) was significantly shorter with topical ciprofloxacin/dexamethasone than with ciprofloxacin alone (4.22 vs. 5.31 days; P = .004). This resulted in significantly better clinical responses on days 3 and 8 (P < .0001 and P = .0499, respectively). However, there were no significant differences between the two treatment groups in either the clinical response or the microbial eradication rate by day 14.Conclusions Topical otic treatment with ciprofloxacin/dexamethasone is superior to treatment with ciprofloxacin alone and results in a faster clinical resolution in children with AOMT. The contribution of the corticosteroid in achieving a 20% reduction (1.1 day) in time to cessation of otorrhea is clinically meaningful and represents an important advance over single‐agent antibiotic therapy.
Immunohistochemical Demonstration of Vascular Endothelial Growth Factor in Vestibular Schwannomas Correlates to Tumor Growth Rate
Authors: Cayé‐Thomasen Per , Baandrup Lone , Jacobsen Grete Krag , Thomsen Jens , Stangerup Sven‐Eric 
Published: December 2003

AbstractObjective Vascular endothelial growth factor (VEGF) is one of the most potent mediators of angiogenesis, which is a mandatory process during tumor growth. The present objectives were to determine expression of VEGF in vestibular schwannomas by immunohistochemistry and to examine a possible correlation with symptom duration, tumor size, or growth rate.Study Design Retrospective patient file review; immunohistochemistry and light microscopy of vestibular schwannomas removed by surgery.Methods Vestibular schwannomas from 18 patients were immunolabelled using a polyclonal antibody against VEGF, followed by light microscopy and blinded semiquantitation of VEGF expression. Fifteen patients had a well‐defined tumor growth rate defined by repeated preoperative magnetic resonance imaging scans.Results All tumors showed expression of VEGF in the Schwann cell cytoplasm, with a more intense staining of the perinuclear region of some cells. The staining intensity varied from tumor to tumor, and semiquantitation revealed a significant correlation between VEGF expression and tumor growth rate, but not symptom duration or tumor size.Conclusion VEGF is expressed in vestibular schwannomas and the level of expression correlates positively with tumor growth rate, but not with tumor size and symptom duration. We conclude that VEGF seems to be a factor involved in the growth of vestibular schwannomas.
Results of Caldwell‐Luc After Failed Endoscopic Middle Meatus Antrostomy in Patients With Chronic Sinusitis
Authors: Cutler Jeffrey L. , Duncavage James A. , Matheny Keith , Cross Jenny L. , Miman Murat C. , Oh Charles K. 
Published: December 2003

AbstractObjectives/Hypothesis The Caldwell‐Luc operation for treatment of medically refractory chronic maxillary sinusitis has largely been replaced by functional endoscopic sinus surgery. Despite this change, the Caldwell‐Luc procedure still has well documented indications including treatment of both failed endoscopic middle meatus antrostomy and irreversible mucosal changes. The purpose of the study was to review the authors' experience and results of Caldwell‐Luc procedure after failed endoscopic middle meatus antrostomy in patients clinically deemed to have irreversible mucosal changes.Study Design Retrospective review of preoperative and postoperative results of patients who underwent Caldwell‐Luc procedure for refractory chronic maxillary sinusitis after failed endoscopic middle meatus antrostomy.Methods The preoperative and postoperative clinical course of patients treated with Caldwell‐Luc procedure performed by a single surgeon between 1996 and 2001 were reviewed. Only patients with a history of chronic sinusitis after failed maximal medical therapy, no prior Caldwell‐Luc procedure, prior endoscopic middle meatus antrostomy, and at least 6 months of follow‐up were included. Outcome measurements including documented endoscopic examinations and the need for repeat surgery, and postoperative computed tomography scan results were evaluated to assess treatment success.Results The study involved 11 men and 26 women who underwent 50 Caldwell‐Luc procedures. Caldwell‐Luc procedure was performed bilaterally in 13 patients. The average number of prior endoscopic middle meatus antrostomies before Caldwell‐Luc procedure was 2. Of all patients, 92% responded to surgical treatment as demonstrated by an endoscopic examination or computed tomography scan revealing a disease‐free maxillary sinus. Repeat Caldwell‐Luc procedure was required in 8.0% (n = 3) because of continued sinusitis. Two of the three cases with repeat Caldwell‐Luc procedures demonstrated clinical improvement during follow‐up. Average follow‐up was 23.5 months.Conclusion Caldwell‐Luc procedure seems to be highly effective in the management of medically refractory chronic sinusitis after failed endoscopic middle meatus antrostomy. Caldwell‐Luc procedure should remain in the otolaryngologist's surgical repertoire for these selected cases.
Endonasal Surgery for Contact Point Headaches: A 10‐Year Longitudinal Study
Authors: Welge‐Luessen Antje , Hauser Rolf , Schmid Nevenka , Kappos Ludwig , Probst Rudolf 
Published: December 2003

AbstractObjective Some migraine and cluster headaches may be triggered by stimulation of intranasal contact points via the trigeminovascular system. Endonasal surgery is successful in some patients, but long‐term outcomes have not been reported.Study Design ProspectiveMethods This investigation included 20 patients with a mean 18‐year history of refractory cluster or migraine headaches who were selected for surgery. All had endoscopically visible endonasal contact as well as a positive preoperative cocaine test result. Changes in pain severity and frequency and duration of headache attacks were statistically rated using a MANOVA. Follow‐up averaged 112 months.Results Almost 10 years after surgery, six patients remained completely free of pain, seven had significant symptom improvement, and seven received no benefit from surgery (65% improvement). Two patients had been free of all symptoms for 7 and 8 years, respectively, before complaints returned.Conclusion Our data suggest that some patients with refractory headaches and endonasal contact areas benefit from surgery, thereby supporting the existence of a connection between the two. Even though it is clear that surgery should be considered only if all other treatments have failed, a success rate of 65% over almost 10 years justifies evaluation of this option. Preoperative patient selection remains crucial and warrants further investigation.
Pathogenetic Mechanism of Olfactory Cell Injury after Exposure to Sulfur Dioxide in Mice
Authors: Min Yang‐Gi , Kim Jeong‐Whun , Hong Seok‐Chan , Dhong Hun‐Jong , Jarin Peter R. , Jin Yulian 
Published: December 2003

AbstractObjectives This study aimed to investigate the cellular pathogenetic mechanism involved in olfactory tissue injury and regeneration.Study Design Adult male mice were exposed to 40 ppm SO2 for 2 hours.Methods The mice were sacrificed immediately, 4 hours, and 1, 3, 5, 7, 10, 14, and 21 days after exposure to SO2. Olfactory neuroepithelium and bulbs were harvested at the time of sacrifice. Western blot and immunohistochemical staining were performed.Results Injuries of the olfactory neuroepithelium were found 24 hours after exposure to SO2. The number of total olfactory neuroepithelial cells decreased after SO2 exposure and recovered after 3 weeks. In contrast, the number of proliferating cell nuclear antigen (PCNA)–positive cells increased after SO2 injury and then decreased. In the neuroepithelium, where PCNA expression increased, olfactory marker protein (OMP)–positive cells were sparse. The expression of inducible nitric oxide synthase (iNOS) was localized in the lateral half of the turbinates. However, there was no expression of iNOS in the medial half of the turbinates, in which PCNA was strongly expressed. There was increased immunoreactivity of neuronal NOS (nNOS) in the surviving cells after SO2 exposure. Immediately after exposure to SO2, the immunoreactivity to phosphorylated fraction of extracellular signal‐regulated kinases (phospho‐ERK)‐1/2 increased in the cytoplasm and nucleus of supporting cells. In Western blot analysis, nNOS expression increased 4 hours after SO2 exposure.Conclusions These findings suggest that the regenerative activity of the neuroepithelium might be well demonstrated by PCNA immunoreactivity and that regeneration of the neuroepithelium can be activated several days after SO2 injury. The two NOS isoforms, iNOS and nNOS, might contribute to neuroprotection in the olfactory neuroepithelium.
Paranasal Sinus Bony Structures and Sinus Functioning During Viral Colds in Subjects With and Without a History of Recurrent Sinusitis
Authors: Alho Olli‐Pekka 
Published: December 2003

AbstractObjectives/Hypothesis The objective was to assess the impact of ostial obstruction and anatomical variations on paranasal sinus functioning during viral colds with computed tomography (CT) in subjects with and without a history of sinusitis.Study Design Cross‐sectional study.Methods Twenty‐three volunteers with a history of recurrent sinusitis and 25 subjects without such history who had an early (symptoms for 2–4 d) natural cold were examined by taking viral specimens and CT scans and recording symptoms. The pathological sinus changes in the CT scans were scored, and several paranasal bony anatomical variations recorded.Results Viral origin of the cold was identified in 32 (67%) subjects, similarly in the two groups. Ostiomeatal obstruction and anatomical variations were equally frequent in the subjects with and without a sinusitis history (17 of 23 vs. 17 of 25 for ostial obstruction and 17 of 23 vs. 20 of 25 for at least one variation, respectively). However, in the case of ostiomeatal obstruction the combined CT score of ethmoidal and maxillary sinuses was significantly higher in the subjects with a sinusitis history than in those without (mean ± SD, 3.0 ± 0.9 vs. 2.3 ± 1.2 [P = .05, t test]). In the sinusitis‐prone subjects, several variations were associated significantly with various pathological sinus CT changes (septal deviation, horizontally situated processus uncinatus, large concha bullosa, and laterally concave concha media), whereas in the control subjects, only the presence of Haller cells was related to sphenoidal sinus disease.Conclusion Ostiomeatal complex obstruction and bony anatomical variations seem to have a greater impact on the functioning of paranasal sinuses during viral colds in sinusitis‐prone subjects than in subjects without a sinusitis history. These differences may be associated with the increased risk of bacterial sinusitis.
Postoperative Pain and Side Effects After Uvulopalatopharyngoplasty, Laser‐Assisted Uvulopalatoplasty, and Radiofrequency Tissue Volume Reduction in Primary Snoring
Authors: Rombaux Philippe , Hamoir Marc , Bertrand Bernard , Aubert Genevieve , Liistro Giuseppe , Rodenstein Daniel 
Published: December 2003

AbstractObjectives We compared, in a prospective study, the side effects and the postoperative complications of three procedures commonly used for the treatment of primary snoring.Method Forty‐nine patients underwent velopharyngeal surgery for primary snoring (17 for uvulopalatopharyngoplasty [UPPP]; 15 for laser‐assisted uvulopalatoplasty [LAUP], and 17 for radiofrequency tissue volume reduction [RFTVR]). Preoperative full polysomnographic studies ruled out obstructive sleep apnea syndrome. Each patient's evaluation encompassed postoperative pharyngeal pain (as measured by a 5‐point visual analogue scale) and use of narcotic drugs in the early postoperative period as well as a subjective evaluation of late postoperative complaints. A surgeon's examination was performed to report postoperative complications in the oropharynx.Results Postoperative pharyngeal pain was less important in the RFTVR group than in the UPPP and LAUP groups. Mean scores at days 3, 7, 16 were as follows: 4.2, 4.0, and 2.4, respectively, for UPPP; 4.6, 3.8, and 1.6 for LAUP; and 2.4, 2.0, and 0.7 for RFTVR. Mean duration of pain with a score greater than 2 was calculated as follows: UPPP, 21.3 days; LAUP, 15.1 days; and RFTVR, 6.1 days. Mean duration of narcotic drug use for the patients who needed this medication was 10.1 days for UPPP, 7.2 days for LAUP, and 1.3 for RFTVR. Postoperative side effects (trouble with smell and taste, pharyngeal dryness, globus sensation, voice change, and pharyngonasal reflux) were more present in the UPPP and LAUP groups than in the RFTVR group. Surgeon's assessment for postoperative complications reported more wound infection, dehiscence, and posterior pillar narrowing in the UPPP and LAUP groups than in the RFTVR group.Conclusion RFTVR is a safer and less painful procedure than UPPP and LAUP for the treatment of primary snoring. Postoperative discomfort after LAUP and after UPPP appears to be very similar.
Distribution of Collagen in the Lamina Propria of the Human Vocal Fold
Authors: Madruga de Melo Erich Christiano , Lemos Miriam , Aragão Ximenes Filho João , Sennes Luiz Ubirajara , Nascimento Saldiva Paulo Hilário , Tsuji Domingos Hiroshi 
Published: December 2003

AbstractObjectives To describe the arrangement of collagen fibers in the lamina propria of the human vocal fold.Study Design Analysis of the lamina propria of the vocal fold obtained from human cadavers.Methods The Picrosirius‐polarization method was used to visualize collagen fibers.Results Analysis of 20 human vocal folds by the Picrosirius‐polarization method permitted the visualization of two fiber populations arranged in three layers in the lamina propria: two layers of thick, strongly birefringent collagen fibers (collagen type I), one immediately below the epithelium and another more dense layer in the deep region superficially to the vocal muscle, penetrating between muscle fibers. The third layer consisted of fine, weakly birefringent fibers (collagen type III) located between the two layers of thick fibers. In addition, the collagen fibers in the lamina propria showed an intertwined network arrangement in the form of a “wicker basket.”Conclusions This basket‐like configuration better explains how the vocal fold is able to stretch even though it contains nonstretchable fibers and to modulate the frequency of the voice under the action of the intrinsic musculature of the larynx. Segmental areas of disarray of the basket‐like structure of the collagen layers were systematically observed in older patients. Thus, it is possible that vocal alterations occurring in the elderly might be the result of a loss of histoarchitectural arrangement of the collagen system and its relationship with the lamina propria and underlying musculature.