bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new technique for laser‐assisted uvulopalatoplasty: Decision‐tree analysis and results
Authors: Remade Marc , Betsch Christian , Lawson Georges , Jamart Jacques , Eloy Philippe 
Published: November 2003

AbstractObjective: Report a new technique of laser‐assisted uvulopalatoplasty (LAUP) for snoring performed as a one‐stage procedure. Study Design: A decision‐tree was used in a prospective study of 89 patients from April 1994 to May 1997. It included a fiberscopy and Midler's maneuver, rhinomanometry, pH monitoring, computed tomography scan to measure the pharyngeal lumen, pulse oximetry, and polysomnography in case of sleep apnea syndrome was suspected. Methods: The authors performed their LAUP technique on 43 patients (48.5%) whose snoring was mainly caused by the velum. This technique consists of scarifying the velum by vaporizing the mucosa and the submucosa along a rectangle extending from the palatal dimple to the uvula and having a width of 1.5 to 2 cm. Vaporization of the palatal arches follows without exceeding the junction of the anterior and posterior pillars in height. The uvula is cut if necessary, preserving a length of at least 0.5 cm. The other patients underwent different procedures according to the cause of snoring. Results: There was no significant difference between LAUP and uvulopalatoplasty (UPPP) regarding pain. No permanent phonatory disorders and no regurgitation occurred. Satisfaction evaluated on a scale ranging from 0 to 10 was equivalent for the two techniques: mean value = 7.68 (±2.18) for LAUP and 8.60 (±2.27) for UPPP. The mean follow‐up was 17 months (range, 1–37 mo). Satisfaction was also identical for all techniques. Conclusion: Our LAUP technique combined with other procedures according to a decision‐tree is efficient and safe.
Acoustic neuroma surgery: Absent auditory brainstem response does not contraindicate attempted hearing preservation
Authors: Roberson Joseph B. , Jackson Lance E. , Mcauley James R. 
Published: November 2003

AbstractObjective: Absence of auditory brainstem response (ABR) waveforms has been associated with a poor likelihood of hearing preservation following resection of acoustic neuromas. Our experience is reviewed for patients with absent preoperative ABR regarding hearing preservation, hearing improvement, and return of ABR.Study Design: Retrospective review of 22 cases of acoustic neuroma resection. Nine patients with absent preoperative ABR were identified. All underwent tumor resection utilizing intraoperative cochlear nerve action potential (CNAP) monitoring. Postoperative hearing results and ABR waveforms were examined.Methods: Charts were reviewed and tabulated for age, sex, tumor side, tumor size, preoperative and postoperative audiometric and ABR results, intraoperative monitoring results by ABR and CNAP, and surgical complications.Results: Hearing preservation was achieved in seven of nine patients (78%) with absent preoperative ABR, as well as six of seven patients (86%) with tumors less than or equal to 20 mm in greatest dimension. Although intraoperative ABR monitoring was not possible in any of these patients, CNAP monitoring was successful in all. Return of ABR waveforms was observed in four of the six patients (67%) tested from 3 to 22 months postoperatively. Four of the seven patients (57%) enjoyed improvement in hearing class as defined by the guidelines of the American Academy of Otolaryngology—Head and Neck Surgery.Conclusions: Absent ABR waveforms have not been a negative prognostic sign regarding hearing preservation. CNAP monitoring is possible in these patients and likely helps to minimize iatrogenic cochlear nerve trauma. Patients with no ABR waveforms have hope of hearing preservation and even improvement following acoustic neuroma resection performed utilizing CNAP monitoring and hearing preservation surgical techniques.Key Words: Acoustic neuroma, auditory brainstem response, cochlear nerve action potential, hearing preservation.
Double cartilage block ossiculoplasty in chronic ear surgery
Authors: Harvey Steven A. , Lin Sandra Y. 
Published: November 2003

AbstractObjectives/Hypothesis: Multiple techniques of ossicular reconstruction have been advocated for hearing rehabilitation in the setting of chronic otitis media. No single method can adequately address the clinical spectrum of disease severity. In the situation of a severely diseased ear requiring a canal wall down (CWD) mastoidectomy in the presence of an intact stapes superstructure, the authors have employed a double cartilage block (DCB) ossiculoplasty. The technique and short‐term results are reviewed. Study Design: Retrospective chart review in a tertiary referral otologic practice. Methods: Twenty‐three patients underwent a CWD tympanomastoidectomy with DCB ossiculoplasty. Ages ranged from 6 to 85 years (mean, 36.1 y). The majority of ears were actively draining at the time of surgery (83%) and most procedures were revisions of prior mastoidectomies (74%). Audiometric data (mean postoperative follow‐up, 19.5 mo) were calculated according to 1995 American Academy of Otolaryngology–Head and Neck Surgery guidelines. Results: Audiometric results were available in 20 patients. The mean air‐bone gap (ABG) was 23.8 dB after surgery. Closure of the ABG to within 20 dB was achieved in 10 of 20 patients (50%). No cases of DCB extrusion have occurred to date. Conclusions: The DCB represents an excellent alternative to biocompatible prostheses for ossicular reconstruction in the setting of severe chronic ear disease. As with all methods of ossiculoplasty, long‐term follow‐up will be necessary to determine if this technique remains stable in the hostile environment in which it has been employed. Key Words: Double cartilage block, ossiculoplasty, chronic otitis media.
Reduced postoperative infections with an immune‐enhancing nutritional supplement
Authors: Snyderman Carl H. , Kachman Kim , Molseed Rd Laura , Wagner Robin , D'amico Frank , Bumpous Jeffrey , Rueger Robert 
Published: November 2003

AbstractObjectives/Hypothesis: Malnutrition is a significant risk factor for postoperative infections in patients undergoing oncologic surgery. This study was undertaken to determine if perioperative nutritional supplementation with an immune‐enhancing formula is superior to standard formula in the prevention of postoperative infectious complications. Study Design: This was a prospective, randomized, double‐blind trial comparing perioperative nutritional supplementation with Impact and standard nutritional formulas. Methods: Following stratification, 136 patients undergoing oncologic head and neck surgery were randomly assigned to one of four treatment groups: preoperative/postoperative Impact, postoperative Impact, preoperative/postoperative standard formula, and postoperative standard formula. Outcome measures included laboratory evaluations of nutritional status, infectious and wound healing complications, and duration of hospitalization. Statistical analysis was performed using ξ2 or two‐tailed Fisher Exact Tests, when appropriate. Results: Intent‐to‐treat (P = .02) and actual therapy (P = .04) analyses revealed a significant decrease in the incidence of postoperative infectious complications (all sites) in patients who received Impact. There was no significant difference in wound healing problems or duration of hospitalization. Postoperative measures of nutrition status demonstrated a higher serum albumin (P = .05) in patients who received Impact compared with standard formula. Conclusions: Compared with standard formula, perioperative nutritional supplementation with Impact significantly reduced the incidence of infectious complications. The length of hospitalization was significantly prolonged in patients with postoperative infections, suggesting potential cost savings with the use of immune‐enhancing formulas such as Impact. Key Words: Nutritional supplements, malnutrition, head and neck cancer.
Influence of lateral osteotomies in the dimensions of the nasal cavity
Authors: Grymer Luisa F. , Gregers‐Petersen C. , Pedersen H. Baymler 
Published: November 2003

AbstractObjectives: To elucidate the importance of placement of lateral osteotomy in rhinoplasty at a level above or below the insertion of the inferior turbinate at the pyriform aperture.Study Design: Controlled lateral osteotomies were performed in 16 cadaver noses. Eight of the lateral ostetomies were placed below (low) and eight were placed above (high) the insertion of the inferior turbinate. In all 16 noses medial osteotomies were performed. Dimensions of the nasal cavity were measured by acoustic rhinometry before and after the osteotomies.Methods: The total minimum cross‐sectional area (TMCA) and the cross‐sectional area at the pyriform aperture (TCA‐3.3) were calculated and the preoperative and postoperative values were analyzed statistically.Results: There was no significant difference in the reduction of cross‐sectional area in the group that underwent high lateral osteotomy compared with the group the underwent low lateral osteotomy. In both groups the TMCA was reduced, with 12% of the value (P= .001) before osteotomy, and the TCA‐3.3 was reduced, with 15% of the value before osteotomy (P= .000).Conclusions: After lateral and medial ostetomies a significant decrease in the anterior dimensions of the nose is observed. The decrease following osteotomy does not seem to be due to the placement of the lateral osteotomy at the pyriform aperture but rather to the detachment of the bony vault from the surrounding structures.Key Words: Lateral osteotomy, rhinoplasty, acoustic rhinometry, nose dimensions.
Quantitative evaluation of the upper airway during nasopharyngoscopy with the müller maneuver
Authors: Ritter Christen T. , Trudo Frank J. , Goldberg Andrew N. , Welch Kevin C. , Maislin Greg , Schwab Richard J. 
Published: November 2003

AbstractObjective: To quantitatively examine changes in the upper airway caliber of normal subjects at graded negative inspiratory pressures generated during nasopharyngoscopy with a Müller maneuver. Study Design: Eighteen normal subjects prospectively underwent nasopharyngoscopy with Müller maneuvers. Subjects performed graded and maximal effort Müller maneuvers while sitting upright, and maximal‐effort Müller maneuvers in the supine position. Two regions of the upper airway—the retropalatal and retroglossal—were examined. Methods: Images from the endoscopic examination were objectively analyzed by adjusting manually traced airway contours using full‐width, half‐maximum edge detection algorithm software. The adjusted tracings' area and dimensions through the airway centroid were measured. Results: Müller maneuvers performed at ‐40 cm H2O resulted in a 64% ± 17% (P = .0001) reduction in upper airway area that consisted of a 51% ± 20% (P = .0001) reduction in the lateral dimension and a 21% ± 24% (P = .0026) reduction in antero‐posterior dimension. Müller maneuvers in the retroglossal region did not significantly reduce airway area (P = .575), but demonstrated an altered airway conformation that consisted of lateral narrowing and an increase in antero‐posterior dimension. Changes in body position did not result in significant differences in either airway caliber or airway dimension. Conclusions: Airway caliber during forced inspiration is mediated primarily through changes in the lateral pharyngeal walls. This study has also shown that antero‐posterior and lateral airway structures are largely independent in their response to Müller maneuvers. Similarly, the retropalatal and retroglossal regions of the upper airway respond differently to forced negative intraluminal pressure. Key Words: Nasopharyngoscopy, Müller maneuver, normal subjects, upper airway, obstructive sleep apnea.
Establishment and characterization of human laryngeal squamous cell carcinoma cell lines
Authors: Ku Ja‐Lok , Kim Woo‐Ho , Lee Jae‐Ho , Park Hyun‐Sook , Kim Kwang Hyun , Sung Myung‐Whun , Park Jae‐Gahb 
Published: November 2003

AbstractObjectives: Six human laryngeal squamous cell carcinoma cell lines (SNU‐46, ‐585, ‐899, ‐1066, ‐1076, ‐1214) established from Korean patients are reported. Study Design: In vitro culture of six squamous cell carcinoma cell lines derived from primary tumors of the larynx. Description of the cell line phenotypes and determination of molecular characteristics. Methods: Six laryngeal squamous cell carcinoma cell lines were cultured. The cell phenotypes, including the histopathology of the primary tumors and in vitro growth characteristics, were determined. Molecular characterization was also performed, including DNA fingerprinting analysis and abnormalities of p15, p16, p53, and TGF‐βRII genes by polymerase chain reaction‐based single strand conformation polymorphism and sequencing analysis. Results: All cell lines grew as adherent cells; five lines grew as monolayers and one other line grew as stratifying colonies. All lines showed 1) high viability (75%–92%) with various doubling times (36–96 h); 2) absence of Mycoplasma and other bacteria; and 3) genetic heterogeneity by DNA profile analysis. p53 Mutations were found in three lines and p16 mutations were observed in five cell lines. TGF‐βRII mutations were found in two lines: one line had frameshift mutation and another line had a missense mutation at the kinase domain. Conclusions: These newly established and characterized laryngeal squamous cell carcinoma cell lines will be useful for investigating the biologic characteristics of laryngeal cancer. Key Words: Laryngeal squamous cell carcinoma, cell lines, p53, p16, TGF‐βRII.
Idiopathic bilateral vocal fold weakness
Authors: Dray Todd G. , Robinson Lawrence R. , Hillel Allen D. 
Published: November 2003

AbstractObjective: To describe an unrecognized clinical entity, idiopathic bilateral vocal fold weakness, and propose recommendations regarding the diagnosis and management of these cases. Study Design: Retrospective, nonrandomized case study. Methods: All cases of bilateral vocal fold weakness evaluated at the University of Washington Voice Disorders Clinic between 1991 to 1998 were reviewed. Results: Four patients with bilateral laryngeal weakness were determined to have idiopathic bilateral vocal fold paresis following exhaustive workups, including videostroboscopy, bilateral laryngeal electromyography (EMG), neurological consultation, and other pertinent studies. Conclusions: Performing bilateral laryngeal EMG is an essential aspect of the workup of any laryngeal weakness case, particularly if the etiology is unknown on presentation. Idiopathic bilateral vocal fold weakness is an underrecognized but real clinical diagnosis that will become more familiar with the increasing utilization of laryngeal EMG in clinical situations.
Cosmetic Enhancement Associated With Surgery for Obstructive Sleep Apnea
Authors: Terris David J. 
Published: November 2003

AbstractObjective: To document the capacity of surgery for obstructive sleep apnea (OSA) to incorporate techniques that incidentally improve the cosmetic features of the patients. Study Design: Retrospective analysis of surgical outcomes at an academic practice. Methods: Moderate to severe OSA usually requires multilevel pharyngeal surgery, including tongue base surgery. The surgical procedures, including hyoid myotomy and mandibular osteotomy with tongue advancement, afford the opportunity to address cosmetic deficits, such as microgenia and excessive submental skin and fat. Outcomes achieved using these procedures over a 4‐year period were analyzed. Results: Of 428 consecutive patients presenting for evaluation of sleep‐related breathing disorders, 212 were deemed surgical candidates. Ninety‐seven of these had office‐based procedures for snoring, upper airway resistance syndrome, or mild OSA. The remaining 115 had formal surgical procedures done, and 68 of these had multilevel pharyngeal surgery. Of these, 12 had defined cosmetic deficiencies that were addressed at the time of the sleep apnea surgery. There were 7 men and 5 women, with a mean age of 48.2 years. The group was moderately obese (mean BMI = 31.8) and had moderate to severe OSA (mean RDI = 37.0, mean LSAT = 78%). Cosmetic deficits identified included turkey gobbler deformity (n = 8), microgenia (n = 6), excessive submental fat (n = 2), and nasal deformity (n = 1); several patients had more than one addressable problem. All patients achieved an improved postoperative appearance. Representative photographs are presented. Conclusions: A surgical approach to the management of sleep apnea affords an opportunity to also address cosmetic deficiencies, including excessive submental skin and fat, microgenia, and nasal deformities.
Treatment of the Clinically Negative Neck in Oral Squamous Cell Carcinoma
Authors: Persky Mark S. , Lagmay Victor M. 
Published: November 2003

AbstractObjective: To define the most effect treatment plan of patients with oral cavity squamous cell carcinoma with clinically negative (N0) neck staging. Study Design: Retrospective review of 54 patients with N0 neck staging who underwent resection of an oral cavity primary tumor with or without elective neck dissection between January 1982 and December 1992 and with a minimum follow‐up of 3 years. Methods: The records of 54 patients with previously untreated oral cavity squamous cell carcinoma and N0 neck staging were retrospectively reviewed to determine the impact of elective neck dissection on patient outcomes including regional recurrence and overall survival. Results: All patients underwent surgical resection of their oral cavity tumors, with 33 patients undergoing “watchful waiting” observation for the development of neck disease while 21 patients had elective neck dissections. The most controversial group of patients were those with intermediate‐sized (T2 and T3) primary tumors. Eighteen of these patients underwent elective neck dissection, with two patients developing recurrent neck disease and an ultimate prognosis of 72%. Twelve patients had observation of their necks, with five of these patients subsequently requiring neck dissection. An additional seven patients did not undergo neck dissection, and this group had four survivors free of disease. The prognosis was 42% in patients not having elective neck dissections. Conclusions: Tl tumors do well with neck treatment other than careful observation. The data suggest that patients with T2 and T3 oral squamous cell carcinoma should undergo surgical resection of their primary tumor site and elective neck dissection. Patients with T4 oral cavity lesions should routinely undergo neck dissection.
Patient Use of Traditional and Complementary Therapies in Treating Rhinosinusitis Before Consulting an Otolaryngologist
Authors: Krouse John H. , Krouse Helene J. 
Published: November 2003

AbstractObjectives: It has been estimated that 50 million Americans are bothered with symptoms of allergic disease and sinusitis. Patients treat these symptoms with a variety of traditional and complementary therapies. This study examined the use of these therapies by patients before consulting an otolaryngologist.Study Design: This investigation involved a prospective clinical survey.Methods: The sample consisted of 120 adult patients seen in a community‐based otolaryngology practice, who presented with complaints of sinusitis and rhinitis. Patients completed a set of questionnaires at their initial office visit to assess the various traditional and complementary therapies they had used. In addition, they completed a questionnaire evaluating the various symptoms with which they presented to the physician. All data were analyzed with descriptive statistics.Results: The results demonstrated that patients had been symptomatic for a mean length of 3.5 years before seeking therapy from the otolaryngologist. In addition, 87% of patients had previously seen a primary care provider, and 42% of patients had previously consulted an otolaryngologist. While traditional therapies including medications were commonly used, many patients also attempted a variety of complementary treatments, including dietary management, herbal therapy, exercise, and chiropractic. Patients who had previously seen an otolaryngologist were commonly treated with surgery.Conclusions: These findings demonstrate that patients employ both traditional and complementary therapies before seeking the care of an otolaryngologist. In addition, findings suggest that, despite aggressive medical and surgical therapy, many patients continue to remain symptomatic.
Tongue Base Reduction With Hyoepiglottoplasty: A Treatment for Severe Obstructive Sleep Apnea
Authors: Chabolle Frédéric , Wagner Isabelle , Blumen Marc B. , Séquert Catherine , Fleury Bernard , De Dieuleveult Thibault 
Published: November 2003

AbstractObjective:To describe a surgical procedure for the treatment of severe obstructive sleep apnea syndrome (OSAS), the procedure's indications, and its results.Study Design:A retrospective study of 10 male patients with OSAS treated by tongue base reduction with hyoepiglottoplasty (TBRHE) at the Foch Hospital (Suresnes, France) between 1994 and 1997. Patients had a mean body mass index (BMI) of 32 kg/m2, a mean respiratory disturbance index (RDI) of 70 events/h, and a mean minimal oxygen saturation of 78%. They had refused positive airway pressure therapy or wished to discontinue it.Methods:Subtotal tongue base reduction preceded by lingual neurovascular bundle identification and derouting, epiglottal verticalization, mouth floor horizontalization, and hyoid bone repositioning was performed, associated in some cases to uvulopalatopharyngoplasty (UPPP). Indications were based on a site‐related obstruction, on the absence of craniofacial deficiencies, and on the presence of hyolingual abnormalities determined by cephalometry and magnetic resonance imaging.Results:TBRHE associated to UPPP in most cases had an 80% success rate, based on a postoperative RDI below 20 events/h and a reduction of the preoperative RDI of more than 50%. Snoring and excessive daytime sleepiness decreased or disappeared, respectively, in 100% and 90% of the cases. No neurovascular complications occurred.Conclusion:TBRHE is a safe procedure for the neurovascular bundle. Associated to a pharyngotomy, it is an effective treatment for severe OSAS attributable to tongue base obstruction. These results require confirmation in a larger series of patients.
Comparative Study of Vocal Function After Near‐Total Laryngectomy
Authors: Hanamitsu Masakazu , Kataoka Hideyuki , Takeuchi Eiji , Kitajima Kazutomo 
Published: November 2003

AbstractObjectives: To assess vocal function after near‐total laryngectomy (NTL) and to compare that with after vertical hemilaryngectomy (VHL), both of which use the laryngeal mucosa as the vibratory tissue.Study Design: We retrospectively evaluated 29 patients, 11 of whom underwent NTL and 18 of whom underwent VHL. However, 2 patients failed to speak and 1 patient's voice sample was lost following NTL, so we analyzed the voices of 8 patients who underwent NTL and 18 patients who underwent VHL.Methods: Vocal function was examined by acoustic and aerodynamic analysis. Acoustic analysis involved the evaluation of pitch, intensity, pitch perturbation quotient, amplitude perturbation quotient, and normalized noise energy. In aerodynamic analysis, we studied the mean airflow rate, vocal efficiency index (alternating current/direct current [AC/DC]), and maximum phonation time.Results: Vocal function except pitch after either NTL or VHL had much variability, but the results following each procedure did not differ significantly.Conclusions: There are no significant differences between vocal function following NTL and VHL. Fiberscopic examination of the mucosa of the arytenoid was observed to vibrate in patients who underwent NTL, so that the phonatory mechanism after NTL resembled that after VHL.