bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Spanish Language Educational Materials by American Cleft Palate–Craniofacial Association Teams
Authors: Edwards Paul D. , Bonilla Zobeida E. 
Published: October 2004

Objective The goals of this study were to assess U.S.-based American Cleft Palate–Craniofacial Association (ACPA) teams’ use and perceived need for Spanish-language educational materials and to evaluate trends in number of Spanish-speaking patients treated. Methods A facsimile survey was sent to U.S.-based teams listed in the ACPA 1999 to 2000 and 2001 to 2002 Team Directories. Questions addressed demographics for Spanish-speaking patients/families and use of Spanish-language educational materials. Teams with a recent increase in Spanish speakers, 25% or more Spanish speakers, or both received a more in-depth follow-up survey. Results Response rate to the initial survey was 71%. Almost 16% of teams reported having greater than 25% primarily Spanish speakers. Forty-four percent of responders saw an increase in Spanish speakers over the past 5 years, and 41% of responders used Spanish-language materials of some type. Fifty-seven teams were sent a follow-up survey and 29 (51%) teams responded. Teams reported a need for more Spanish-language educational materials on specific craniofacial conditions, and many expressed frustration in communication and interaction with Spanish speakers. Conclusions Many U.S.-based ACPA teams reported an increase in primarily Spanish speakers and expressed a need for more Spanish-language educational materials in different formats. Consideration of the diverse dialectic, cultural, and literacy needs of U.S. Spanish speakers can contribute to more effective educational efforts and improved care of the increasing number of Latinos treated by ACPA teams.
Does Repairing a Cleft Lip Neonatally Have Any Effect on the Longer-Term Attractiveness of the Repair?
Authors: Goodacre Tim E. E. , Hentges Françoise , Moss Tony L. H. , Short Vicky , Murray Lynne 
Published: October 2004

Objective To determine whether attractiveness and success of surgical outcome differ according to the timing of cleft lip repair. Design Three experiments were conducted: (1) surgeons rated postoperative medical photographs of infants having either neonatal or 3-month lip repair; (2) lay panelists rated the same photographs; (3) lay panelists rated dynamic video displays of the infants made at 12 months. Normal comparison infants were also rated. The order of stimuli was randomized, and panelists were blind to timing of lip repair and the purposes of the study. Setting Four U.K. regional centers for cleft lip and palate. Participants Infants with isolated clefts of the lip, with and without palate. Intervention Early lip repair was conducted at median age 4 days (interquartile range [IQR] = 4), and late repair at 104 days (IQR = 57). Main Outcome Measures Ratings of surgical outcome (Experiment 1 only) and attractiveness (all experiments) on 5-point Likert scales. Results In Experiment 1 success of surgical outcome was comparable for early and late repair groups (difference = −0.08; 95% confidence interval [CI] = −0.43 to 0.28; p = .66). In all three experiments, attractiveness ratings were comparable for the two groups. Differences were, respectively, 0.10 (95% CI = −2.3 to 0.44, p = .54); −0.11 (95% CI = −0.42 to −0.19, p = .54); and 0.08 (95% CI = −0.11 to 0.28, p = .41). Normal infants were rated more attractive than index infants (difference = 0.38; 95% CI = 0.24 to 0.52; p < .001). Conclusion Neonatal repair for cleft of the lip confers no advantage over repair at 3 months in terms of perceived infant attractiveness or success of surgical outcome.
Magnetic Resonance Imaging of the Levator Veli Palatini Muscle before and after Primary Palatoplasty
Authors: Kuehn David P. , Ettema Sandra L. , Goldwasser Michael S. , Barkmeier Joseph C. 
Published: October 2004

Objective To explore the application of magnetic resonance imaging (MRI) in the evaluation of patients with cleft palate before and after primary palatoplasty with particular attention focused on the levator veli palatini muscle. Design Prospective study using MRIs of subjects before and after primary cleft palate surgery. Setting Hospital and university based. Patients One female infant with normal anatomy. Three male and four female infants with cleft palate of varying severity. Intervention Furlow double-opposing Z-plasty and V-Y palatoplasty. Main Outcome Measures Magnetic resonance images. Results It was found that the levator veli palatini muscle can be imaged before and after palatal surgery in infants using MRI. The muscle may have sufficient volume, proportionate to a normal infant or adult, in infants born with cleft palate. If retrodisplaced properly, the muscle is likely to be steeper (more vertical) from its origin at the base of the skull to its insertion into the velum following palatoplasty, thus providing a more favorable angle for elevating the velum. Following palatal surgery, the levator muscle mass may not be as cohesive across the velar midline, compared with normal musculature. Conclusion MRI is a viable imaging modality for the evaluation of the anatomy of the levator veli palatini muscle before and after primary palatoplasty in infants born with cleft palate.
Predisposing Factors to Formation of Cleft Lip and Palate: Inherited Craniofacial Skeletal Morphology
Authors: Chatzistavrou Evangelia , Ross R. Bruce , Tompson Bryan D. , Johnston Malcom C. 
Published: October 2004

Objective To identify inherited craniofacial morphologic features in individuals at high risk for cleft of the lip, cleft palate, or both. Subjects Twins without cleft from 33 pairs of monozygotic twins discordant for cleft lip, cleft palate, or both were studied. There were 17 males and 16 females of Caucasian origin, ranging from 3 to 18 years (15 with cleft lip and palate [CLP], 10 with cleft lip [CL], and 8 with cleft palate [CP]), collected from five craniofacial centers (United States and Canada). Design The twin without cleft (noncleft) from each set was compared with an age- and sex-matched control individual from the Burlington Growth Centre, Toronto, Ontario. Posteroanterior and lateral cephalograms were traced and digitized using a computer custom analysis. Descriptive statistics, Student's t tests, and analysis of variance were used to test 40 variables in a pilot study comparing the noncleft twin groups with the controls. Preliminary analysis permitted pooling of the CLP and CL groups (n = 25). To minimize false-positive significance, only 14 variables (from the maxillofacial area) were tested. Results Using the raw probabilities, eight variables showed significant differences between the pooled noncleft CLP and CL (CL[P]) twin group and the controls. However, when the level of significance was adjusted, only four (nasal width [p < .01], cranial base length [p < .05], cranial base width/length ratio [p < .001], and maxillary width/length ratio [p < .05]) were significantly different. No significant differences were confirmed between the noncleft CP twin group and the controls. Conclusions The noncleft member of a discordant monozygotic pair has a number of facial characteristics that differ from the general population. These may predispose to the formation of a cleft lip or palate and may result from a deficiency or distortion of the mesenchyme that forms the craniofacial structures.
Persistent Cough: Prevalence of Gastroesophageal Reflux and Study of Relevant Laryngeal Signs
Authors: El Din M. El Hennawi Diaa , Iskander Nagy M. , Hassan Ibrahim Ibrahim , Hamid A. Serwah Abdel 
Published: October 2004

Cough is one of the atypical manifestations of gastroesophageal reflux disorder (GERD). The aim of this study was to evaluate the prevalence of GERD among patients presenting with persistent cough. The study included 80 patients over a period of 3 years. The inclusion criteria were nonsmoker adults with normal chest radiograph whose chief complaint was cough for at least 4 weeks duration. All patients included were subjected to nasal endoscopy, laryngoscopy, and 24‐hour pH monitoring. Reflux was recorded in the different positions. Laryngeal signs of reflux were traced for and their significance was calculated. Patients who proved to have GERD received antireflux treatment with a follow‐up of 3 months. The response to antireflux treatment was assessed according to subjective and objective improvement. Relapse in the follow‐up period occurred in 9% of patients. It is concluded that laryngeal signs of GERD should be well known to diagnose and properly manage persistent cough.
Selective Neck Dissection for Clinically N0 Neck in Laryngeal Cancer: Is Dissection of Level IIb Necessary?
Authors: Coskun H. Hakan , Erisen Levent , Basut Oguz 
Published: October 2004

The most common morbidity associated with selective neck dissection (SND; II–IV) is spinal accessory nerve dysfunction and related shoulder disability. Nerve dysfunction is usually attributed to stretching of the nerve during clearance of lymph nodes lying posterior and superior to the spinal accessory nerve (level IIb). If these lymph nodes were left in place and not removed, stretching of the spinal accessory nerve during neck dissection and postoperative shoulder disability could be avoided. 113 SNDs (II–IV) performed on clinically N0 necks of patients with laryngeal carcinoma were enrolled in this prospective study. During SND, level IIb was separately removed and processed. Mean number of lymph nodes in level IIb was 6.26 (range, 0‐19). In none of the 113 SND (II‐IV) specimens did level IIb contain metastases, thus providing an oncological basis that leaving these lymph nodes in place is an oncologically safe approach, probably avoiding postoperative shoulder disability.
Preliminary Functional Results of Tympanoplasty with Titanium Prostheses
Authors: M Menéndez‐Colino L. , Bernal‐Sprekelsen M. , Alobid I. , Traserra‐Coderch J. 
Published: October 2004

OBJECTIVETo assess the use of titanium prostheses in tympanoplasty for reconstruction of the sound pressure and to evaluate the audiometric results obtained.STUDY DESIGN AND SETTING AND PATIENTSRetrospective chart review in a tertiary referral center. Between September 1998 and October 2000, 23 titanium middle ear implants (23 TORP) were used for reconstruction of the ossicular chain after tympanomastoidectomy. Preliminary functional results were obtained in 23 cases.RESULTSAverage follow‐up time was 18 months (range, 12‐40) and no adverse reactions or extrusions occurred. Seven of 16 canal wall down tympanoplasties (43.7%), and 3 of 7 canal wall up tympanoplasties performed (42.9%) had a postoperative air‐bone gap of between 0 and 10 dB.CONCLUSIONSPreliminary results show that titanium prosthesis provide a promising hearing result after total ossicular reconstruction, although long‐term results are not yet available. The low weight of these prostheses may be the reason for the decrease in the air‐bone gap.
Recurrent Pneumoparotid: Cause and Treatment
Authors: Han Sehjin , Isaacson Glenn 
Published: October 2004

OBJECTIVETo document the etiology and successful treatment of severe recurrent pneumoparotid.STUDY DESIGNComputed tomography, ductal measurement by probe size, surgical treatment.RESULTSWe performed a superficial parotidectomy for a 13‐year‐old with a history of recurrent parotitis. He subsequently developed recurrent pneumoparotid in the contralateral gland with subcutaneous dissection of air into the face, neck, and mediastinum. At surgery, Stensen's ducts were measured and found to be abnormally patent bilaterally compared to standardized norms. Parotid duct ligation, commonly used for sialorrhea, was employed as a novel treatment and was curative.CONCLUSIONInsufflation of air into the parotid duct system can trouble woodwind instrument players, can complicate dental procedures, or can be self‐induced. It is generally a benign condition requiring no therapy. Occasionally, pneumoparotid can be recurrent and lead to inflammation and infection of the parotid or subcutaneous emphysema.SIGNIFICANCEIn selected cases of recurrent pneumoparotid, ductal ligation may be curative.
Pseudoaneuploid Subpopulations Detected in Normal Upper Aerodigestive Tract Mucosa Consistent with Physiological Apoptosis in Normally Differentiating Squamous Mucosa
Authors: El‐Rayes Bassil F. , Korkmaz Hakan , Maciorowski Zosia , Sakr Wael , Jacobs John R. , Ensley John F. 
Published: October 2004

OBJECTIVESWhile evaluating the validity of using normal human mucosal cells from the upper aerodigestive tract as diploid standards for DNA content studies of squamous cell cancer of head and neck by flow cytometry, pseudoaneuploidy was frequently detected. The purpose of this study was to further evaluate these DNA content abnormalities encountered in normal human mucosal cells and correlate them to physiological apoptosis.STUDY DESIGNThirty‐two specimens of upper areodigestive tract mucosa from 18 surgical resections, 11 fresh autopsies, and 3 buccal scrapings were examined for DNA content by flow cytometry.RESULTSPseudoaneuploidy, which ranged from sub‐G0/G1 peaks to hyperdiploid peaks with increased 90° light scattering properties was found in 60% of these specimens. Fluorescent microscopic examination of the sorted DNA pseudoaneuploid cells demonstrated cells undergoing apoptosis.CONCLUSIONThis unexpected pseudoaneuploidy in normal mucosal cells was a result of physiological apoptosis, a normal component of squamous differentiation. EBM rating: B‐2.
Study of Lubricant‐Induced Changes in Chronic Snorers (SLICCS)
Authors: Wijewickrama Rohan C. , Blalock David , Mims James W. 
Published: October 2004

OBJECTIVEThe efficacy of many of the noninvasive treatments for snoring has not been evaluated in controlled trials. This paper seeks to evaluate the efficacy of an oil‐based spray in the treatment of snoring, in a double‐blinded, placebo‐controlled, crossover trial using objective acoustic analysis and subjective questionnaires.STUDY DESIGN AND SETTINGParticipants were randomized to use both oil‐based oral spray (treatment) and water‐based oral spray (placebo) during a two‐night in‐home study period. Questionnaires were completed by participant and bed‐partner in addition to audio‐tape recordings which were analyzed for frequency, duration, and mean energy of snoring.RESULTSGreatest snoring rate demonstrated 30% = benefit; 40% = no change; 30% = adverse effect (n = 20). Percent time snoring yielded: 30% benefit; 15% no change; 55% adverse effect (n = 20). Study data results for mean energy were (n = 12): benefit = 17%, no change = 33%, adverse effect = 50%. Bed‐partner observations (n = 17) demonstrated 37% = benefit; 38% = no change; 25% = adverse effect.CONCLUSION/SIGNIFICANCEObjective and subjective evaluation of the performance of the oil‐based Snoreless spray in comparison to placebo demonstrated a lack of efficacy in snoring reduction.
Oral Dextromethorphan Reduces Perioperative Analgesic Administration in Children Undergoing Tympanomastoid Surgery
Authors: Hasan Rashed A. , Kartush Jack M. , Thomas John D. , Sigler Diana L. 
Published: October 2004

OBJECTIVETo determine whether oral dextromethorphan (1 mg/kg) given one hour prior to surgery decreases opioid administration in the perioperative period in children undergoing tympanomastoid surgery.METHODSThis was a prospective randomized double‐blinded and placebo‐controlled study in which 20 male and 18 female children (age 11.5 ± 3.5 years) were enrolled. Nineteen children received dextromethorphan (DM), while the other 19 received placebos. Postoperative pain was assessed using a visual analogue scale and a pain score of ≥5 was treated with intravenous morphine sulfate. Patients were discharged home on oral oxycodone.RESULTSThe total doses of fentanyl administered during surgery were higher in the placebo group compared to the DM group (4.1 ± 2 vs 2.6 ± 1.4 μg/kg, P = 0.02) and the total doses of intravenous morphine administered in the postoperative period were also higher in the placebo group compared to the DM group (150 ± 80 vs 73 ± 56 μg/kg, P = 0.004). The placebo group had a higher pain score at the time of admission to the Day Surgery Unit (DSU) and a higher maximum pain score, compared to the DM group, during their combined stay in the Post‐Anesthesia Care Unit and DSU (7.3 ± 1.5 vs 3.1 ± 2.6, P = 0.001).CONCLUSIONSPremedication with DM reduces the need for opioid administration in the perioperative period in children undergoing tympanomastoid surgery. EBM rating: A.
Surface Electromyographic Studies of Swallowing in Normal Subjects: A Review of 440 Adults. Report 2. Quantitative Data: Amplitude Measures
Authors: Vaiman Michael , Eviatar Ephraim , Segal Samuel 
Published: October 2004

OBJECTIVESSurface electromyographic (EMG) studies were performed on 420 normal adults to establish normative database for muscle activity's amplitude during swallowing and drinking clinically useful for ENT department.STUDY DESIGNProspective observational study of healthy volunteers.METHODSParameters evaluated during swallowing include the EMG activity of the orbicularis oris, masseter, submental, and infrahyoid muscle groups covered by platysma (range, mean, SD). Four tests were examined including voluntary swallow of saliva (“dry” swallow), voluntary single water swallows as normal (variable volume of a bolus), voluntary single swallows of fixed amount of water (20 mL), and continuous drinking of 100 mL of water. Activity of the above‐mentioned muscles during swallowing was measured for groups of adults of different age groups. Groups included volunteers and were separated into age groups as follows: ages 18‐30, 31‐40, 41‐50, 51‐60, 61‐70, and 70+ years of age.RESULTSNormative data for electric muscle activity (mean ± SD; range, in μV) during single swallowing and continuous drinking are established for healthy adults. The range of submental group activity during swallows showed a significant decrease with the age, whereas the range of masseter activity changed insignificantly (1‐dimensional analysis of variance, SPSS, Chi‐square criterion, 95% confidence interval). There were no significant changes in mean muscle activity between different age groups. These parameters represent activities required for normal deglutition, and can be used to identify abnormalities in ENT patients, and provide a basis for comparison of swallowing performance both within and between patients. These measurements can be performed in a simple way, cause no discomfort, do not use radiation, and are noninvasive. The relevance and clinical utility of new and alternative measures, in particular, are discussed.CONCLUSIONSIn single swallow tests range of electric activity of involved muscles is more informative than its mean. In the continuous drinking test, the mean electric activity is the only electric variance that can be evaluated. Orbicularis oris muscle activity is not important when reflex phase of a swallow is evaluated. Surface EMG of swallowing is a simple and reliable method for evaluation of swallowing with a low level of discomfort during the examination. The method can be easily used in outpatient ENT departments for quick evaluation of patients. The normative amplitude data can be used for comparison purposes in preoperaive and postoperative stages and in EMG monitoring during ENT treatment.
The Impact of Fiducial Distribution on Headset‐Based Registration in Image‐Guided Sinus Surgery
Authors: Knott P. Daniel , Maurer Calvin R. , Gallivan Ryan , Roh Hwan‐Jung , Citardi Martin J. 
Published: October 2004

OBJECTIVEThe objective of this study was to assess registration error due to fiducial configuration for the ENT headsets for the CBYON Suite (CBYON, Mountain View, CA) and InstaTrak (GEMS Navigation and Visualization, Waukesha, WI).STUDY DESIGNAxial CT scans (1‐mm slice thickness) were obtained of for 24 cadaveric heads using the CBYON headset and for 23 cadaveric heads using the GEMS headset. The CBYON and GEMS NAV software were used to calculate the fiducial registration error (FRE). Fiducial localization error (FLE) was estimated from FRE. Theoretical target registration error (TRE) was calculated at 11 targets.RESULTSThe FRE for CBYON and GEMS NAV was 0.69 mm and 0.27 mm, respectively. The theoretical TRE for CBYON and GEMS NAV was 0.41 mm and 0.30 mm, respectively. The theoretical TRE was greater at targets posterior in the sinus cavities.CONCLUSIONTheoretical TRE values for both ENT headsets are less than clinically observed TRE. Clinically observed TRE is likely due to repositioning accuracy. EBM rating: B‐2.
The Dilemma of the Normal Baseline Parathyroid Hormone Level using the Intraoperative PTH Assay
Authors: Vasan Nilesh R. , Blick Kenneth E. , Krempl Greg A. , Medina Jesus E. 
Published: October 2004

OBJECTIVETo analyze patients with “normal” baseline quick intraoperative parathyroid hormone (QPTH) levels during parathyroidectomy and to determine the prevalence of this finding, the usefulness of the assay in this situation, and to explain the possible causes for this phenomenon.STUDY DESIGN AND SETTINGPatients who underwent parathyroidectomy using QPTH in a tertiary hospital.METHODSRetrospective analysis of 39 patients treated surgically for primary hyperparathyroidism using QPTH.RESULTSOf the patients, 14 (36%) had normal baseline QPTH. 8 patients with localizing sestamibi scans had a single adenoma, and excision resulted in a mean decrease of 85.4% in QPTH. Six patients had nonlocalizing sestamibi scans, 1 patient had an 84% drop in QPTH level after removal of a single adenoma, and 5 patients had hyperplasia requiring ≥3 glands excision. At 11.36 months' mean follow‐up, 13 patients (93%) were normocalcemic.CONCLUSIONSA “normal” baseline QPTH level was found in 36% of patients. A 50% decrease in QPTH remains predictive of biochemical cures in patients with localizing sestamibi scans. The likely explanation for this variability in “normal” levels between different assays is the variability in detection of the 7‐84 PTH fragment, which results in an overestimation of the PTH level. Assays such as the QPTH, which are more sensitive for the biologically active PTH molecule [(1‐84) PTH] than other laboratory PTH assays will tend to have lower PTH levels that can be within the normal range. EBM rating: B‐3.
Use of the 2.0‐mm Locking Reconstruction Plate in Primary Oromandibular Reconstruction after Composite Resection
Authors: Militsakh Oleg N. , Wallace Derrick I. , Kriet J. David , Girod Douglas A. , Olvera Melissa S. , Tsue Terance T. 
Published: October 2004

OBJECTIVETo review our experience with 2.0‐mm locking reconstruction plate (LRP) system for patients requiring oromandibular reconstruction.STUDY DESIGNRetrospective case review of 43 consecutive patients who underwent mandibular composite resection with immediate reconstruction.SETTINGTertiary care center.RESULTSForty‐three patients underwent oromandibular reconstruction with the 2.0‐mm mandibular LRP system and free flaps containing vascularized bone. Mean follow‐up was 11 months. There were no intraoperative difficulties utilizing this system. Two (5%) patients had partial fasciocutaneous flap loss resulting in plate exposure. There were no instances of plate fracture or complications requiring plate removal to date.CONCLUSION2.0‐mm LRP mandibular system is reliable even in the setting of previous or adjuvant radiation therapy. Its technical ease of application, contouring malleability, and very low profile have proven to be advantageous in oromandibular reconstruction.SIGNIFICANCENo previous descriptions of use of the 2.0‐mm LRP in combination with osteocutaneous free flaps for mandibular reconstruction are found in the literature. EBM rating: C.