bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ototoxicity of Common Topical Antimycotic Preparations
Authors: Tom Lawrence W. C. 
Published: November 2003

AbstractObjective To determine the ototoxic effects of five commonly used topical antimycotic agents—clotrimazole, miconazole, nystatin, tolnaftate, and gentian violet—in the guinea pig.Design A controlled animal study in which the ototoxicity of commonly used topical antifungal agents was investigated by measurement of hair cell loss.Methods Several readily available topical antimycotic preparations were instilled into the middle ears of female Hartley guinea pigs over a 1‐week period. Two weeks after the last instillation, the animals were euthanized. An active control group was treated with neomycin to confirm the adequacy of the treatment in delivering a known ototoxin; an untreated control group defined the normal distribution of hair cells. The temporal bones were removed, and the cochleas were fixed and dissected. The basilar membranes were examined under the scanning electron microscope. A map of hair cell survival was made for each row in segments of each turn.Results The untreated control animals had no discernible hair cell loss in the two lower turns. In the apical turn and sometimes the third turn, loss of hair cells was a common finding; this is a known effect of aging in this species. The animals treated with neomycin had damage consistently in the basal turn, sometimes extending into the second turn, as well as the expected hair cell loss in the apical turn. Clotrimazole, miconazole, or tolnaftate did not cause any hair cell loss in the first two turns. Hair cell loss in the third and fourth turns was similar to that of the untreated control group. Likewise, nystatin exhibited no evidence of ototoxicity. Of note, however, the preparation used in this study left a persistent residue in the round window niche. Of the first four animals treated with gentian violet, three developed pronounced behavioral signs of vestibular damage, and three demonstrated extensive middle ear inflammation and extensive new bone growth. Hair cell counts were not attempted because the extreme bone growth interfered with successful perfusion and dissection.Conclusions Extrapolating from guinea pigs to humans requires caution. However, it is likely that guinea pigs are, if anything, more susceptible to topical ototoxins than are humans. The specific antimycotics clotrimazole, miconazole, and tolnaftate appear to be safe. Gentian violet has the potential for severe damage. The persistent residue left by the nystatin preparation is cause for concern and is a reminder that both the active ingredient and vehicle must be considered in evaluation of safety.
Intractable Benign Paroxysmal Positional Vertigo in Patients With Meniere's Disease
Authors: Gross Eric M. , Ress Bradford D. , Viirre Erik S. , Nelson James R. , Harris Jeffrey P. 
Published: November 2003

AbstractObjective To provide a detailed description of the coexistence of benign paroxysmal positional vertigo (BPPV) and Meniere's disease in individuals and to offer a possible mechanism that explains the findings in these patients.Study Design Retrospective.Methods Chart review.Results Of 162 patients diagnosed with Meniere's disease between January 1998 and January 1999, 9 were found to have both “definite” Meniere's disease and “certain” BPPV. Meniere's symptoms preceded the onset of BPPV in all of our patients. Seven of the 9 patients were female. Except for one patient who experienced BPPV bilaterally, BPPV was limited to the same ear as the Meniere's disease. All patients presented with intractable BPPV that did not respond completely to otolith repositioning procedures. A detailed description of five patients is presented.Conclusion Our data, in conjunction with that of others, suggest that Meniere's disease may predispose patients to intractable BPPV. Hydropically induced damage to the maculae of the utricle and saccule or partial obstruction of the membranous labyrinth may be possible mechanisms that explain the coexistence of Meniere's disease and BPPV.
The Versatile Contact Nd:YAG Laser in Head and Neck Surgery: An in Vivo and Clinical Analysis
Authors: Brown Dale H. 
Published: November 2003

AbstractObjective Lasers have been used in otolaryngology as a surgical instrument for more than 25 years, and the CO2 laser has emerged as the most widely employed surgical laser in use today. However, recent technological advances have made the Nd:YAG laser a challenger as an effective photothermal surgical tool.Study Design and Methods This is a two‐part study. Tissue injury and healing profiles after application of both the CO2 and Nd:YAG lasers are compared using an in vivo rat tongue model. A prospective clinical review based on the experience of 327 operative cases spanning a 7‐year interval using the Nd:YAG laser, highlighting its various applications and associated complications, is detailed.Results Comparable tissue and healing effects were noted with both lasers in the in vivo rat tongue model with no statistical differences. The clinical application of the laser showed wide versatility in the head and neck with a complication rate of 3%.Conclusion The Nd:YAG laser has proved equivalent in tissue damage and healing to the CO2 laser. The Nd:YAG laser has proved itself to be an excellent and perhaps superior laser for use in head and neck surgery.
Candidate's Thesis: Polymer Chemotherapy for Head and Neck Cancer
Authors: Shikani Alan H. , Domb Abraham J. 
Published: November 2003

AbstractObjectives To study a new method of delivery of chemotherapy for the treatment of squamous cell carcinomas (SCCs) of the head and neck, to evaluate the pharmacokinetics of four anticancer agents (cisplatin, fluorouracil [5‐FU], methotrexate [MTX], and paclitaxel) loaded into the biodegradable polymer, polyanhydride polymer poly(FAD:SA), and to evaluate the effectiveness and toxicity of the drug‐polymer combination against human SCCs, both in vitro and in vivo.Study Design Poly(FAD:SA) was loaded with different chemotherapeutic drugs and its in vitro and in vivo drug release and tissue penetration characteristics were studied. The biocompatibility and toxicity of the polymer‐drug combination were determined. The effectiveness of the drug‐polymer was evaluated against three different human SCCs (larynx O11, pharynx FADU, and floor of mouth UM‐ SCC1) cultured in vitro and in nude mice carrying human SCC xenografts.Methods The in vitro drug release pharmacokinetics of the drugs were performed using atomic absorption spectrometry for cisplatin and high‐pressure liquid chromatography for the 5‐FU, MTX, and paclitaxel studies. In vitro tumor cytotoxicity was assessed by growth assay. In vivo cytotoxicity was assessed by growth rate inhibition in a nude mouse model.Results All four chemotherapy drugs demonstrated a continuous release that followed first‐order kinetics from the polymer. More than 95% of the MTX and 5‐FU, 70% of the cisplatin, and 20% of the paclitaxel was released within the 10 days of the assay. Tumor cytotoxicity revealed that the polymer was very effective against the human SCCs O11, FADU, and UM‐ SCC1 in vitro. When a small amount of polymer (1–2 g) was added to the cell culture and left for 7 days, 96.6% of the UM‐SCC1 cells, 86.9% of the FADU cells, and 94.6% of the O11 cells were killed. When the culture medium was then changed every 2 days to remove the effect of nutrient depletion or chemicals released by the degrading polymer, 74% of the UM‐SCC1 cells, 94.5% of the FADU cells, and 66.1% of the O11 cells were killed at 7 days. The tumor animal model was the nude mouse carrying human floor of mouth SCC xenografts. Different amounts of cisplatin were incorporated into the polymers (5% and 7% drug/polymer at a weight/weight [wt/wt] load). Thirty‐five days after implantation of the polymer in nude mice, the mean treated tumor size was 65.5% of controls in the 5% group and 31.8% in the 7% group. Seventy days after implantation the mean treated tumor size was 41.4% of controls in the 5% group and 38.1% in the 7% group, indicating a statistically significant delay of tumor growth compared with controls or with intraperitoneally injected cisplatin. The blank polymer was well tolerated by the mouse and had no effect on tumor growth.Conclusions The study results indicate that polymer chemotherapy is effective against a variety of SCCs of the head and neck, both in vitro and in vivo, and may become a useful therapeutic option for head and neck cancer.
Allograft Dermal Implant (AlloDerm) in a Previously Irradiated Field
Authors: Dubin Marc G. , Feldman Michael , Ibrahim Hani Z. , Tufano Ralph , Evans Sydney M. , Rosenthal David , Wolf Patricia F. , Weber Randal S. 
Published: November 2003

AbstractObjective To evaluate the integration of AlloDerm (LifeCell Corp., The Woodlands, TX) in a field exposed to external‐beam radiation (EBR) by analyzing graft thickness, fibroblast recellularization, and neovascularization.Study Design Randomized control.Methods Thirty‐six male Sprague‐Dawley rats (n = 36) were randomly assigned to four groups. One hind leg of each rat was exposed to 20 Gy of EBR; the other limb served as the nonirradiated control. Two weeks after irradiation, AlloDerm was implanted into both hind legs. Grafts were harvested at 3, 4, 6, and 14 weeks after implantation and underwent histological analyses.Results There was no statistically significant difference in graft thickness, fibroblast count, or neovascularization between the grafts placed in the irradiated bed and the controls (n = 33, P = .332, P = .336, and P = .057, respectively). However, at week 3, fibroblast counts in the graft placed in the field exposed to EBR were significantly lower than those of controls (P = .019), although at week 14 the counts in the experimental limb were higher than those of the controls (P = .002). Graft thickness (P = .001) and fibroblast count (P < .004) were lower at week 14 than at earlier time periods for both the experimental and control grafts.Conclusions In the rat model, graft thickness and neovascularization of the AlloDerm dermal implant do not appear to be adversely affected by a field that has received EBR. Fibroblast ingrowth may be hindered in the early postimplantation period but appears to normalize in the long term. Furthermore, overall graft thickness and fibroblast counts decrease over time, regardless of irradiation status.
Effect of Photodynamic Therapy on Revascularization of Fasciocutaneous Flaps
Authors: Belmont Michael J. , Marabelle Nicole , Mang Thomas S. , Hall Richard , Wax Mark K. 
Published: November 2003

AbstractObjective Photodynamic therapy (PDT) may be used as an adjuvant intraoperative treatment to improve locoregional control. PDT has been shown both to delay wound healing and to have a deleterious effect on flap survival after a primary ischemic insult. This delay in wound healing may make the flap dependent on its pedicled blood supply for a prolonged period. Long‐term flap loss may be experienced. The effect of PDT on flap revascularization, with subsequent dependence on its vascular pedicle, is evaluated.Study Design Randomized controlled trial using a rodent model.Methods A rat fasciocutaneous flap was used. Study groups were as follows: group I received no treatment; group II received treatment with 630‐nm light; groups III and IV were given Photofrin (in group III, loupes without a fiberoptic light source were used for flap elevation, and in group IV, light source was employed); and group V was given Photofrin and 630‐nm light. Primary ischemic times of 2 or 4 hours were used. Vascular pedicles were ligated on postoperative day (POD) 5, 6, or 7, and percentage of flap survival was evaluated 7 days later.Results With 2 hours of ischemia, revascularization was decreased in the PDT group on POD 6 (P < .05) and on day 7 (P < .005) when compared with the other groups. With 4 hours of ischemia, revascularization was decreased in the PDT group on PODs 5 (P < .001), 6 (P < .01), and 7 (P < .005).Conclusion Intraoperative PDT decreases revascularization of a rat fasciocutaneous flap.
Interlocking Calvarial Bone Grafts: A Solution for the Short, Depressed Nose
Authors: Leach Joseph 
Published: November 2003

AbstractObjectives/Hypothesis In patients severely affected with collapse of the nose, deprojection and upward rotation of the nasal tip are commonly seen. Traditional maneuvers to derotate and project the tip may be insufficient, because of the natural tendency of the nasal skin/soft tissue envelope to pull the tip in a cephalic and posterior direction. If the forces of scar contracture can be resisted, the tip and dorsum should remain adequately positioned.Study Design Retrospective chart review of 20 cases.Methods Using an open rhinoplasty approach, two strips of calvarial bone are fitted together in a tongue‐in‐groove fashion, and esthetics are analyzed. Rotation and projection are altered as indicated. A screw inserted at the indicated level along the caudal bone graft acts to prevent retrodisplacement of either the dorsal or caudal strut as scarring occurs.Results The procedure has been used in 20 patients. Two patients had displacement of the dorsal bone graft. Two patients have been lost to follow‐up. Follow‐up in the remainder has ranged from 6 weeks to 4 and a half years. All have maintained adequate tip and dorsal projection without excess upward tip rotation. Bone grafts have undergone minimal resorption.Conclusion The interlocking calvarial bone graft technique stabilizes the nasal tip and dorsum in such a way that resists the forces of contracture and provides improved esthetics and function.
Long‐Term Experience With Endoscopic Diagnosis and Treatment of Salivary Gland Inflammatory Diseases
Authors: Nahlieli Oded , Baruchin Abraham M. 
Published: November 2003

AbstractObjectives To assess the efficacy of the sialoendoscopic technique for treatment of inflammatory salivary gland diseases. This report documents the authors' long‐term experience with sialoendoscopy and discusses the long‐term results of the procedure, technical issues, and varieties that they have utilized, as well as the advantages and limitations of this modality.Study Design Retrospective clinicopathologic study of 236 patients who were endoscopically treated from 1994 to 1999 for suspected salivary gland obstructive disease.Methods Endoscope employed was the third generation sialoendoscope (Nahlieli Sialoendoscope, Karl Storz, Tuttlingen, Germany).Results Ten sialoendoscopies were immediate failures as a result of technical problems. In the remaining 226 glands, 170 had obstructions and 56 had sialadenitis without evidence of obstructions. The success rate was 83%. Multiple endoscopic findings were encountered. No severe complications were noted.Conclusion This report demonstrates the efficacy and safety of sialoendoscopy as a promising new method for use in the diagnosis, removal, and postoperative management of sialolithiasis, sialadenitis, and other obstructive salivary gland diseases.
Treatment of Laryngeal Carcinomas by Laser Endoscopic Microsurgery
Authors: Moreau Pierre R. 
Published: November 2003

AbstractObjectives To determine if laser endoscopic microsurgery is a reliable and appropriate approach in the treatment of laryngeal cancers.Study Design Retrospective study of 160 patients treated from 1988 to 1996 at Liège. Analysis of indication, technique, and oncologic results.Methods Glottic tumors were treated with either type I, type II, or type III cordectomy, with or without conservation of an inferior muscular band, and extended if necessary to all or part of the contralateral cord. For supraglottic cancers, an excision limited to a part of the vestibule, a trans‐preepiglottic resection, or a radical supraglottic resection was carried out.Results Our corrected actuarial survival at 5 years was 97% for the 98 infiltrative glottic tumors and 100% for the 18 infiltrative supraglottic and 27 in situ carcinomas. No local recurrences were noted, in either the group of 118 infiltrating cancers (in whom two precancerous lesions were treated with a further laser excision), or in the 27 in situ carcinomas. Local control was thus 100%. One patient died of his cancer, with lung metastases after neck recurrence.Conclusions Like Steiner and Rudert, this series demonstrates the oncologic validity of this surgical approach to the treatment of unadvanced glottic tumors. Unlike these authors' study, however, strict case selection, as in cases with significant involvement of the anterior commissure, has allowed us to avoid local recurrences and consequently to avoid salvage total laryngectomies. Our experience with supraglottic cancers is too small to confirm the oncologic validity of this type of surgery but seems promising.
Aging Effects on Motor Units in the Human Thyroarytenoid Muscle
Authors: Takeda Naoya , Thomas Giovana R. , Ludlow Christy L. 
Published: November 2003

AbstractObjectives To determine whether age differences are present in the human laryngeal thyroarytenoid muscle that would indicate that different normative values would be needed for identifying motor unit abnormalities.Study Design Twenty‐six consecutively recruited healthy subjects between the ages of 21 and 72 years participated in a laryngeal electromyography study.Methods Bipolar needle electrodes were used to record motor unit action potentials from several locations in the right and left thyroarytenoid muscles of each subject. The duration of a motor unit was measured when at least 10 firings of the same motor unit could be identified. On the average, four units were measured per muscle.Results In the subjects less than 60 years of age, motor unit duration did not increase significantly with age. However, motor units from subjects greater than 60 years of age had longer durations than those from subjects less than 60 years of age (P < .00005), and 25% of the units measured in subjects greater than 60 years of age had longer durations than any of the units measured in subjects less than 60 years of age. Further, the older subjects differed from each other in their mean unit durations (P < .0001). In subjects less than 60 years of age, significantly longer durations were found for units innervated by the longer, left‐side recurrent laryngeal nerve in comparison with the right‐side nerve (P = .005).Conclusions Different mean and SD values should be used for patients less than and greater than 60 years of age and for the right and left sides, when evaluating motor units in the thyroarytenoid muscles.
Effects of Thyroplasty Type I on Vocal Fold Vibration
Authors: Omori Koichi , Slavit David H. , Kacker Ashutosh , Blaugrund Stanley M. , Kojima Hisayoshi 
Published: November 2003

AbstractObjective To ascertain effects of medialization thyroplasty on vocal fold vibration in glottic incompetence dysphonia.Study Design Quantitative videostroboscopic glottic measurements and vocal function study were perioperatively undertaken in 20 patients undergoing Isshiki's thyroplasty type I.Methods In digitized images, the glottal area, glottal width, posterior glottal width, and amplitude over an entire glottal cycle were measured and normalized by membranous vocal fold length. The ratio of closed phase to total phase of vibratory cycle was calculated from the data of the glottal area and the glottal width at the middle point of the membranous vocal fold. Well‐accepted acoustic, aerodynamic, and perceptual measures analyzed vocal function.Results Glottal area and glottal width were reduced after surgery. While preoperative closure of glottal area was incomplete in all 20 patients, incomplete closure was obtained in 16 patients after surgery. In these 16 patients, closure of glottal width at the middle point of the membranous vocal fold was complete, whereas a posterior glottal gap remained in 14 patients. Closed phase over one cycle of glottal width waveform and amplitude of vocal fold vibration were increased after surgery. Glottal area, glottal width, posterior glottal width, and closed phase over one cycle of glottal width waveform correlated with vocal function measures.Conclusions Thyroplasty type I reduces a glottal gap and increases closed phase over one cycle and amplitude of vocal fold vibration, although a posterior glottal gap remains. With the improved glottic vibration, thyroplasty type I provides more efficient phonation in patients with glottic incompetence dysphonia.
Transcranial Magnetic Stimulation in Acute Facial Nerve Injury
Authors: Har‐El Gady , McPhee Joseph R. 
Published: November 2003

AbstractObjective/Hypothesis Available electrodiagnostic tests that are used to evaluate facial nerve injury examine the nerve distal to the stylomastoid foramen; because most facial nerve injuries are within the temporal bone, the tests cannot evaluate the nerve at or across the injury site. The interpretation of these tests depends on the predictability (or unpredictability) of distal degenerative process. Transcranial magnetic stimulation may be able to stimulate the nerve proximal to the injury site. The hypothesis of the present study is that in cases of mild traumatic facial nerve injury where axonal integrity is maintained, proximal stimulation of the nerve using higher than normal stimulus intensities to “overcome” the block at the injury site result in recordable facial nerve activity.Study Design A prospective controlled animal study comparing response to transcranial magnetic stimulation of the facial nerve in the following groups: mild injury, severe injury/transection, and control.Methods We studied 44 facial nerves in 22 cats. Fifteen nerves were subjected to mild trauma. Five nerves were severely crushed, 2 nerves were completely transected, and 22 nerves were not traumatized. All nerves were examined with the transcranial magnetic stimulation system before the trauma, immediately after the trauma, and at 3, 8, and 12 weeks after trauma.Results All nerves in the mild and severe trauma groups showed complete clinical paralysis immediately after trauma. The nerves in the mild trauma group showed significant increase in threshold as well as significant increase in latency for recordable facial muscle response to transcranial magnetic stimulation. Thresholds and latencies decreased gradually within 3 to 12 weeks and returned almost to preinjury levels. This paralleled the return of clinical facial muscle movement. In the severe trauma/transection group, the nerves had no facial muscle response to transcranial magnetic stimulation after trauma. Neither facial muscle response to transcranial magnetic stimulation nor facial muscle movements recovered.Conclusions In cats transcranial magnetic stimulation can assess the integrity of the facial nerve after trauma and predict its potential for regeneration. This technique can excite the nerve proximal to the injury site and may play a role in the clinical evaluation of the acute traumatic facial nerve paralysis. It can be used immediately after trauma, because it does not depend on wallerian degeneration to occur.