bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for Second Primary Lung Cancer After Treatment of Laryngeal Cancer
Authors: Ritoe Savitri C. , Krabbe Paul F. M. , Jansen Margriet M. G. , Festen Jan , Joosten Frank B. M. , Kaanders J. Hans A. M. , van den Hoogen Frank J. A. , Verbeek André L. M. , Marres Henri A. M. 
Published: November 2003

AbstractObjectives/Hypothesis As a result of smoking, patients who have received curative treatment for laryngeal cancer run a high risk of developing lung cancer. Therefore, these patients enter a screening program that aims to detect lung cancer at an asymptomatic stage. The study evaluated whether screening for lung cancer by means of regular chest x‐ray examinations contributed to prolonging survival.Study Design A longitudinal follow‐up study was performed to analyze the survival of patients who had received curative treatment for squamous cell laryngeal cancer and developed lung cancer during the follow‐up period.Methods Patients with lung cancer were divided into two groups: 1) patients with asymptomatic screen‐detected lung cancer and 2) patients with complaints indicating lung cancer, whose tumor was detected in the interval between screening examinations by chest x‐ray films.Results In the complete group of patients with laryngeal cancer, no prognostic factors could be identified for developing lung cancer. There was no prolongation of survival in the screen‐detected asymptomatic lung cancer patients. The median survival of both groups was 56 months (P = .57). The date of detection of the lung cancer was clearly brought forward by screening; a difference of 8 months was found between the median detection date of the two groups (P <.001). There was no difference in tumor‐specific mortality between the two groups.Conclusion Screening by chest x‐ray examination to detect lung cancer in an asymptomatic stage after curative treatment for squamous cell laryngeal cancer does not improve survival for patients who develop lung cancer.
Effect of 23 Valent Pneumococcal Polysaccharide and Haemophilus influenza Conjugated Vaccines on the Clinical Course of Otitis Media With Effusion
Authors: Kiliç Rahmi , Şafak Mustafa A. , Özdek Ali , Göçmen Hakan , Kiliç Dilek , Samim Erdal 
Published: November 2003

AbstractObjective To determine if there is any clinical effect of 23‐valent pneumococcal and Haemophilus influenza type B conjugate vaccine on prognosis of otitis media with effusion.Method All children who have middle ear effusion despite long‐standing antibiotherapy with a beta lactamase stable agent were offered for tympanostomy tube insertion between February 1999 and December 2001. Patients who accepted the surgical intervention were operated under general anesthesia and a Shepard grommet‐type tympanostomy tube was inserted. Those who refused the surgical intervention were vaccinated with 23‐valent pneumococcal and Haemophilus influenza type B conjugate vaccine. State of the middle ear effusion was evaluated at the end of the 12th month in the vaccine group and 1 month after the myringotomy site was healed in the tympanostomy tube insertion group.Results Twenty‐six children in the vaccine group and 37 children in the tympanostomy tube insertion group proved the inclusion criteria at the end of study. Complete or partial resolution of middle ear effusion was observed in 73.1% of 26 children in the vaccine group and 59.5% of children in the tympanostomy tube insertion group. There was no significant difference between the two groups.Conclusion Vaccination against Streptococcus pneumonia and Haemophilus influenza type b seems to aid resolution of middle ear effusion in children with otitis media with effusion.
Minimally Invasive Parathyroidectomy: The Role of Radio‐Guided Surgery
Authors: Shaha Ashok R. , Patel Snehal G. , Singh Bhuvanesh 
Published: November 2003

AbstractObjectives Objectives were to review our current experience with radio‐guided parathyroid surgery and to compare various techniques of minimally invasive parathyroidectomy.Study Design 1) To review our recent experience of radio‐guided gamma probe localization during surgery for primary hyperparathyroidism and 2) to compare the intraoperative findings with the preoperative sestamibi scan.Methods Analysis was made of the 10 most recent surgical procedures for primary hyperparathyroidism at a single institution to compare the operative localization with preoperative sestamibi scan and to determine the radioactivity in the tissue removed during surgery, such as parathyroid adenoma, normal parathyroid gland, thyroid tissue, or lymph nodes.Results The sestamibi scan was able to localize the enlarged parathyroid gland in eight patients. Although gamma probe was helpful in localizing the parathyroid gland, the identification of an enlarged parathyroid gland was directly based on the preoperative findings of sestamibi scan. In the remaining two patients, the intraoperative gamma probe was not helpful.Conclusions The major advantage of gamma probe in the series was to evaluate the radioactivity in the tissue that was removed and to determine whether it was an enlarged parathyroid gland, lymph node, thyroid tissue, or fatty tissue. The radio‐guided surgery did not add substantially to the surgical procedure in patients in whom the sestamibi scan had localized the enlarged parathyroid gland preoperatively.
Treatment of Isolated Sphenoid Sinus Inflammatory Disease by Endoscopic Sphenoidotomy Without Ethmoidectomy
Authors: Kieff David A. , Busaba Nicholas 
Published: November 2003

AbstractObjectives/Hypothesis Isolated chronic sphenoid sinusitis is a rare entity. The study was conducted to determine the efficacy of endoscopic sinus surgery with partial middle turbinectomy and without ethmoidectomy in treating isolated sphenoid opacification from inflammatory and infectious disease.Study Design Case series of 20 patients generated by retrospective review of 307 consecutive patients who underwent surgical treatment for chronic rhinosinusitis.Methods The medical records were reviewed for pertinent demographic, symptom, radiographic, and endoscopic data preoperatively, interoperatively, and postoperatively. All patients in the series underwent computed tomographic image–guided endoscopic sphenoid sinus surgery with partial middle turbinectomy.Results The study population consisted of 12 male and 8 female patients between 28 and 75 years of age. Headache (15 patients) and/or postnasal drip (14 patients) were the presenting symptoms in 17 of the patients. Three patients were asymptomatic. Surgical findings included inspissated secretions (15 patients), fungal debris (2 patients), and mucopyoceles (3 patients). The 17 patients with preoperative symptoms were symptom free by 12 weeks postoperatively and have remained so with follow‐up ranging from 12 months to 3.25 years (mean follow‐up, 23.1 mo). There were no operative complications in the series.Conclusions Endoscopic sphenoid sinus surgery without ethmoidectomy is effective for treating isolated sphenoid sinus opacification associated with inflammatory or infectious sinus disease. Partial middle turbinectomy at the time of surgery facilitates the approach, as well as postoperative cleaning and surveillance.
Correlation of pH Probe–Measured Laryngopharyngeal Reflux With Symptoms and Signs of Reflux Laryngitis
Authors: Noordzij J. Pieter , Khidr Aliaa , Desper Ellen , Meek Robert B. , Reibel James F. , Levine Paul A. 
Published: November 2003

AbstractObjectives/Hypothesis Laryngitis secondary to gastric acid reflux is a prevalent, yet incompletely understood, otolaryngological disorder. Further characterization of the relationship between symptoms and signs and reflux severity is needed.Study Design Prospective clinical trial.Methods Forty‐two consecutive, nonsmoking patients with one or more reflux laryngitis symptoms were recruited to complete a symptom questionnaire, videostrobolaryngoscopy, and 24‐hour, dual‐sensor pH probe testing. Twenty‐nine patients had more than four episodes of laryngopharyngeal reflux, and the remaining 13 served as control subjects. Symptom scores were produced by multiplying the severity by the frequency for the following: hoarseness, throat pain, “lump‐in‐throat” sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn. Endoscopic laryngeal signs included erythema and edema of the vocal folds and arytenoids, and interarytenoid irregularity.Results Symptom scores varied significantly, with throat clearing being greater than the rest. None of the symptoms, except heartburn, correlated with reflux (laryngopharyngeal and esophageal) severity. Patients with worse laryngopharyngeal reflux were found to have worse esophageal reflux. Endoscopic laryngeal signs were rated as mild, on average, and did not correlate with laryngopharyngeal reflux severity. The number of laryngopharyngeal reflux episodes (per 24 h) ranged from 0 to 40 (mean number, 10.6 episodes).Conclusions Throat clearing was the most intense symptom in the present group of patients with proven reflux laryngitis. Dual‐sensor pH probe testing could not predict the severity of patient's reflux laryngitis symptoms or signs. Only the heartburn symptom correlated with laryngopharyngeal and esophageal reflux.
Congenital Dacryocystocele Associated With Intranasal Cysts: Diagnosis and Management
Authors: Shashy Ronald G. , Durairaj Vikram , Holmes Jonathan M. , Hohberger George G. , Thompson Dana M. , Kasperbauer Jan L. 
Published: November 2003

AbstractObjective To improve the diagnostic and therapeutic database for congenital dacryocystoceles.Study Design/Methods Retrospective case study of 10 patients with dacryocystoceles treated in an academic integrated tertiary care practice. Management and outcomes are compared to previous reports in the literature.Results Between the years 1990 and 2001, 10 patients were diagnosed with dacryocystoceles. Seven were females, and 3 were males. Age ranged from 1 to 75 days. Nine of 10 had a unilateral dacryocystocele, and 1 had bilateral dacryocystoceles. Epiphora was reported in 8 patients. Preoperatively, dacryocystitis, facial cellulitis, or both were present/developed in 2 patients. Symptoms of airway obstruction were present in 3 neonates. Surgery was performed in 9 of 10 patients and was a combined ophthalmology/otolaryngology surgery in 7 cases. Two patients were treated with probing only. Intranasal cysts were identified in all 7 patients who underwent a combined approach. Three of 7 patients had bilateral intranasal cysts. Follow‐up ranged from 9 months to 10 years (mean, 5 years). Complete resolution was observed in 9 patients. One patient had postoperative nasolacrimal duct obstruction 2 months postoperatively, presenting with mucopurulent drainage and cellulitis. The existing literature often suggests conservative management as a treatment option.Conclusion True dacryocystoceles are a relative rarity. The literature describes a variable natural course of these lesions with resultant controversy in their management. The current results demonstrate successful treatment in 6 of 7 patients with an early combined surgical approach and 2 of 2 patients treated by probing alone. The high failure rate with conservative management, reported in the literature, supports early surgical intervention.
Transnasal Endoscopic Closure of Cerebrospinal Fluid Leaks
Authors: Chin Gregory Y. , Rice Dale H. 
Published: November 2003

AbstractObjectives/Hypothesis To demonstrate an effective method for transnasal endoscopic closure of anterior skull base fistulas that does not involve lumbar drains or fat packing.Study Design Retrospective.Methods We reviewed the charts of 36 patients who had 37 anterior skull base defects that were repaired endoscopically between 1993 and 2001.Results Thirty‐three defects were successfully closed on the first attempt. Three were successfully closed on the second attempt. One large defect was repaired by neurosurgery after a failed endoscopic attempt. Our results are similar to those of other published series.Conclusion Our method is effective and does not require adjuvant procedures or prolonged hospital stays.
p53 and Cyclin D1 as Prognostic Factors in Squamous Cell Carcinoma of the Larynx
Authors: Vielba Raquel , Bilbao Juan , Ispizua Angel , Zabalza Iñaki , Alfaro Jesús , Rezola Ricardo , Moreno Enrique , Elorriaga Jon , Alonso Ibón , Baroja Antonio , de la Hoz Carmen 
Published: November 2003

AbstractObjectives/Hypothesis Proteins p53 and cyclin D1 play a crucial role in cell cycle control. Protein p53 mutations are one of the most common genetic alterations in human cancer, and cyclin D1 gene amplification has been found to be associated with poor prognosis in different types of tumors. Functional alterations of these proteins may play an important role both in the carcinogenesis of squamous carcinomas of the head and neck and in the clinical evolution of these tumors. The objective of the present study was to evaluate whether the presence of p53 and/or cyclin D1 proteins (detected by immunohistochemical analysis) could serve as relevant variables for the assessment of the prognosis of laryngeal squamous cell carcinoma.Study Design Retrospective multicentric study.Methods Paraffin‐embedded biopsy specimens from 62 human epidermoid laryngeal carcinomas were randomly selected. The expression of p53 and cyclin D1 was examined by means of immunohistochemical analysis with a view to evaluating whether there is a correlation between the aberrant expression of these proteins and disease prognosis.Results In the sample, the presence of immunohistochemically detectable p53 is associated with shorter survival and disease‐free intervals, as shown in Kaplan‐Meier survival curve analysis. Indeed, multivariate statistical analysis revealed that the accumulation of p53 is an independent prognostic factor, which is associated with shorter survival. This association was not evident in the case of cyclin D1.Conclusion A more precise prognosis of patients with laryngeal epidermoid carcinomas could be achieved by taking into account the presence of p53 (as assayed by immunohistochemical analysis) in biopsy tissue .
Salvage Frontal Sinus Surgery: The Endoscopic Modified Lothrop Procedure
Authors: Wormald Peter John 
Published: November 2003

AbstractObjectives/Hypothesis Until recent years, the osteoplastic flap with frontal sinus obliteration has been the gold standard for recalcitrant frontal sinusitis. The present series evaluated the role of the endoscopic modified Lothrop procedure, which has recently been advocated as an alternative.Study Design Prospective non‐randomized interventional case series.Methods The study prospectively assessed 83 consecutive patients who underwent endoscopic modified Lothrop procedure. The mean age was 52.4 years (SD = 13.6 y) with a male‐to‐female ratio of 3:1. Patients had a mean of six previous sinus surgical procedures with 17 patients having undergone previous frontal sinus obliteration with mucocele formation. Seventy‐six patients (91%) had frontal pain or headache as their primary presenting symptom, with 72 having nasal discharge. There were 14 patients who presented with 17 complications of frontal sinus disease. There were eight erosions of the posterior table of the frontal sinus with extension of the mucocele intracranially, seven orbital complications, and one cerebrospinal fluid leak. Twenty‐four patients (30%) had fungus cultured from their sinuses at the time of surgery.Results Six of the 83 patients (7%) developed frontal ostium stenosis resulting in a 93% primary success rate after an average follow‐up of 21.9 months (SD = 6.1 mo). These patients all underwent a revision modified Lothrop procedure and had a patent frontal ostium at their last review. Twenty‐one patients (25%) developed recurrent symptoms, which were managed medically. Of these 21 patients, 9 with previously diagnosed fungal sinusitis developed mucosal changes again in their frontal sinuses, but their ostia have remained patent. Four patients have had recurrent infections in the frontal sinuses, and three patients with aspirin‐sensitive asthma and polyps have developed polyps again in their frontal sinuses. Five patients continued to have frontal pain without radiological evidence of further frontal disease. No patients required an osteoplastic flap procedure.Conclusion The endoscopic Lothrop procedure is a successful short‐term management option for recalcitrant and complicated frontal sinusitis caused by a wide range of diseases.
Vestibular Neuronitis in Pilots: Follow‐up Results and Implications for Flight Safety
Authors: Shupak Avi , Nachum Zohar , Stern Yoram , Tal Dror , Gil Amnon , Gordon Carlos R. 
Published: November 2003

AbstractObjectives To report our experience over the past 12 years with the evaluation and follow‐up of pilots with vestibular neuronitis and to discuss points relevant to flight safety and the resumption of flying duties.Study Design A retrospective, consecutive case series.Methods Eighteen military pilots with vestibular neuronitis were examined and followed up. A complete otoneurological workup was performed, including both physical examination and laboratory evaluation. The latter included electro‐oculography (EOG) and a rotatory chair test using the smooth harmonic acceleration protocol.Results The mean patient age was 35 ± 6 years (range, 23 to 42 y), and the average follow‐up period was 20.5 ± 12.8 months (mean ± standard deviation [SD]; (range, 11 to 48 mo). Electro‐oculography caloric test on presentation documented significant unilateral hypofunction in all patients. Thirteen of the 18 patients (72%) had abnormal smooth harmonic acceleration test results. None of the pilots reported any symptoms on follow‐up. However, five (28%) had positive otoneurological examination findings, and eight (44%) still had significant caloric lateralization (>25%). The average caloric hypofunction was reduced from 67.8% ± 29.3% at onset to 40% ± 16% (mean ± SD, P <.05, paired t test). Seven of the patients (39%) had additional electro‐oculography findings beyond caloric hypofunction. These included spontaneous, positional, and positioning nystagmus. Smooth harmonic acceleration disease on follow‐up was documented in eight patients (44%), five of whom had canal paresis. Eleven patients (61%) demonstrated residual vestibular damage on follow‐up. In 6 of these 11 cases (55%), the laboratory evaluation revealed vestibular deficits otherwise undiagnosed by the bedside test battery.Conclusions The vestibular system plays a central role in orientation awareness and is often challenged by flying conditions. The finding that approximately 60% of pilots who have had vestibular neuronitis continue to show signs of vestibular malfunction, despite apparent clinical recovery, emphasizes the need for a complete vestibular evaluation, including specific bedside testing and laboratory examinations, before flying duties can be resumed.
Petrous Anatomy for Middle Fossa Approach
Authors: Sennaroglu Levent , Slattery William H. 
Published: November 2003

AbstractObjective The objective was to describe the relationship of anatomical landmarks required for the middle fossa approach to lesions of the petrous apex and internal auditory canal (IAC). Landmarks for safe identification of the IAC are defined, as are two zones (safe zones I and II) anterior and posterior to the IAC.Study Design Temporal bone anatomical study.Methods Ten temporal bones underwent high‐resolution computed tomography followed by wet bench dissection. A set of 39 different distances between vital structures was measured, where possible, from both radiology films and under the microscope. Mean, median, minimum, and maximum measurements of all distances were determined. Angular measurements were made using a specially designed instrument.Results Measurements were made in an anatomical position to mimic the middle fossa surgical technique. Measurements are presented for the superior surface of the temporal bone from the sigmoid sinus and inner table to vital structures, from the anterior and posterior petrous apex, and from the IAC.Conclusions Petrous apex anatomical knowledge is required for the safe middle fossa approach to the IAC and petrous apex. Two safe zones are defined that should prevent damage to the cochlea and the superior semicircular canal.
Mesenchymal Chondrosarcoma of the Sinonasal Tract: A Clinicopathological Study of 13 Cases With a Review of the Literature
Authors: Knott P. Daniel , Gannon Francis H. , Thompson Lester D. R. 
Published: November 2003

AbstractObjectives/Hypothesis Mesenchymal chondrosarcoma of the sinonasal tract is a rare, malignant tumor of extraskeletal origin. Isolated cases have been reported in the English literature, with no large series evaluating the clinicopathological aspects of these tumors.Study Design Retrospective review.Methods Thirteen patients with sinonasal mesenchymal chondrosarcoma were retrieved from the Otorhinolaryngologic—Head and Neck Registry of the Armed Forces Institute of Pathology.Results Nine women and 4 men (age range, 11 to 83 y; mean age, 38.8 y) presented with nasal obstruction (n = 8), epistaxis (n = 7), or mass effect (n = 4), or a combination of these. No patients reported prior head and neck irradiation. The maxillary sinus was the most common site of involvement (n = 9), followed by the ethmoid sinuses (n = 7) and the nasal cavity (n = 5). Tumors had an overall mean size of 5.1 cm. Microscopically, the tumors displayed a small, blue, round cell morphology appearance arranged in a hemangiopericytoma‐like pattern with foci of cartilaginous matrix. All cases were managed by surgery with adjuvant radiation therapy (n = 4) and/or chemotherapy (n = 3). The overall mean survival was 12.1 years, although five of six patients who developed local recurrences died of disease (mean survival, 6.5 y). Six patients were alive and disease free (mean survival, 17.3 y), and two patients were lost to follow‐up.Conclusions Mesenchymal chondrosarcoma of the sinonasal tract is an aggressive tumor with a predilection for young women. The pattern of growth and scarcity of cartilaginous matrix result in frequent misdiagnosis. Recurrence develops in approximately one‐third of patients and seems to predict a poor prognosis. Aggressive, exenterative surgery combined with adjuvant therapy appears to yield the best clinical outcome.
Proximity of Carotid Canal Wall to Tympanic Membrane: A Human Temporal Bone Study
Authors: Hasebe Seishi , Sando Isamu , Orita Yorihisa 
Published: November 2003

AbstractObjective The objective was to examine the possible risk of injury to the internal carotid artery during procedures in the middle ear, including myringotomy.Study Design Histopathological morphometric study of human temporal bones.Methods One hundred forty‐two human temporal bone specimens obtained from 92 individuals without any known ear disease were prepared for light microscopic study. Using 83 bones that were available for measurement, the thickness of the carotid canal wall (CCW), which is the medial wall of the bony portion of the eustachian tube, was measured. Using 15 bones selected for three‐dimensional measurement, the closest distance from CCW to the anterior tympanic annulus was measured. Using all 142 temporal bone specimens, the CCW was examined to detect the presence of partial dehiscence. In one case, the images of CCW dehiscence and its surrounding structures were reconstructed by a personal computer.Results The thickness of the CCW was 0.00 to 0.73 mm (average thickness, 0.24 mm [±0.12 mm]). The distance from the CCW to the anterior tympanic annulus was 1.8 to 8.1 mm (average distance, 4.9 [±1.7 mm]). Dehiscence of CCW was observed in 7 (4.9%) of 142 temporal bone specimens. The reconstructed image showed that the posterior half of the dehiscence of CCW could be seen from the external ear canal.Conclusions The CCW was found to be extremely thin or even dehiscent in some cases, rendering the internal carotid artery vulnerable during transtympanic procedures. The study's findings emphasized the need for judicious care when operating in the anterior mesotympanum.