bluuebunny/crossref_metadata_2025_split huggingface dataset:
Studies in the Quality of Life of Head and Neck Cancer Patients: Results of a Two‐Year Longitudinal Study and a Comparative Cross‐Sectional Cross‐Cultural Survey
Authors: Morton Randall P. 
Published: November 2003

AbstractObjectives To examine quality‐of‐life (QL) changes that occur over time among patients treated for head and neck cancer and to compare QL outcomes in two geographically separate and culturally distinct populations.Study Design A prospective, observational longitudinal study was made of QL changes over time in head and neck cancer patients, and a matched‐pairs cross‐sectional study was conducted for comparison of QL outcomes between groups of head and neck cancer patients from two different sociocultural environments.Methods Patients attending a tertiary head and neck cancer center in Auckland, New Zealand, were interviewed using a validated questionnaire before treatment and at 3, 12, and 24 months after treatment. Changes over time were assessed according to gender, site and stage of primary tumor, and type of treatment received. A second group of patients from Toronto, Ontario, Canada, were matched to the first group for age, gender, site and stage of tumor, and time since treatment and interviewed using the same questionnaire. The group comparison was followed by a matched‐pairs analysis for the 12‐month follow‐up interval.Results In the longitudinal study, combined modality treatment resulted in greater physical and somatic dysfunction than single modality treatment. Patients learned to cope well with dysfunction and disability and with adjusting their lifestyle so that overall QL was not related to treatment received. Even so, pain scores and measures of psychological distress were related to overall QL. Otherwise there was no consistent correlation between specific symptoms and QL. An illustration of patients' adaptation to dysfunction was evident in scores for perceived difficulty swallowing, which decrease despite the ongoing need for a soft or liquid diet. In the comparative study, significantly different global QL scores were evident in the two clinical groups studied, despite similar social, somatic, and physical functioning. There was also a significant but inconstant difference in emotional functioning. Although the clinical groups received significantly different treatment regimens, the observed differences in global QL were independent of treatment received.Conclusions Patients with head and neck cancer generally managed well despite disability and dysfunction after treatment. Patients' expectations, emotional responses, and desired outcomes seemed to be determined by sociocultural factors, causing different patient groups to view their overall QL outcome somewhat differently.
Volume Analysis of Preadipocyte Injection for Vocal Cord Medialization
Authors: Glatz Frank R. , Kalkanis James , Neumeister Michael , Suchy Hans , Lyons Sharon , Mowlawi Arian 
Published: November 2003

AbstractObjective To compare the volume retention of injected preadipocytes with that of standard fat injection in a paralyzed rabbit true vocal cord.Study Design Prospective analysis with blinded data collection.Methods Thirteen New Zealand white rabbits were divided into two groups. Group 1 consisted of seven animals undergoing left‐side vocal cord paralysis by resection of a 1‐cm segment of the left‐side recurrent laryngeal nerve and abdominal fat harvest for isolation of preadipocytes. Preadipocytes were cultured under sterile conditions in cell culture media. Animals in group 2 also underwent left‐side vocal cord paralysis without fat harvest. After 10 to 14 days, in a second procedure, group 1 underwent injection of 0.1 mL cultured autologous preadipocytes, and group 2 underwent routine injection of 0.1 mL abdominal fat harvested during the same procedure. At 6 and 12 months, volumetric analysis was performed.Results Volume analysis at 6 months showed a mean volume of 0.029 mL retained fat in group 2 representing a retention of approximately 29% (SD = 0.023) of the original injected volume. Retention in group 1 animals approximated 0.002 mL (SD = 0.0024) or 2% of the injected volume. Analysis at 12 months showed a mean volume of 0.008 mL (SD = 0.0078) in group 2 and of 0.002 mL (SD = 0.0015) in group 1. Group 2 showed significantly higher volumes of the injected fat at 6 and 12 months (P <.033).Conclusion Volumes obtained with standard fat injection were superior to those obtained with preadipocyte injection at both 6 and 12 months.
Surgical Robotic Applications in Otolaryngology
Authors: Haus Brian M. , Kambham Neeraja , Le David , Moll Frederic M. , Gourin Christine , Terris David J. 
Published: November 2003

AbstractObjectives To explore the feasibility of performing endo‐robotic neck surgery in a porcine model and to compare the results of robotically enhanced endoscopic surgery with those from a conventional endoscopic technique.Study Design Prospective, nonrandomized experimental investigation in a porcine model.Methods We performed a consecutive series of endoscopic neck surgeries using the daVinci surgical system (Intuitive Surgical Inc.). The length of time required to establish the operative pocket and to assemble the robotic components, as well as the total duration of each operation, was recorded. The animals were continuously monitored for heart rate, blood pressure, and end‐tidal CO2 pressure, and evaluation for presence of pneumothorax and subcutaneous emphysema was undertaken postoperatively. The specimens were examined histologically.Results Four different types of neck surgery were successfully performed on both sides of the neck of four animals using the daVinci surgical system. Creation of the operative pocket took, on average (±SD), 18.1 ± 11.9 minutes, and assembly of the robot required 12.5 ± 9.9 minutes, resulting in a mean preparation time for all procedures of 30.6 ± 21.0 minutes. The mean operative time for submandibular resection (n = 3) was 19.0 ± 6.6 minutes, with a total procedure time of 39.0 ± 10.2 minutes. Selective neck dissections (n = 3) required a mean operative time of 66.0 ± 18.5 minutes and a total procedure time of 85.7 ± 16.7 minutes. One partial parotidectomy and one thymectomy were also performed. The median estimated blood loss was 0 mL (range, 0–10 mL). The end‐tidal CO2 pressure fell from the start to the end of the procedures by a mean of 4.4 ± 7.9 mm Hg. The blood pressure fell by a mean of 1.9 ± 7.5 mm Hg. There was one case of modest subcutaneous emphysema, and there were no cases of pneumothorax or air embolism. No conversions to open resection were necessary.Conclusions Robotically enhanced endoscopic surgery in the neck is feasible and offers a number of compelling advantages over conventional endoscopic neck surgery. Clinical trials will be necessary to determine whether these advantages can be achieved in clinical practice.
Reanimation of the Paralyzed Human Larynx With an Implantable Electrical Stimulation Device
Authors: Zealear David L. , Billante Cheryl R. , Courey Mark S. , Netterville James L. , Paniello Randal C. , Sanders Ira , Herzon Garrett D. , Goding George S. , Mann Wolf , Ejnell Hasse , Habets Alfons M. M. C. , Testerman Roy , Van de Heyning Paul 
Published: November 2003

AbstractObjectives/Hypothesis Electrical stimulation of the posterior cricoarytenoid muscle, when paced with inspiration, offers a physiological approach to restore ventilation in bilateral laryngeal paralysis without any of the disadvantages associated with conventional treatment.Study Design A prospective study of six patients.Methods The patients were successfully implanted with an Itrel II stimulator (Medtronic, Inc). In postoperative sessions, stimulated vocal fold abduction, patient ventilation, and voice were assessed and compared with preoperative values.Results The optimum stimulus paradigm was a 1‐ to 2‐second train of 1‐millisecond pulses delivered at a frequency of 30 to 40 Hz and amplitude of 2 to 7 V. Posterior cricoarytenoid stimulation produced a large dynamic abduction (3.5–7 mm) in three patients and moderate abduction (3 mm) in a fourth patient. The fifth patient showed a large but delayed response of 4 mm to stimulation with some lateralization of the vocal fold. In the sixth patient, stimulated abduction was noted on device implantation but was lost postoperatively. All five patients with stimulated abduction postoperatively met the ventilatory criteria for decannulation, and three patients subsequently had decannulation. Long‐term stimulation of the posterior cricoarytenoid muscle had no appreciable effect on voice quality.Conclusions Electrical stimulation of the posterior cricoarytenoid muscle shows potential as an improved therapy for bilateral vocal fold paralysis.
Laser‐Assisted Uvulopalatoplasty and Tonsillectomy for the Management of Obstructive Sleep Apnea Syndrome
Authors: Kern Robert C. , Kutler David I. , Reid Kathryn J. , Conley David B. , Herzon Garrett D. , Zee Phyllis 
Published: November 2003

AbstractObjectives/Hypothesis Laser‐assisted uvulopalatoplasty (LAUP) is a widely accepted procedure for the management of snoring, but its role in the treatment of obstructive sleep apnea syndrome is currently unclear. The objective of the study was to evaluate the role of LAUP in treating moderate and severe obstructive sleep apnea syndrome.Study Design Retrospective review of a surgical treatment protocol for obstructive sleep apnea syndrome.Methods Between October 1993 and January 1999, 80 patients with moderate or severe obstructive sleep apnea syndrome and a significant component of retropalatal obstruction were treated with surgery at the Department of Otolaryngology at Northwestern University Medical School (Chicago, IL). Surgery consisted of LAUP with tonsillectomy (if tonsils were present) with the patient under general anesthesia or LAUP alone with local anesthesia (if the tonsils were absent). No patients received traditional uvulopalatopharyngoplasty. Sixty‐four of the 80 patients underwent both preoperative and postoperative polysomnograms. Surgical “response” was defined as a 50% decrease in the apnea‐hypopnea index (AHI) (the total number of apneic and hypopneic events per hour of sleep); surgical “cure” was defined as a 50% decrease in AHI and a final AHI of less than 20.Results The surgical response rate was 59% (38 of 64 patients), and the surgical cure rate was 39% (25 of 64 patients). Twelve patients (18.8%) had a higher AHI after surgery. The AHI (mean ± SD) changed significantly from 51.4 ± 30.9 preoperatively to 26.3 ± 20.8 on postoperative polysomnogram (P = 7.0 × 10−9). Laser‐assisted uvulopalatoplasty alone was performed in 33 patients with a response rate of 61% and a cure rate of 42%. Laser‐assisted uvulopalatoplasty with tonsillectomy was performed in 31 patients with a response rate of 58% and a cure rate of 35%. The overall incidence of nasopharyngeal insufficiency was 0%.Conclusion The results of the study suggested that LAUP with adjunctive tonsillectomy is an effective treatment for patients with obstructive sleep apnea syndrome and retropalatal obstruction with a lower complication rate than standard surgical therapy (uvulopalatopharyngoplasty).
The Epidemiology of Chronic Rhinosinusitis in Canadians
Authors: Chen Yue , Dales Robert , Lin Mei 
Published: November 2003

AbstractObjective To study the prevalence of chronic rhinosinusitis and its risk factors among Canadians.Study Design Complex survey design incorporating stratification, multiple stages of selection, and unequal probabilities of selection of respondents.Methods We used the cross‐sectional data from 73,364 subjects (34,241 male and 39,123 female subjects) 12 years of age or older who participated in the second cycle of the National Population Health Survey, which was conducted from 1996 to 1997. All these individuals were asked whether they had certain chronic health conditions that had lasted or were expected to last 6 months or longer, including rhinosinusitis.Results The prevalence of rhinosinusitis was higher in female (5.7%) than in male (3.4%) subjects. The sex difference was consistent across age groups. The prevalence increased with age and leveled off after the age of 60 years. In female but not in male subjects, the prevalence was slightly higher among those living the eastern region or among native Canadians as compared with those living in the central or western regions or immigrants. Cigarette smoking and low income were associated with a higher prevalence of rhinosinusitis in both sexes. The smoking effect was modified by allergy history in male subjects. Rhinosinusitis was more common among subjects with allergy history, asthma, or chronic obstructive pulmonary disease. The prevalence of rhinosinusitis was similar in subjects with or without reporting regular alcohol drinking and exercise.Conclusion Previous data indicating an increased susceptibility of women to asthma and chronic obstructive pulmonary disease, together with the similar finding for rhinosinusitis, suggest that women have a general increase in susceptibility to respiratory tract disease.
The Expression of Proto‐Oncogene eIF4E in Laryngeal Squamous Cell Carcinoma
Authors: Liang Zhou , Lei Tao , LuYing Zheng , YuPing Gao 
Published: November 2003

AbstractObjectives/Hypothesis The translation initiation factor eukaryotic initiation factor 4E (eIF4E) binds to the cap of messenger RNA in the first step of messenger RNA recruitment. Overexpression of eIF4E results in the upregulation of specific angiogenic factor basic fibroblast growth factor (bFGF). The study aims to demonstrate that the overexpression of eIF4E could facilitate recognizing initiation start sites for the translation of bFGF and play an important role in the tumorigenesis of laryngeal squamous cell carcinoma.Study Design Retrospective.Methods Paraffin‐embedded sections of 37 samples of laryngeal squamous cell carcinoma, 10 samples of vocal cords polyps, and 20 fresh samples of laryngeal squamous cell carcinoma were analyzed using immunohistochemical streptavidin peroxidase technique, Western blot analysis, and reverse transcriptase–polymerase chain reaction.Results The overexpression of eIF4E was observed in all 37 paraffin‐embedded samples of laryngeal squamous cell carcinoma, whereas no staining was noticed in vocal cords polyps samples. There were significant correlations between the overexpression of protein eIF4E and TN stages, histological grades, local recurrence, and the states of metastasis (P <.01). Moreover, the overexpressions of both bFGF protein and bFGF messenger RNA correlated with the histological grades and the states of metastasis (P <.01), but the overexpression of eIF4E and bFGF did not correlate with age, sex, and tumor sites (P >.05).Conclusions Eukaryotic initiation factor 4E can enhance the expression of bFGF at translation level. The eIF4E and bFGF collaborate in tumorigenesis, development, invasion, and metastasis of laryngeal squamous cell carcinoma, in view of which the former can be considered as a tumor molecular marker and an independent prognostic molecular marker of laryngeal squamous cell carcinoma.
Analysis of Treatment Results for Base of Tongue Cancer
Authors: Sessions Donald G. , Lenox Jason , Spector Gershon J. , Chao Clifford , Chaudry Omer Ahmad 
Published: November 2003

AbstractObjective The study reported the results of treatment for base of tongue cancer with five different treatment modalities with long‐term follow‐up.Study Design This was a retrospective study of 262 patients with base of tongue cancer treated in the Departments of Otolaryngology—Head and Neck Surgery and Radiation Therapy at Washington University School of Medicine (St. Louis, MO) from July 1955 to January 1998.Methods The study population included previously untreated patients with biopsy‐proven squamous cell carcinoma of the base of tongue who were treated with curative intent by one of five modalities and were all eligible for 5‐year follow‐up. The treatment modalities included local resection alone, composite resection alone, radiation therapy alone, local resection with radiation therapy, and composite resection with radiation therapy. Multiple diagnostic, treatment, and follow‐up parameters were studied using standard statistical analysis to determine statistical significance.Results The overall 5‐year disease‐specific survival (DSS) was 49.6% with death due to tumor in 50.4%. The 5‐year cumulative disease‐specific survival probability (CDSS) was 0.526 (Kaplan‐Meier) with a mean of 7.8 years and a median of 5.6 years. Patients with early disease had significantly improved DSS compared with patients with more advanced disease (stages I and II; TN stages T1N0, T2N0, and T2N1; and T stages T1 and T2.). Patients with N0 had better DSS than patients with positive lymph nodes (P = .010). The DSS for all stages by treatment modality included local resection (70.0%), composite resection (47.6%), radiation therapy (40.4%), local resection and radiation therapy (50.0%), and composite resection with radiation therapy (51.5%). Overall and within the stages there was no significant difference in either DSS or CDSS by treatment modality. Local–regional recurrence occurred in 26% of patients, and overall salvage was 10.5%. Patients with clear resection margins did better than patients with close or involved margins (DSS and CDSS). Patients treated with radiation therapy alone had improved capacity to swallow (P = .001), speak (P = .01), and work (P = .001) compared with patients treated with the other modalities.Conclusions Cancer of the base of tongue is a lethal disease, and its treatment results in significant disability. No treatment produced a significantly improved survival advantage. Focus on improving local–regional control might improve overall survival. All treatment modalities were associated with major treatment‐related complications. Radiation alone produced significantly improved post‐treatment function and quality of life compared with the other modalities. Because of the recurrence rates at the primary and neck sites and the high rates of development of distant metastasis and second primary cancers, patients should be monitored for a minimum of at least 4 years.
Facial Nerve Paralysis Following Cochlear Implant Surgery
Authors: Fayad Jose N. , Wanna Georges B. , Micheletto Jennifer N. , Parisier Simon C. 
Published: November 2003

AbstractObjectives Facial nerve paralysis is a rare but devastating complication of cochlear implant surgery. The aims of the study were to define the incidence of facial nerve paralysis in our series and understand possible mechanisms of injury.Study Design Retrospective chart review and case reports.Methods Charts were reviewed of all 705 patients implanted between 1980 and 2002 at the authors' institutions to identify those with postoperative facial nerve weakness and determine incidence. For patients with facial nerve weakness, onset, degree, and timing of paralysis were noted; clinical findings were correlated to operative report findings. The method of treatment was noted, and the final facial nerve function outcome was recorded.Results Five patients (one child and four adults) were found to have postoperative facial nerve weakness, for an incidence of 0.71%. This complication was delayed in all cases, ranging from 18 hours to 19 days postoperatively. All patients were treated with steroids or steroids combined with antiviral medication, and all ultimately recovered normal facial function.Conclusions In the study series, the incidence of facial nerve paralysis following cochlear implant surgery was 0.71%. Possible mechanisms of injury included heating injury and viral reactivation. All patients presented with a delayed facial nerve paralysis and did recover normal facial nerve function.
Embolic Inner Ear Decompression Illness: Correlation With a Right‐to‐Left Shunt
Authors: Klingmann Christoph , Benton Peter John , Ringleb Peter Arthur , Knauth Michael 
Published: November 2003

AbstractObjectives/Hypothesis Inner ear decompression illness is thought to be a rare phenomenon in recreational divers, isolated signs and symptoms of inner ear dysfunction usually being attributed to inner ear barotrauma.Study Design We present 11 cases of inner ear dysfunction in nine divers with inner ear decompression illness.Results All nine divers had significant right‐to‐left shunt as diagnosed by transcranimal Doppler sonography.Conclusions The authors thought that mechanism of causation in these cases may have been intravascular bubble emboli and that inner ear decompression illness may be more common among recreational divers than currently recognized. Failure to treat inner ear decompression illness with recompression therapy can result in permanent disability. Because the differential diagnosis between inner ear barotrauma and inner ear decompression illness can be impossible, the authors suggested that divers who present with inner ear symptoms following a dive should have recompression immediately after having undergone bilateral paracentesis.
Temporal Bone Histopathological and Quantitative Analysis of Mitochondrial DNA in MELAS
Authors: Takahashi Katsumasa , Merchant Saumil N. , Miyazawa Tetsuo , Yamaguchi Toshikazu , McKenna Michael J. , Kouda Hiroko , Iino Yukiko , Someya Tsutomu , Tamagawa Yuya , Takiyama Yoshihisa , Nakano Imaharu , Saito Ken , Boyer Philip , Kitamura Ken 
Published: November 2003

AbstractObjectives/Hypothesis Although hearing loss is common in MELAS (syndrome of mitochondrial encephalopathy, lactic acidosis and stroke‐like episodes), the histopathology of the temporal bone has not been reported. The majority of cases of MELAS are linked to a mitochondrial DNA (mtDNA) mutation at nucleotide 3243. In MELAS, normal mtDNA and mutant mtDNA coexist in a heteroplasmic manner. The purpose of the study was to report the otopathological findings from two patients with MELAS and quantitative mtDNA analysis in the inner ear of one of these patients.Study Design Basic scientific histopathological examination and quantitative mtDNA analysis of the temporal bone.Methods Temporal bones were embedded in celloidin and sectioned for light microscopic study. Graphic reconstruction of the cochlea was performed using the method described by Schuknecht. For quantitative mtDNA analysis, total DNA from the membranous part of the inner ear was collected, amplified by polymerase chain reaction, and digested with the restriction enzyme. The percentage of mutant/total mtDNA was measured by the ratio of fluorescence intensity.Results Histopathological examination revealed severe degeneration of the stria vascularis and degenerative change of spiral ganglion cells in both patients. The quantitative DNA studies showed that the proportion of mutant to wild‐type mtDNA was similar in both histologically affected and histologically unaffected tissues within the inner ear.Conclusion Dysfunction of the stria vascularis and spiral ganglion cells causes sensorineural hearing loss in MELAS.