bluuebunny/crossref_metadata_2025_split huggingface dataset:
Otoacoustic Emissions and Tympanometry Screening Among 0–5 Year Olds
Authors: Ho Vu , Daly Kathleen A. , Hunter Lisa L. , Davey Cynthia 
Published: November 2003

AbstractObjectives To determine the rate of otitis media (OM)‐associated transient evoked otoacoustic emissions (TEOAE) screening failure in a sample of preschool children, to evaluate concordance between TEOAE and tympanometry, to investigate risk factors for TEOAE failure, and to determine agreement between TEOAE failure and physician findings at referral.Study Design Cross‐sectional.Methods Children from birth to 5 years underwent screening by TEOAE and tympanometry, and those with one or more abnormal test result(s) were referred to their physician for further evaluation. Univariate associations between risk factors and TEOAE failure were determined using chi‐square analysis. Multiple logistic regression analysis was done to examine the relationship between specific risk factors and TEOAE failure.Results A total of 664 children aged 2 weeks to 71 months were screened between September 1997 and May 1999. TEOAE and tympanometry failure was found in 25% and 35% of all subjects, respectively. The overall prevalence of OM‐associated hearing loss was 20%. Agreement between tympanometry and TEOAE was better for the youngest (<6 mo) and oldest ⩾36 mo) age groups. Of those who failed TEOAE, a physician saw 81% within 3 months, and 80% of these had a diagnosis consistent with hearing loss but only 18% had audiometric testing. Sibling history of OM was the only significant predictor for TEOAE failure.Conclusions TEOAE screening failure was highly consistent with physician diagnosis at follow‐up. Failure of TEOAE in a screening program should be followed with diagnostic audiology testing to determine whether conductive or sensorineural hearing loss is present.
Increased Vulnerability of Auditory System to Noise Exposure in mdx Mice
Authors: Chen Tsan‐Ju , Chen Shun‐Sheng , Wang Dean‐Chuan , Hsieh Yueh‐Ling 
Published: November 2003

AbstractObjectives Dystrophin is a cytoskeletal protein mainly found just beneath the sarcolemma. Lack of dystrophin is known to be the cause of Duchenne muscular dystrophy (DMD). Other tissues, including the brain, retina, and cochlear hair cells, also express dystrophin. Recently, a gene (Xp21.2) associated with sensorineural hearing impairment has been mapped within the localization site for dystrophin in two families. Thus, it is reasonable to assume that dystrophin may play a role in auditory function. However, animal studies have produced conflicting results.Study Design An attempt was made to clarify the differences between the auditory systems of dystrophin‐deficient mdx mice and control B‐10 mice by exposure to noise.Methods In the present study, mdx mice and B‐10 mice were used. Animals were exposed daily to noise for 1 month, and their auditory functions were evaluated by recording the brainstem auditory evoked potentials (BAEPs).Results Before noise exposure, the mdx mouse demonstrated normal BAEP threshold when compared with the B‐10 mouse. After 1 month of noise exposure, the B‐10 mouse showed no apparent change in hearing threshold and BAEP latencies. In contrast, significantly increased hearing threshold and prolonged BAEP peak and interpeak latencies were observed in the mdx mouse after noise exposure.Conclusions These results indicate that the mdx mice are more vulnerable to noise damage. This involves not only the peripheral auditory system, but also the brainstem central auditory pathway. Therefore, a significant role for dystrophin in the auditory system, especially under noise stress, is suggested.
Application of Unbiased Stereology on Archival Human Temporal Bone
Authors: Tang Yong , Lopez Ivan , Ishiyama Akira 
Published: November 2003

AbstractObjective The current report presents unbiased stereological sampling and counting strategies for estimating the total number of neurons in the spiral and vestibular ganglia of the archival human temporal bone.Study Design Application of unbiased stereology using archival human temporal specimens. Observational study.Methods The practical sampling and counting strategies for estimating the number of neurons are presented. To illustrate the method described, the total number of neurons in spiral and vestibular ganglia from archival human temporal bone was estimated.Results The study found, on average, 41,643 (coefficient of variation = 0.12) spiral ganglion neurons in the subjects with an average age of 35.6 years (age range, 22–60 y) and, on average, 27,635 (coefficient of variation = 0.10) vestibular ganglion neurons in the subjects with an average age of 28.6 years (age range, 2–58 y).Conclusions The total number of primary auditory and vestibular ganglion neurons from the current study differs significantly from the previously published data using assumption‐based methods. The unbiased stereological technique presented in the current report thus would be invaluable for future studies on such specimens, including the study of the changes of neurons during aging and various pathological conditions.
Digital Image Processing of Laryngeal Lesions by Electronic Videoendoscopy
Authors: Kawaida Masahiro , Fukuda Hiroyuki , Kohno Naoyuki 
Published: November 2003

AbstractObjectives To present electronic videoendoscopy of the larynx with digital image processing and to discuss this endoscopic technique from the standpoint of diagnostic usefulness of laryngeal lesions.Study Design Electronic videoendoscopic evaluation of laryngeal lesions with digital image processing.Methods Seventy patients underwent electronic videoendoscopy without digital image processing and, subsequently, with the digital image processing function. Of these, 15 patients with white lesion of the vocal fold and laryngeal neoplasms were assessed in the study. Clinical assessments made before enhancement of digital image processing function were compared with those after enhancement in 15 patients.Results Of the 15 patients observed, the clinical diagnoses of two patients were changed after enhancement. Both patients underwent endolaryngeal microsurgery with histopathological examination of the removed lesions, which confirmed the definitive diagnosis. The clinical diagnoses of both patients after enhancement were compatible with histopathological diagnoses.Conclusions The enhanced color images provided by this system are superior in both quality and resolution to those obtained by conventional flexible fiberoptic endoscopy with a video camera. This system should be a valuable tool for the diagnosis of laryngeal lesions.
Nasal Mucociliary Transport: New Evidence for a Key Role of Ciliary Beat Frequency
Authors: Boek Wilbert M. , Graamans Kees , Natzijl Hanny , van Rijk Peter P. , Huizing Egbert H. 
Published: November 2003

AbstractObjectives/Hypothesis Mucociliary transport is an important defense mechanism of the respiratory tract. Nonetheless, the factors determining mucociliary transport are only partially understood. Ciliary beat frequency is assumed to be one of the main parameters, although the experimental evidence remains inconclusive.Study Design Comparing influences on mucociliary transport to influences on ciliary beat frequency.Methods The present study measures the effects on mucociliary transport of two ciliary beat frequency‐inhibiting compounds (0.1% xylometazoline and 0.9% NaCl) and a ciliary beat frequency enhancer (0.1% salbutamol). The measurements were performed by a technetium‐99m nebulizing scintigraphic method. The experiments were carried out in 15 healthy young volunteers.Results The 0.1% xylometazoline appeared to slow ciliary transport, although the decrease was not significant (P = .44). The 0.9% NaCl did reduce mucociliary transport significantly (P = .033). The 0.1% salbutamol resulted in a highly significant increase of mucociliary transport (P = .009). Xylometazoline brings about drastic changes in the nasal cavity, both anatomically and physiologically. Any comparison of mucociliary transport before and after using this vasoconstrictive agent must take this effect into account.Conclusions The present study demonstrates a significant similarity in the effects of NaCl and salbutamol on ciliary beat frequency in vitro and on mucociliary transport in vivo. The evidence from our experiments suggests that ciliary beat frequency is a determining factor in the mucociliary transport rate in the nose.
Alar Batten Grafting for Management of the Collapsed Nasal Valve
Authors: Millman Brad 
Published: November 2003

AbstractObjective The purpose of the study is to describe a commonly overlooked etiology of nasal airway obstruction. Collapse of the nasal valve can be corrected with precise placement of cartilage grafts. This study demonstrates the surgical technique, rarely described in the literature, of placing a contoured cartilage graft in the nasal valve region for the improvement of the nasal airway.Study Design Retrospective review of surgical results of the 21 patients who underwent alar batten grafting performed over a 3‐year period at the Geisinger Medical Center (Danville, PA).Methods A retrospective review was conducted of 21 patients surgically treated with alar batten grafts for nasal valvular collapse between the 1997 and 1999. The surgical technique is described, and our results are analyzed including for both functional and aesthetic outcome.Results All patients treated with alar batten grafting at the nasal valve improved with regard to their airway obstruction. There were no complications, and there was only minor aesthetic fullness in six cases.Conclusions Alar batten cartilage grafting is an easy, highly effective therapeutic measure in the treatment of nasal valve collapse. The surgical technique is demonstrated.
Analysis of Treatment Results for Oral Tongue Cancer
Authors: Sessions Donald G. , Spector Gershon J. , Lenox Jason , Haughey Bruce , Chao Clifford , Marks James 
Published: November 2003

AbstractObjective The study reports the results of treatment of oral tongue cancer with five different treatment modalities with long‐term follow‐up.Study Design Retrospective study of 332 patients with oral 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 1957 to 1996.Methods Patients with biopsy‐proven squamous cell carcinoma of the oral tongue who were previously untreated and were treated with curative intent by one of five modalities and who were eligible for 5‐year follow‐up were included. The treatment modalities included local resection alone, composite resection alone (with neck dissection), 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 rate (DSS) was 57% with death due to tumor in 43%. The 5‐year cumulative disease‐specific survival probability (CDSS) was 0.61 (Kaplan‐Meier) with a mean of 17.5 years and a median of 30.1 years. The DSS by treatment modality included local resection (73%), composite resection (61%), radiation therapy (46%), local resection and radiation therapy (65%), and composite resection with radiation therapy (CR/RT) (44%). Overall, local resection had a significantly improved DSS and CR/RT had a decreased DSS that was related to the stage of disease being treated. In treating stage IV disease, CR/RT produced a more significantly improved CDSS than the other treatment modalities. Recurrence at the primary site was as common as recurrence in the neck. Eighty‐nine percent of recurrences occurred within the first 60 months. Recurrence significantly decreased survival. DSS was significantly improved in patients with clear margins of resection. Metastasis to a distant site occurred in 9.6% of patients. Twenty‐one percent of patients had second primary cancers, and 54% of these patients died of their second primary cancer.Conclusions Significant improvement in DSS was seen in patients with clear margins, early stage grouping and clinical (pretreatment) tumor stage, and negative nodes. Significant decrease in DSS was seen in patients with close or involved margins, advanced stage grouping and clinical (pretreatment) tumor staging, positive clinical (pretreatment) node staging, and tumor recurrence. Obtaining clear margins of resection is crucial because it significantly affects survival. A minimum of 5 years of close monitoring is recommended because of the high incidence of second primary cancers.
Expression of Bcl‐2 Family Proteins in Advanced Laryngeal Squamous Cell Carcinoma: Correlation With Response to Chemotherapy and Organ Preservation
Authors: Trask Douglas K. , Wolf Gregory T. , Bradford Carol R. , Fisher Susan G. , Devaney Kenneth , Johnson Mark , Singleton Timothy , Wicha Max 
Published: November 2003

AbstractObjectives/Hypothesis Induction chemotherapy and definitive radiation therapy in advanced laryngeal cancer has been shown to achieve survival rates that are similar to total laryngectomy and postoperative radiation therapy. In patients with advanced laryngeal cancer, quality of life can be significantly enhanced by treatment regimens that preserve the larynx. However, which patients will respond best to organ preservation protocols remains unknown. The Bcl‐2 family proteins are involved in control of apoptosis and, potentially, tumor response to chemotherapy.Study Design Retrospective analysis of immunohistochemical tumor characteristics and clinical outcome.Methods To determine whether Bcl‐2 family proteins were predictive of successful organ preservation, immunohistochemical analysis of tissue specimens from 47 patients with advanced laryngeal cancer from the U.S. Department of Veterans Affairs Cooperative Study Program (VA CSP‐268) were evaluated for the expression of Bcl‐2, Bcl‐XL, and Bax protein expression. Tumor response was classified as either complete or partial/nonresponse after induction chemotherapy. Protein expression was correlated with tumor response, organ preservation, and overall patient survival.Results The Bcl‐2 protein was expressed at high levels in only 15% of specimens, but five of seven tumors with high Bcl‐2 showed complete response (P = .10). The majority of tumors expressed high levels of Bcl‐XL (74%). Reduced expression of Bcl‐XL was associated with a complete response (P = .143) and with larynx preservation (P =.06). Most patients (81%) had increased levels of Bax expression. Reduced expression of Bax was associated with a complete response rate (P = .074), but there was no correlation between Bax expression and larynx preservation.Conclusions The findings indicate that laryngeal cancer cells typically produce high levels of only one of the apoptosis protective proteins, Bcl‐2 or Bcl‐XL. Prospective studies of larger numbers of patients are under way to determine whether Bcl‐XL expression will be a useful marker predicting larynx preservation.
Ventilation Time of the Middle Ear in Otitis Media With Effusion (OME) After CO2 Laser Myringotomy
Authors: Sedlmaier Benedikt , Jivanjee Antonio , Gutzler Rico , Huscher Dörte , Jovanovic Sergije 
Published: November 2003

AbstractObjective The aim of this study was to investigate the transtympanic ventilation time, the healing course of the tympanic membrane, the early and late complications, and the recurrence rate of otitis media with effusion (OME) within 6 months after CO2 laser myringotomy with the CO2 laser otoscope Otoscan.Study Design Prospective clinical study.Materials and Methods In this study, laser myringotomy was performed with the CO2 laser otoscope Otoscan in a patient population comprising 81 children (159 ears) with a history of otitis media with effusion (OME) associated with adenoidal and sometimes tonsillar hyperplasia. The procedure on the tympanic membrane was accordingly combined with an adenoidectomy, a CO2 laser tonsillotomy, or a tonsillectomy and therefore performed under insufflation anesthesia. In all ears, approximately 2 mm circular perforations were created in the lower anterior quadrants with a power of 12 to 15 W, a pulse duration of 180 msec, and a scanned area of 2.2 mm in diameter.Results None of the children showed postoperative impairment of cochleovestibular function such as sensorineural hearing loss or nystagmus. Otomicroscopic and videoendoscopic monitoring documented the closure time and healing pattern of tympanic membrane perforations. The mean closure time was found to be 16.35 days (minimum, 8 days; maximum, 34 days). As a rule, an onion‐skin‐like membrane of keratinized material was seen in the former myringotomy perforations at the time of closure. At the follow‐up 6 months later, the condition of the tympanic membrane of 129 ears (81.1%) could be checked by otomicroscopy and videoendoscopy and the hearing ability by audiometry and tympanometry. The CO2 laser myringotomy sites appeared normal and irritation‐free. Two of the tympanic membranes examined (1.6%) showed atrophic scar formation, and 1 (0.8%) had a perforation with a diameter of 0.3 mm. The perforation was seen closed in a control otoscopy 15 months postoperatively. OME recurred in 26.3% of the ears seen intraoperatively with mucous secretion (n = 38) and in 13.5% of the ears with serous secretion (n = 37;P <.05).Conclusion The most important principle in treating OME is ventilation of the tympanic cavity. CO2 laser myringotomy achieves this through a self‐healing perforation in which its diameter roughly determines the duration of transtympanic ventilation. Laser myringotomy competes with ventilation tube insertion in the treatment of OME. It may be a useful alternative in the surgical management of secretory otitis media.
Polypoid Mucosa With Eosinophilia and Glandular Hyperplasia in Chronic Sinusitis: A Histopathological and Immunohistochemical Study
Authors: Berger Gilead , Kattan Avi , Bernheim Joelle , Ophir Dov 
Published: November 2003

AbstractObjective To evaluate the histopathological and immunohistochemical characteristics of chronic sinusitis, with reference to the extent of sinus involvement.Study Design A nonrandomized, retrospective, controlled qualitative and quantitative study.Methods Twenty‐nine adults with refractory chronic sinusitis underwent functional endoscopic sinus surgery. The score of computed tomography scans was used to determine the extent of disease. Six patients with normal sinus mucosae served as control subjects. Specimens underwent routine histological processing and hematoxylin‐eosin and periodic acid–Schiff staining. Immunohistochemistry for T and B lymphocytes was applied. Low‐magnification microscopy was designed to yield typical pathological features, and high magnification to count various inflammatory cells.Results Patients were divided into two groups according to their dominant pathological features: 16 had polypoid mucosa and eosinophilia, and 13 had glandular hyperplasia. The number of eosinophils, T and B lymphocytes in the lamina propria was significantly higher in patients with polypoid mucosa and eosinophilia, compared with those with glandular hyperplasia and with normal control subjects, whereas the difference between patients with glandular hyperplasia and control subjects was insignificant. Although the overall inflammatory reaction was relatively modest, nasal polyposis was more prevalent in patients with polypoid mucosa and eosinophilia; likewise, computed tomography revealed a significantly more extensive disease in these patients compared with the patients with glandular hyperplasia.Conclusion Two pathophysiological pathways, inducing prolonged obstruction to the outflow of sinus secretion and ultimately causing chronic inflammation, are suggested: 1) swollen polypoid mucosa with activation of eosinophils that damage the epithelium and 2) continued increased mucus secretion originated from hyperplastic submucosal seromucous glands.
Hereditary Hemorrhagic Telangiectasia: A Review of 76 Cases
Authors: Shah Rahul K. , Dhingra Jagdish K. , Shapshay Stanley M. 
Published: November 2003

AbstractObjectives/Hypothesis Hereditary hemorrhagic telangiectasia has long been viewed as a rare condition. Recent evidence indicates that the disorder is more frequent than previously thought. Recalcitrant epistaxis is a salient feature of this disease, and the otolaryngologist is often called on to make the diagnosis and guide the primary management of patients with hereditary hemorrhagic telangiectasia. Wider recognition of this condition, awareness of the natural history and associated findings, appropriate workup and screening for arteriovenous malformations (lungs, brain, liver), and knowledge of appropriate interventions can help avoid the considerable morbidity associated with hereditary hemorrhagic telangiectasia.Study Design Retrospectivereview.Methods Records of patients treated by the senior author (s.m.s.) for hereditary hemorrhagic teleangiectasia from 1993 to 2000 were reviewed.Results Seventy‐six patients were identified, 98% of whom had epistaxis as their presenting complaint, with 75% having a family history of hereditary hemorrhagic telangiectasia. The severity of epistaxis varied in the patients: 66% had mild, 21% moderate, and 13% severe epistaxis. Sixty‐four percent of patients had no transfusions, 25% had 1 to 10 transfusions, and 11% of patients had more than 10 transfusions. Complications of hereditary hemorrhagic telangiectasia were documented in 30% of patients. Screening for arteriovenous malformations was performed in only 34% of patients. Eighty‐two percent of patients received a variable number of Nd:YAG laser treatments.Conclusions The study presents the largest retrospective review of patients treated for hereditary hemorrhagic telangiectasia by a single otolaryngologist. The importance of a multidisciplinary approach facilitated by the otolaryngologist for evaluation of concomitant complications and morbidity (arteriovenous malformations) from hereditary hemorrhagic telangiectasia is demonstrated. An algorithm for controlling the epistaxis is presented.
Nasalance, Nasality, Voice, and Articulation After Uvulopalatopharyngoplasty
Authors: Van Lierde Kristiane M. , Van Borsel John , Moerman Mieke , Van Cauwenberge Paul 
Published: November 2003

AbstractObjectives/Hypothesis The main purpose of the study was to determine the impact of uvulopalatopharyngoplasty (UPPP) on nasalance and nasality. It was hypothesized that nasalance would change from the presurgical to the postsurgical condition because the surgical protocol involves removal of palatal tissue. An additional objective of the study was to provide objective and subjective data about changes in voice and articulation after UPPP. Because the surgical procedure of UPPP does not involve laryngeal tissue, it was hypothesized that the voice characteristics remain relatively stable. Because of removal of effective velar length, articulation problems of the uvular /R/ can occur in the Dutch language.Study Design Prospective study in which 26 men were studied before (1 week before UPPP) and after (3 weeks after UPPP) surgery.Methods The Nasometer was used to obtain nasalance scores. The mirror‐fogging test, a perceptual evaluation of each subject's readings, and the Gutzmann and the Bzoch hypernasality tests were used for the assessment of nasality. For the assessment of articulation, a phonetic analysis was performed. Voice assessment included a perceptual rating of the voice and a determination of fundamental frequency.Results No significant differences were found between the conditions before and after surgery regarding nasalance (except for the vowel /i/), nasality, and voice. Regarding articulation, only 1 patient showed a derhotacized /R/.Conclusions The findings of the study indicate that UPPP does not have an impact on nasality, voice, and articulation. Regarding nasalance, no significant nasalance change occurred after UPPP, except for the high vowel /i/.