bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Investigation of Airway Wound Healing Using a Novel in vivo Model
Authors: Hardillo Jose , Vanclooster Christoph , Delaere Pierre R. 
Published: November 2003

AbstractObjective To study the amount of wound contraction and reepithelialization occurring in the healing process of full‐thickness mucosal defects treated with and without mitomycin.Study Design A new wound healing model was developed in which the tracheal mucosa was exteriorized without interference with the blood supply or with the cartilage support of the trachea. This was done by: 1) orthotopic tracheal revascularization in vascularized fascia; 2) isolation of revascularized segment after 14 days; 3) posterior longitudinal incision of revascularized segment; 4) exteriorization of tracheal mucosa with formation of anterior full‐thickness mucosal defect; and 5) closure of posterior tracheal incision and reimplantation in the airway. This model was used to study airway wound healing in three groups of animals: 1) controls (revascularization, exteriorization, reimplantation) (N = 6); 2) full‐thickness mucosal defect: patch defect (N = 5), circumferential defect (N = 3); and 3) full‐thickness mucosal defect after topical mitomycin application: patch defect (N = 7), circumferential defect (N = 3). The animals were followed for periods varying from 2 to 4 weeks or until signs of dyspnea. The surface areas of the wounds before and after follow‐up were measured. Wound healing was studied histologically on axial and longitudinal sections.Results Group 1: All the animals survived for 1 month. No significant difference existed between surface area of isolated trachea and of reimplanted trachea after follow‐up. Group 2: Five animals (patch defects) survived for 1 month. Full‐thickness mucosal defects healed by reepithelialization and by a surface area reduction of 58.9% (mean ‐ standard deviation = 10.5). The animals with the circumferential defects showed dyspnea after an average follow‐up of 14 days as a result of excessive granulation tissue formation. Group 3: Mitomycin reproducibly inhibited wound closure, yielding wounds that on average closed 56% less than controls by day 14 (P <.001). Histologic comparisons showed that mitomycin blocks angiogenesis during wound healing.Conclusions A wound healing model based on tracheal revascularization, isolation, and reimplantation was developed in rabbits. This model allowed us to study the healing of full‐thickness mucosal defects inside the airway.
Functional Magnetic Resonance Imaging of the Pediatric Swallow: Imaging the Cortex and the Brainstem
Authors: Hartnick Christopher J. , Rudolph Colin , Willging J. Paul , Holland Scott K. 
Published: November 2003

AbstractObjective To design and implement a functional magnetic resonance imaging (fMRI) protocol to investigate the cortical and brainstem patterns of activity in children with regard to the act of swallowing.Study Design Pilot study to assess the clinical feasibility of the project.Methods Using a 3T Bruker Biospec 30/60 MRI scanner, images were obtained using the Behavior Interleaved Gradient/Blood Oxygen Level Dependent (BIG‐BOLD) image acquisition method. Initially, regions of interest (ROI) were developed to identify the mean time from the onset of a swallow to maximum cortical blood flow in the motor cortex. Using this data to design the BIG‐BOLD acquisition method followed by postprocessing of the data, images from two volunteer adults and four volunteer children were obtained.Results The average time from the onset of a swallow to maximum cortical blood flow was 6 to 8 seconds. Regions of cortical activity include pre‐ and post‐central gyrus (Brodmann's areas 3 and 4), superior motor cortex (B.A. 24), insula, inferior frontal cortex (B.A. 44 and 45), Heschl gyrus (B.A. 41 and 42), putamen, globus pallidus, and the superior temporal gyrus (B.A. 38). Of particular note is the first mapping of the functional activity of swallowing at the level of the brainstem; activity was seen in the region of the nucleus ambiguous.Conclusions fMRI provides a novel means of studying the central processes of both normal swallowing and its various pathologic forms in children. Further understanding of how a child coordinates a swallow and how this coordination can be altered at the level of the brainstem and cortex may aid in the development of novel rehabilitative strategies.
Pulsed‐Dye Laser and Retinoic Acid Delay Progression of Oral Squamous Cell Carcinoma: A Murine Model
Authors: Shah Rahul K. , Valdez Tulio A. , Wang Zhi , Shapshay Stanley M. 
Published: November 2003

AbstractObjectives/Hypothesis This study examined the role of the pulsed‐dye laser (PDL) at 585 nm coupled with retinoic acid at therapeutic (5.0 mg/kg) and nontherapeutic (0.5 mg/kg) doses to delay the progression of cancer with a two‐hit approach. The existing vasculature is selectively targeted by the laser, whereas retinoic acid inhibits future angiogenesis.Study Design Randomized, prospective study in a murine model.Methods Twenty‐five athymic nude mice were inoculated with oral squamous cell cancers on six flank sites and randomly divided into five groups: 1) control subjects, 2) treatment with 0.5 mg/kg retinoic acid (RA 0.5), 3) treatment with 5.0 mg/kg retinoic acid (RA 5.0), 4) treatment with RA 0.5 + PDL, and 5) treatment with RA 5.0 + PDL. The PDL groups received irradiation after inoculation. The retinoic acid was administered daily. The tumors were counted and measured for 14 days.Results The control group developed visible tumors in 50% of the inoculation sites at 3 days compared with 3 days (RA 0.5) and 4 days (RA 5.0) for the retinoic acid groups and 9 days (RA 0.5 + PDL) and 10 days (RA 5.0 + PDL) for the laser treatment groups. There was no tumor growth until day 7 in the RA 5.0 + PDL group. The tumor volume was statistically different between the treatment groups.Conclusion This study demonstrated the superiority of a single treatment with the PDL coupled with retinoic acid to delay the progression of cancer when compared with treatment with retinoic acid alone, thus introducing a novel strategy in cancer control.
Nasal Ciliary Function and Ultrastructure in Down Syndrome
Authors: Piatti Gioia , Allegra Luigi , Ambrosetti Umberto , De Santi Maria Margherita 
Published: November 2003

AbstractObjectives/Hypothesis To investigate the in vivo nasal ciliary beat and the ciliary ultrastructure in Down syndrome because, although in this condition an increased susceptibility to respiratory tract infections has been reported by several authors, the nature of this phenomenon is not fully understood.Study Design Experimental study of 18 subjects with Down syndrome and 18 healthy control subjects.Methods Ciliary beat frequency (CBF) was measured on samples of ciliated epithelium obtained from the inferior nasal turbinate; a further brushing for ultrastructural analysis was performed only in subjects showing a CBF reduction or a ciliary movement alteration.Results The mean CBF in the group with Down syndrome was 7 ± 2.82 Hz, and in the control subjects it was 10.94 ± 0.65 Hz. In the same 66.6% of subjects with Down syndrome, we observed a fibrillatory movement of cilia and no metachronicity was present. Moreover, in 14 subjects with Down syndrome as hyperproduction of mucus was present. Ultrastructural evaluation at transmission election microscopy instead revealed a normal architecture of cilia.Conclusion We attribute the nature of the mucociliary defect in Down syndrome to recurrent respiratory tract infections causing changes in mucus properties as in rheological parameters and not to a primitive defect of cilia.
A Large Arteriovenous Malformation of the External Ear in an Adult: Report of a Case and Approach to Management
Authors: Pham Tuan H. , Wong Brian J. F. , Allison Glenn 
Published: November 2003

AbstractObjectives/Hypothesis Arteriovenous malformations involving the external ear are relatively uncommon in adults. Arteriovenous malformations in the head and neck can poses difficult therapeutic challenges.Study Design Case report.Methods We report a case of a large arteriovenous malformation in the external ear in a 41‐year‐old man.Results Extensive enlargement of the previously latent and asymptomatic arteriovenous malformation was triggered by blunt trauma to the ear.Conclusion We discuss the definition, clinical findings, diagnostic approaches, and therapeutic management of arteriovenous malformations.
Surgical Management of Retropharyngeal Space Infections in Children
Authors: Kirse Daniel J. , Roberson David W. 
Published: November 2003

AbstractObjective To study the perioperative management strategies in a large group of pediatric patients undergoing surgical therapy for suppurative adenitis of the parapharyngeal and retropharyngeal spaces.Study Design Retrospective analysis of all patients treated surgically from January 1, 1989, to December 31, 1998, in a tertiary care pediatric hospital.Methods Charts were reviewed for demographic data, duration and nature of symptoms, radiological workup, surgical approach, complications, duration of medical therapy and antibiotic choice, and bacteriological findings. Computed tomography (CT) results were correlated to surgical findings.Results A dramatic increase in the incidence of deep neck space infection was seen during the study period; this increase was congruent with the increase in culture‐positive group A β‐hemolytic streptococcal abscesses. More than two‐thirds of the patients were boys with the peak incidence being in the 3‐ to 5‐year‐old group. The duration of symptoms before presentation was less than might be expected, especially in the younger age groups. Seventy of 73 children were treated with a transoral approach. Sixty‐eight of 73 were successfully treated with one operative intervention. Irregularity of the abscess wall was found to be a stronger predictor of the presence of pus than the presence of ring enhancement.Conclusions The current study represents the largest series of pediatric retropharyngeal abscesses in the modern medical literature. Changes in the disease process and in management from the first half of the century to today are reviewed, and recommendations for optimal management presented. The data in this series support a transoral approach to these abscesses unless there is extension lateral to the great vessels.
Cochlear Implantation in Healthy and Otitis‐Prone Children: A Prospective Study
Authors: Luntz Michal , Teszler Christian B. , Shpak Talma , Feiglin Hava , Farah‐Sima'an Afnan 
Published: November 2003

AbstractObjective To evaluate and compare the timing of surgery, intraoperative findings, and otitis media‐related outcome of cochlear implantation in children who are otitis‐prone with their counterparts who are not otitis‐prone.Study Design Prospective.Methods Children referred for cochlear implantation were assigned to a non‐otitis‐prone group (group A: normal otoscopy on their first visit after referral) or an otitis‐prone group (group B: current or a recent history of otitis media at referral). Group B patients were managed using a structured protocol aimed at preimplantation otitis media control. The study reviewed pre‐, intra‐, and postoperative data.Results Of the 18 children studied, 8 were assigned to group A (mean age at referral, 40.6 mo) and 10 to group B (mean age at referral, 31.6 mo). For otitis media control, all otitis‐prone children underwent ventilating tube insertion (various numbers of procedures before implantation). Only one otitis‐prone child required cortical mastoidectomy also. Time from referral to implantation was similar in the two groups (mean, 6.6 mo). High‐resolution computed tomography data showed mastoid pneumatization to be significantly smaller in the otitis‐prone group, but the facial recess was not smaller in this group. During implantation, 10 children had inflamed middle ear mucosa. Seven of these belonged to group B. All of these seven children had a round window niche obliterated by the inflamed mucosa, which had to be removed for round window membrane identification. After implantation, only one child had drainage through the ventilating tube for more than 1 week. Two children in group B developed otitis media (1 year postimplantation) that was overcome within 1 week. There were no otitis media‐related complications.Conclusions If a structured protocol is used for the control of otitis media before cochlear implantation, otitis media should not require a delay in implantation. In otitis media‐prone children, the round window niche is often obscured by inflamed mucosa. Its removal is mandatory for identification of the round window membrane. After cochlear implantation, otitis media is not a frequent occurrence.
Relationship of Vestibular Aqueduct and Inner Ear Pressure in Ménière's Disease and the Normal Population
Authors: Sennaroglu Levent , Ylmazer Cuneyt , Basaran Figen , Sennaroglu Gonca , Gursel Bulent 
Published: November 2003

AbstractObjective Etiopathogenesis of Ménière's disease has not been resolved. The principal histopathologic finding in this disease is endolymphatic hydrops. The majority of radiologic and histopathologic studies demonstrated a narrow vestibular aqueduct in Ménière's disease. There is no study in the literature investigating the relationship between inner ear pressure and vestibular aqueduct dimensions. Static acoustic compliance is a noninvasive procedure that is thought to measure perilymphatic pressure at the footplate. An increase in mechanical fluid pressure in the inner ear is transmitted to the footplate of the stapes. This causes a reduction in the compliance at the drum. The aim of this study is to investigate the relationship between vestibular aqueduct dimensions and static acoustic compliance in Ménière's disease and the normal population.Study Design Prospective study.Methods Forty patients with Ménière's disease and 40 healthy individuals with no otolaryngologic disorders were the subjects of this study. Each group was further divided into two according to static compliance value (normal and low static compliance). In these four groups dimensions of vestibular aqueduct were determined radiologically by high‐resolution computerized tomography and correlated with normal and low static acoustic compliance values (normal and high perilymphatic pressure).Results The results demonstrated that vestibular aqueduct is narrower in patients with Ménière's disease than the normal population. However, there is no relationship between vestibular aqueduct dimensions and inner ear pressure obtained by static acoustic compliance measurements.
Acute Laryngotracheitis in the Rat Induced by Sendai Virus: The Influx of Six Different Types of Immunocompetent Cells Into the Laryngeal Mucosa Differs Strongly Between the Subglottic and the Glottic Compartment
Authors: Jecker Peter , McWilliam Andrew , Marsh Amanda , Holt Patrick G. , Mann Wolf J. , Pabst Reinhard , Westermann Jürgen 
Published: November 2003

AbstractObjectives Acute laryngotracheitis is a disease in which mainly the subglottic area is infected, whereas adjacent parts of the larynx, especially the narrow glottic fold, remain unaffected. The reason for the difference between these two directly adjacent regions is unknown. Therefore, in the present study the influx of dendritic cells, neutrophils, T and B lymphocytes, natural killer cells, and macrophages into the mucosa of different laryngeal compartments was investigated after Sendai virus infection in the rat. The aims were to study both the influx of immunocompetent cells and the adhesion of the pathogen and to correlate them to the different reactions of the laryngeal areas during pseudocroup.Methods Acute laryngotracheitis was induced by intranasal application of Sendai virus in brown Norway rats. This virus is exclusively pneumotropic in rodents and belongs to the parainfluenza virus type 1, the main pathogen of acute laryngotracheitis in children. The numbers of dendritic cells, neutrophils, T and B lymphocytes, natural killer cells, and macrophages were determined in the supraglottic, glottic, subglottic, and tracheal mucosa on days 2, 5, 7, and 14 after virus application. Furthermore, the nucleoprotein of the virus and major histocompatibility complex (MHC) Class II expression were detected immunohistologically on the laryngeal epithelium.Results All cell subsets entered the laryngeal mucosa during inflammation. The highest influx was detected among dendritic cells subglottically. This was accompanied by a strong virus adhesion and MHC Class II expression on the subglottic epithelium. In contrast, only a few immunocompetent cells entered the adjacent glottic mucosa, and on the glottic epithelium staining for virus nucleoprotein and MHC Class II expression was weak.Conclusions The inflammatory response of the laryngeal mucosa shows great regional differences in this animal model during experimental viral infection. The response was characterized by a strong subglottic and a weak glottic reaction. A possible reason for this difference might be region‐specific viral adhesion on the epithelium of the laryngeal areas, as well as differences in MHC Class II expression. Thus, these data agree with the clinical observation during acute laryngotracheitis and may explain why the subglottic part of the larynx is affected preferentially during pseudocroup. The molecular mechanisms mediating the different reactions await clarification.
Pott's Puffy Tumor and Epidural Abscess Arising From Dental Sepsis: A Case Report
Authors: Chandy Binoy , Todd John , Stucker Fred J. , Nathan Cherie‐Ann O. 
Published: November 2003

AbstractObjective To present an unusual case of two uncommon cranial complications of frontal sinusitis: Pott's puffy tumor and epidural abscess arising from frontal sinusitis of dental origin, and also two systemic complications of sinusitis: septicemia and empyema, all occurring in an immunocompetent patient.Study Design A 21‐year‐old man presented with a scalp swelling and epidural abscess. Magnetic resonance imaging and computed tomographic scans revealed unilateral opacification of the frontal sinus and an epidural abscess with a direct connection to the scalp abscess. Further history revealed that his symptoms occurred coincidentally with a tooth extraction 2 months before, and he was hospitalized soon after the tooth extraction for sepsis and a lung abscess.Methods A combined neurosurgical and otolaryngologic approach was required to treat the sinusitis and the associated epidural and scalp abscess.Results Cultures returned as Streptococcus intermedius from all three sites. The patient was free of disease at the 3‐month follow‐up.Conclusions Odontogenic maxillary sinusitis is well documented; however, there is little reported of frontal sinusitis arising from dental disease. The prevalence of sinusitis of dental origin will be reviewed, including the microbiology of this particularly virulent organism that persisted despite earlier treatment with ampicillin. Also, the current thoughts on management of these cases will be discussed with particular reference to local therapy for sinusitis in addition to systemic treatment with antibiotics.
Preoperative Computed Tomography Diagnosis of Non‐Recurrent Inferior Laryngeal Nerve
Authors: Watanabe Akihito , Kawabori Shinichi , Osanai Hirofumi , Taniguchi Masanobu , Hosokawa Masao 
Published: November 2003

AbstractObjective The non‐recurrent inferior laryngeal nerve (NRILN) is a nerve anomaly that is associated with the developmentally aberrant subclavian artery. Thus, it is possible to predict NRILN by preoperative diagnosis of an aberrant subclavian artery. Preoperative recognition of the NRILN should be advantageous in the prevention of intraoperative nerve damage. The purpose of this study was to assess the possibility of diagnosis of an aberrant subclavian artery by computed tomography (CT) of the neck, which is often performed before thyroid surgery.Methods We retrospectively studied the preoperative CT films from 594 thyroid or esophageal surgery patients treated in our hospital between May 1995 and December 2000. An NRILN was identified intraoperatively in 6 of these patients, and a right recurrent inferior laryngeal nerve (RILN) was observed in 588 of these patients. We evaluated whether the brachiocephalic artery could be identified on the CT scan and classified the positional relationship between the right subclavian artery and the tracheoesophagus into three types.Results The brachiocephalic artery was identified on the CT films in 158 cases, all of which were cases of RILN. The right subclavian artery was detected on the ventral side of the membranous wall of the trachea in all 588 RILN cases, whereas it was detected on the dorsal side in all 6 NRILN cases.Conclusions It was possible to predict an aberrant subclavian artery by identifying the brachiocephalic artery and position of the right subclavian artery on the CT film of the neck. When an anomaly of the subclavian artery is thus preoperatively detected, NRILN can be preoperatively predicted, which likely will enable prevention of vocal cord paralysis.
Proportion of Heritable Paraganglioma Cases and Associated Clinical Characteristics
Authors: Drovdlic Carrie M. , Myers Eugene N. , Peters June A. , Baysal Bora E. , Brackmann Derald E. , Slattery William H. , Rubinstein Wendy S. 
Published: November 2003

AbstractObjective/Hypothesis To determine the heritable proportion of paraganglioma (PGL) and identify clinical features associated with heritable PGL.Study Design Patients diagnosed with head and neck PGLs, identified retrospectively through clinical otolaryngology practices and/or participation in previous PGL research studies, were given a medical and family history questionnaire.Methods Questionnaire information was used to classify participants as having “heritable” or “non‐heritable” cases of PGL. Classification of the participants identified through otolaryngology clinics was used to estimate the heritable proportion of PGL. Statistical analysis was performed to identify significant differences in the clinical characteristics of the heritable versus non‐heritable groups.Results Among the otolaryngology clinic population, 35% were classified as having heritable PGL. Individuals with heritable PGL were younger on average than those with non‐heritable PGL. The majority of non‐heritable participants were female, but there was an equal gender ratio among the heritable participants. Individuals diagnosed with a carotid body tumor (CBT) were 5.8 times more likely to be classified as heritable than those diagnosed with PGL at other anatomic locations.Conclusions Approximately 35% of individuals who present to an otolaryngologist with a head and neck PGL have inherited a predisposition for this growth. Among individuals diagnosed with head and neck PGL, those diagnosed with CBT are 5.8 times more likely to have an inherited predisposition than those diagnosed with PGL at other anatomic locations.