bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate Mobilization Following Fixation of Mandible Fractures: A Prospective, Randomized Study
Authors: Kaplan Brian A. , Hoard Martin A. , Park Stephen S. 
Published: November 2003

AbstractObjectives To compare outcomes of open reduction and internal fixation of displaced mandible fractures followed by either immediate mobilization or 2 weeks of mandibular‐maxillary fixation.Study Design A prospective, randomized, single‐blinded study was performed.Methods The study was performed between January 1, 1997, and March 30, 2000. Inclusion criteria were displaced fractures between the mandibular angles, age greater than 16 years, and no involvement of the alveolus, ramus, condyles, or maxilla. All fractures were repaired by means of open reduction and internal fixation using 2.0‐mm titanium plates secured either in transoral fashion or percutaneously. Data were collected at 6‐week and 3‐ and 6‐month postoperative examinations. Variables were assessed by a surgeon blinded to the history of immobilization and included pain, malunion or nonunion, occlusion, trismus, wound status, infection rates, dental hygiene, and weight loss. Twenty‐nine consecutive patients were enrolled, 16 patients to immediate function and 13 patients to 2 weeks of mandibular‐maxillary fixation.Results No statistically significant differences were found between groups for any of the variables. Immediate release and temporary immobilization showed mean weight loss of 10 and 8 pounds and trismus of 4.2 and 4.6 cm, respectively. One wound separation and one infection were seen in the immobilization population, and no wound separation or infection was seen in the immediate‐release group. Dental hygiene was similar between the groups. No malunion or nonunion was noted in either group.Conclusions In this prospective and randomized study, no significant differences were noted between the groups receiving either immediate release or 2 weeks of mandibular‐maxillary fixation. The findings support the treatment of selective mandible fractures with 2.0‐mm miniplates and immediate mobilization.
Tympanic Membrane Grafting With AlloDerm
Authors: Benecke James E. 
Published: November 2003

AbstractObjective/Hypothesis The purpose of this work is to evaluate the performance of an acellular dermal allograft (AlloDerm; LifeCell Corp., The Woodlands, TX) in tympanic membrane (TM) grafting.Study Design A retrospective review of 20 consecutive tympanoplasty surgeries using temporalis fascia and 20 consecutive procedures using AlloDerm.Methods The charts of 20 consecutive adults who underwent tympanoplasty surgery were reviewed to evaluate graft take and hearing results. Similarly, 20 consecutive patients who had TM grafting with AlloDerm were reviewed. Pre‐ and postoperative air–bone gaps (ABG) at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz were compared.Results There were no graft failures in either the temporalis fascia group or the AlloDerm group. No statistically significant difference was noted in hearing results when comparing the residual conductive loss in both postoperative groups.Conclusions AlloDerm is a suitable material for TM grafting. This product is especially valuable in revision surgery in which the availability of appropriate autologous grafting material is limited.
Fine‐Needle Aspiration Biopsy
Authors: Amedee Ronald G. , Dhurandhar Nina R. 
Published: November 2003

AbstractObjectives: Fine‐needle aspiration biopsy (FNAB) is a technique in which a fine needle is introduced into a mass, cellular material is aspirated, and a cytological diagnosis is rendered. It separates reactive and inflammatory processes that do not require surgical intervention from neoplasia and benign from malignant tumors. FNAB lends itself to the diagnosis of palpable head and neck masses, in particular, those that persist following antibiotic treatment.Study Design/Methods: This clinical state‐of‐the‐art review article is intended to provide an overview of the clinical use of FNAB in the management of head and neck masses. Relevant case histories are used to illustrate this point.Results: Fine‐needle aspiration biopsy has a high overall diagnostic accuracy of 95% for all head and neck masses, 95% for benign lesions, and 87% for malignant ones.Conclusions: There are virtually no contraindications, and complications are minimal. Advantages of FNAB are that it is safe and simple, it can be performed as an outpatient procedure, and it is well tolerated by patients. In the present managed care environment, it also proves cost‐effective. The diagnosis is readily known to the clinician, and appropriate treatment modalities can be discussed with the patient. It is recommended as a first line of investigation in palpable head and neck masses.
Functional Outcomes After Supracricoid Laryngectomy
Authors: Zacharek Mark A. , Pasha Raza , Meleca Robert J. , Dworkin James P. , Stachler Robert J. , Jacobs John R. , Marks Steven C. , Garfield Ilene 
Published: November 2003

AbstractObjectives Local control and 5‐year survival rates are similar for patients undergoing total laryngectomy and supracricoid laryngectomy for the treatment of advanced‐stage laryngeal carcinoma. However, comprehensive studies of functional outcomes after supracricoid laryngectomy are lacking.Study Design Cohort study.Methods This investigation provides objective voice laboratory data, skilled listener impressions of voice samples, swallowing evaluations, and patient self‐perceptions of speech ability obtained from 10 supracricoid laryngectomees.Results Results demonstrated variable acoustic and speech aerodynamic disturbances, hoarse‐breathy vocal quality, and speech dysfluency. Patients' self‐perceptions of voice revealed severe dysphonia that induced certain emotional, physical, and functional setbacks. However, blinded judges rated these individuals as possessing intelligible speech and communication skills. All patients demonstrated premature spillage of the bolus and varying degrees of laryngeal penetration, aspiration, and retention during swallowing studies. However, each patient used a compensatory strategy to protect the airway. Voice and swallowing abilities appeared to depend on the mobility of the arytenoid cartilages, base of tongue action, and residual supraglottic tissue for the creation of a competent neoglottal sphincter complex that vibrated during phonation efforts and protected the airway during deglutition.Conclusions Supracricoid laryngectomy avoids the potential complications, limitations, and emotional problems associated with a permanent tracheostoma. All patients demonstrated intelligible voice and effective swallowing function postoperatively, supporting supracricoid laryngectomy as a suitable alternative surgical approach to the total laryngectomy in select patients.
Mutation and Abnormal Expression of the Fragile Histidine Triad Gene in Nasopharyngeal Carcinoma
Authors: Deng Yan‐Fei , Tian Fang , Lu Yong‐De , Chen Zhu‐Chu , Xie Ding‐Hua , Yang Xin‐Ming , Shao Xi‐Yun 
Published: November 2003

AbstractObjective To determine alterations of fragile histidine triad (FHIT) gene in nasopharyngeal carcinoma and the correlation of FHIT gene with nasopharyngeal carcinogenesis.Study Design Prospective study.Methods A total of 28 nasopharyngeal carcinoma and 16 normal nasopharyngeal epithelium specimens were examined for abnormalities of FHIT gene by nested reverse‐transcriptase–polymerase chain reaction and DNA sequencing.Results The deletion of FHIT gene was not observed in 16 normal nasopharyngeal epithelium specimens. In 28 cases of nasopharyngeal carcinoma tissues, 12 (42.9%) exhibited FHIT aberrant transcripts. Complementary DNA sequencing revealed exonic deletion, small DNA insertion, synonymous mutation in exon 8, or frameshift mutation in exon 5.Conclusions The present results suggest that the FHIT gene may play an important role in the pathogenesis of nasopharyngeal carcinoma and may be one of the candidate tumor suppressor genes in nasopharyngeal carcinoma.
Surgical Anatomy of the Natural Ostium of the Sphenoid Sinus
Authors: Kim Hyun‐Ung , Kim Sung‐Shik , Kang Seong Seok , Chung In Hyuk , Lee Jeung‐Gweon , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives This study was undertaken to measure the distance and the angle between the anterior part of nasal cavity and the natural ostium of the sphenoid sinus. The anatomical location of the natural ostium according to the direction of surgeon's operating view toward the anterior wall of the sphenoid sinus was also analyzed.Study Design This study used careful cadaver dissection under a surgical microscope.Methods One hundred sagittally sectioned adult cadaveric heads were used. We measured the distances and angles for identifying the natural ostium of the sphenoid sinus using several reference points such as the limen nasi, the sill, and the posteroinferior end of the superior turbinate. In addition, we tried to identify whether the location of the natural ostium is medial or lateral to the posterior end of the superior turbinate.Results The natural ostium of the sphenoid sinus was located at an angle of 35.9° with a distance of 56.5 mm from limen nasi and at an angle of 34.3° with a distance of 62.7 mm from nasal sill. It was located approximately 1 cm above the posteroinferior end of the superior turbinate and at a medial aspect to the posterior end of the superior turbinate in 83% of specimens.Conclusions We speculate that the posteroinferior end of the superior turbinate is the best landmark for identifying the natural ostium of the sphenoid sinus. Furthermore, the natural ostium should ideally be searched from a superior and medial aspect in relation to the posteroinferior end of the superior turbinate.
Detection of Macrophage Migration Inhibitory Factor (MIF) in Human Cholesteatomas and Functional Implications of Correlations to Recurrence Status and to Expression of Matrix Metalloproteinases‐3/9, Retinoic Acid Receptor‐β, and Anti‐apoptotic Galectin‐3
Authors: Choufani Georges , Ghanooni Rose , Decaestecker Christine , Delbrouck Karine , Simon Patricia , Schüring Max‐Peter , Zick Yehiel , Hassid Sergio , Gabius Hans‐Joachim , Kiss Robert 
Published: November 2003

AbstractObjectives To investigate whether the expression of the macrophage migration inhibitory factor (MIF) 1) is detectable, 2) changes in relation to recurrence and infection status, and 3) relates to the levels of expression of growth regulators/differentiation markers, including galectin‐1, ‐3, and ‐8, retinoid acid receptors (RAR)]‐α, ‐β, and ‐γ, binding sites for sarcolectin, and invasion markers (cathepsins ‐B and ‐D, and matrix metalloproteinases [MMP]‐2, ‐3, and ‐9) in human cholesteatomas.Study Design An analysis of 56 cholesteatomas resected by the same surgeon using canal wall up and canal wall down surgical procedures.Methods The immunohistochemical levels of expression of MIF and the proteases were quantitatively determined (using computer‐assisted microscopy) on routine histologic slides by specific antibodies, and statistically correlated to parameters of the other markers determined previously in conjunction with data on apoptosis/proliferation.Results MIF expression was detected. It was significantly higher in the epithelium (P = .002) and vessels (P = .04) of the connective tissues (but not in the connective tissue itself) of recurrent as opposed to non‐recurrent cholesteatomas. The MIF expression is significantly correlated (P = .006) to the RARβ expression in non‐infected cholesteatomas, and to MMP‐3 (P <.01) and anti‐apoptotic galectin‐3 (P = .01) in infected cholesteatomas. The level of MIF expression was also correlated significantly to MMP‐9 (P = 0.003), RARβ (P <.001), and galectin‐8 (P = .003) expression in the cholesteatomas regardless of their infection status.Conclusions MIF expression in human cholesteatomas is related to the levels of biologic aggressiveness reflected in their recurrence status and MMP expression, and to the differentiation status reflected in their galactin and RARβ expressions. Together with galectin‐3, it could cooperate to form an anti‐apoptotic feedback loop.
Symptoms, Laryngeal Findings, and 24‐Hour pH Monitoring in Patients With Suspected Gastroesophago‐Pharyngeal Reflux
Authors: Ylitalo Riitta , Lindestad Per‐Åke , Ramel Stig 
Published: November 2003

AbstractObjectives To investigate the laryngeal signs and symptoms associated with gastroesophago‐pharyngeal reflux (GEPR).Study Design A prospective controlled study.Methods Nineteen healthy control subjects and 43 patients, 26 with posterior laryngitis (PL) and 17 with a normal larynx and suspected GEPR, were examined using videolaryngoscopy and 24‐hour ambulatory dual‐probe pH monitoring.Results Pharyngeal acid reflux occurred in 18 (69%) patients with PL, in 9 (53%) patients with a normal larynx, and in 5 (26%) healthy control subjects. Multiple‐comparison procedure showed that pharyngeal reflux was significantly more prevalent in patients with PL than in the healthy control subjects (P <.05). The laryngoscopic findings in patients with pharyngeal reflux varied from normal mucosa to thickening or edema of the posterior wall of the glottis, which was the most frequent finding in the PL group. Erythema was uncommon; it was found only in patients with verified pharyngeal reflux. There was no difference in symptom profile between the patients with PL and patients with a normal larynx or patients with or without pharyngeal reflux.Conclusions Pharyngeal reflux is significantly more prevalent in patients with posterior laryngitis than in healthy control subjects. Moreover, a certain degree of pharyngeal reflux appears to be a normal phenomenon. The most common laryngeal finding in patients with posterior laryngitis is thickening or edema of the posterior wall of the glottis. GEPR does not yield specific laryngeal symptoms. Thus, it is unreliable to base the reflux diagnosis on symptoms alone.
Clinical Assessment of Intralaryngeal Ultrasonography
Authors: Tamura Etsuyo , Kitahara Satoshi , Kohno Naoyuki 
Published: November 2003

AbstractObjectives To assess the clinical use of intralaryngeal ultrasonography.Study Design A retrospective study was conducted of 16 patients with laryngeal lesions treated by laryngomicrosurgery.Methods An intraluminal ultrasonic tomography apparatus was connected to a radial scanning 30‐MHz miniaturized probe. Under general anesthesia, ultrasonic images were obtained using the filling method.Results In cases of benign disease, such as vocal cord nodules or polyps, the layers of the mucosa could be identified. Characteristic internal echoes were noted in cases of hemorrhagic polyps, vocal cord cysts, and vocal cord cancer. In case of hemorrhagic polyps, hyperechoic regions were noted within the lesions. In cases of vocal cord cysts, internal echoes were absent, and posterior echoes were mildly enhanced. In cases of vocal cord cancer, infiltration beyond the mucosa could be visualized.Conclusions Laryngeal lesions can be diagnosed by intralaryngeal ultrasonography using the filling method. Although it does not replace the combination of conventional endoscopy and a critical evaluation of the clinical symptoms of the individual disease, it can profitably complement them. Intralaryngeal ultrasonography can help in determining the extent of tumor involvement during microscopic laser surgery performed under general anesthesia. Confirmation of the results of this pilot study with a larger series of patients is desirable.
Significance of Computed Tomography Pathology in Chronic Rhinosinusitis
Authors: Arango Pablo , Kountakis Stilianos E. 
Published: November 2003

AbstractObjectives/Hypothesis Multiple reports show that the extent of disease on computer tomography (CT) of the sinuses does not correlate with patients' subjective sinus symptom scores. In the current study, sinus symptom scores of patients with normal findings on sinus CT scans are compared with sinus symptom scores of patients with chronic rhinosinusitis and with disease on CT of the sinuses. The objective is to determine the significance of CT disease in patients with chronic rhinosinusitis.Study Design Prospective collection of data of consecutive patients seen for possible sinusitis.Methods Prospective data at a tertiary medical center were collected over an 8‐month period. Computed tomography scans were graded according to Lund and MacKay, and patients were asked to grade each of the major and minor rhinosinusitis symptoms listed by the Rhinosinusitis Task Force from 0 to 10. A score of 0 was given for no symptom at all, and 10 indicated the most severe extent of a symptom.Results Twenty‐seven patients with sinus complaints had normal findings on sinus CT scans. The average scores for major and minor rhinosinusitis symptoms were 18.6 and 15, respectively. Twenty‐six patients with sinus complaints had disease on CT of their sinuses. The average scores for major and minor rhinosinusitis symptoms for these patients were 42.9 and 22, respectively. Higher symptom scores were seen in the patients with CT disease, and the differences between these two groups were statistically significant (major symptom, P = .000001; minor symptom, P = .02). Patient symptom scores did not correlate with extent of disease on CT as previously reported (r = 0.16).Conclusion The presence of CT disease translates to higher patient symptom scores compared with symptom scores of patients without CT disease.
Smoking and Tympanoplasty: Implications for Prognosis and the Middle Ear Risk Index (MERI)
Authors: Becvarovski Zoran , Kartush Jack M. 
Published: November 2003

AbstractObjectives/Hypothesis The objectives of this study are to review the effects of smoking on preoperative middle ear disease severity, long‐term surgical outcome, type and extent of surgery required, the need for ossicular chain reconstruction, and the long‐term hearing results.Study Design A retrospective chart review.Materials and Methods The charts of 74 smokers and non‐smokers who underwent over–under tympanoplasty were reviewed. An analysis of the disease severity (using the Middle Ear Risk Index [MERI]) at presentation and type of surgery was performed. A review of graft take and delayed failure (late perforation or atelectasis after 6 mo) and audiologic data were performed.Results Fifteen patients smoked a mean of 20 cigarettes daily for a mean of 15 years. The MERI was well matched for both groups. There was a trend toward smokers having a higher incidence of otorrhea preoperatively and requiring a more extensive surgical procedure. All patients had full take of the tympanic membrane graft at 6 months; however, delayed surgical failure was seen in 20% of non‐smokers compared with 60% of smokers (P = .050). No statistically significant difference was seen in hearing outcome.Conclusions Cigarette smoking is associated with more severe middle ear disease preoperatively. More extensive surgery is often needed in smokers to eradicate the disease. Most significantly, smoking is associated with a threefold increase in the chance of long‐term graft failure. Based on the results of this study, the MERI has been revised to include smoking as a risk factor.
Sound‐Evoked Myogenic Potentials and Responses With 3‐ms Latency in Auditory Brainstem Response
Authors: Ochi Kentaro , Ohashi Toru 
Published: November 2003

AbstractObjectives The vestibular‐evoked myogenic potential (VEMP) has shed new light on vestibular testing. A large negative deflection with a 3‐ms latency within the auditory brainstem response (ABR) has been reported in some patients with deafness. This negative deflection has been termed the N3 potential and it is assumed to be a vestibular‐evoked potential. This study investigated the relationship between the VEMP and the N3 potential.Study Design Prospective evaluation of the VEMP and the N3 potential in 21 patients.Methods The oto‐neurological tests, including caloric test, hearing sensitivity test, VEMP, and ABR, were performed and data were analyzed.Results The average hearing threshold ranged from 65 to above 110 dB, which includes 9 (37.5%) totally deaf ears. The N3 potentials were recorded in 10 (41.7%) ears. A normal VEMP was detected in 16 (66.7%) ears. Canal paresis was observed in 11 (45.8%) ears.Conclusions Both the VEMP and the N3 potential appear to originate from the sacculus, but because the characteristics of these two responses are not identical, additional factors might be involved in the generation of the N3 potential.
Morphologic Correlates for Laryngeal Reinnervation
Authors: Gacek Richard R. 
Published: November 2003

AbstractObjective To describe morphologic correlates for laryngeal reinnervation.Study Design Review of anatomic experiments dealing with laryngeal innervation performed over a 25‐year period.Methods Description of results from experimental studies on the cat and human laryngeal muscles and nerve supply.Results Despite separation of abductor and adductor laryngeal motor neurons in the central nervous system, the mixture of abductor and adductor axons in the recurrent laryngeal nerve indicates that selective re‐innervation of an individual laryngeal muscle must be accomplished at the neuromuscular junction (NMJ) of the muscle. The optimal time for a reinnervating neural source to re‐occupy vacated NMJ is at the time of denervation. If the reinnervation procedure is attempted long (>1 mo) after denervation, extraneous end plates of other neural systems must be eliminated to provide vacant NMJ. The nerve muscle pedicle (NMP) concept is an effective model for reinnervation of a laryngeal muscle provided its activity pattern is similar to that of the denervated muscle and its insertion into vacated NMJ is timely.Conclusion NMP offers a logical method for selective laryngeal muscle reinnervation. Critical to the success of NMP are the physiological input to the NMP and timing of NMP implantation.
Nitric Oxide Improves Cisplatin Cytotoxicity in Head and Neck Squamous Cell Carcinoma
Authors: Azizzadeh Babak , Yip Helena T. , Blackwell Keith E. , Horvath Steve , Calcaterra Thomas C. , Buga Georgette M. , Ignarro Louis J. , Wang Marilene B. 
Published: November 2003

AbstractObjective To test whether nitric oxide (NO) enhances the cytotoxicity of cisplatin in a head and neck squamous cell carcinoma (HNSCC) cell line.Background Cisplatin is one of the most frequently used chemotherapeutic agents in the treatment of HNSCC. NO has been shown to play an important role in regulating tumor growth. Previous studies demonstrate that NO can enhance the cytotoxicity of cisplatin in Chinese hamster lung fibroblasts. In this report, we examined the in vitro interaction of NO and cisplatin in a HNSCC cell line.Materials and Methods CCL23 cells were pretreated with three different NO donors: PAPA/NO (t 1/2 = 15 min), DPTA/NO (t 1/2 = 3 h), and DETA/NO (t 1/2 = 20 h). The cells were rinsed and exposed for 6 hours to a culture medium containing cisplatin. Cell survival and LD50 of cisplatin were calculated with and without NO pretreatment.Results PAPA/NO and DPTA/NO did not show any cytotoxic activity and did not change the LD50 of cisplatin. DETA/NO when used alone resulted in 25.6% cell death at its peak dose (100 μM). Pretreatment with DETA/NO resulted in almost a threefold reduction of the LD50 of cisplatin (6.8 vs. 2.4 μg/mL). Pretreatment with DETA/NO sensitized the HNSCC cells to subsequent cisplatin activity (two‐sided P = .00016).Conclusion Pretreatment of HNSCC cells with long‐acting NO donors enhances cisplatin activity. Short‐ and medium‐acting NO donors do not exert a toxic effect and do not augment the activity of cisplatin. NO agonists should be considered in the future as a possible adjunct to cisplatin in the treatment of HNSCC. Further studies with animal models are necessary to further clarify this relationship.