bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Obstructive Sleep Apnea in Patients Who Snore
Authors: Tami Thomas A. , Duncan Heather J. , Pfleger Michael 
Published: November 2003

AbstractAs the field of sleep medicine has evolved, the clinical implications of obstructive sleep apnea (OSA) in snoring patients have become well accepted. Recent advances in surgical therapy for snoring allow otolaryngologists to offer simple outpatient treatment to patients with this problem. However, because the incidence of OSA in snorers seeking medical attention is unknown, the appropriate pretreatment evaluation of these patients is a subject of continued debate. Ninety‐four snoring patients were recruited for a study to determine the incidence of OSA in this highly selected population. Subjects answered an extensive sleep questionnaire to determine factors that might suggest a diagnosis of OSA. Level III ambulatory sleep studies were performed on each participant. The incidence of OSA in this group was 72% (42% severe and 30% mild to moderate). Twenty of the subjects with OSA also underwent formal level I sleep studies, and the diagnosis of OSA was confirmed in each instance. Although there was a relationship between body mass index and OSA and certain questions correlated with OSA, the sensitivity and specificity of these data alone or in combination were too low to recommend their use in lieu of a formal sleep study. Given the remarkably high incidence of OSA in this group, which may reflect that seen by otolaryngologists who treat snoring, a sleep study should be performed to diagnose OSA and institute therapy for this condition. Level III ambulatory monitoring devices may be the most cos‐teffective alternative for evaluating this high‐risk population.
Childhood Imbalance and Chronic Otitis Media With Effusion: Effect of Tympanostomy Tube Insertion on Standardized Tests of Balance and Locomotion
Authors: Hart Mary C. , Nichols Deborah S. , Butler E. M. , Barin Kamran 
Published: November 2003

AbstractThe goal of this study was to investigate the role of chronic otitis media with effusion as a cause of childhood imbalance. Nineteen 4‐ to 6‐year‐old children with chronic otitis media with effusion and 14 matched control children underwent a series of laboratory tests, including two standardized tests of balance and locomotion: the Peabody Developmental Motor Scales (PDMS) and the Bruininks‐Oseretsky Test of Motor Proficiency (BOTMP). The children in the chronic otitis media with effusion group underwent tympanostomy tube insertion. Both groups underwent the same battery of tests within 6 to 8 weeks of initial testing. Analysis of variance for the PDMS and BOTMP demonstrated significantly lower performance in the balance subscales for the otitis group before (P < .01). Both otitis and control groups improved when retested. The improvement was greater and approaching significance in the otitis group on the PDMS and BOTMP (P = .056 and .097, respectively). It is concluded that chronic otitis media with effusion significantly affects balance and coordination skills in 4‐ to 6‐year‐old children. These skills improve after tympanostomy tube insertion at a rate greater than that of the control group.
Observations on Control of N2 and N3 Neck Disease in Squamous Cell Carcinoma of the Head and Neck by Intra‐arterial Chemoradiation
Authors: Weisman Robert A. , Christen Randolph D. , Jones Vicky E. , Kerber Charles W. , Seagren Stephen L. , Orloff Lisa A. , Glassmeyer Sherrie L. , Howell Stephen B. , Robbins K. Thomas 
Published: November 2003

AbstractPatients with head and neck squamous cell cancer with N2 and N3 neck disease have a poor prognosis and are at risk to fail regionally despite combined surgery and radiation. Twenty‐two patients with N2 and N3 neck disease (and T3‐4 primaries) were treated with intra‐arterial, high‐dose cisplatin (CDDP), 150 mg/m2 per week for 4 weeks, and concurrent radiation. All patients were followed for at least 2 years or until death from any cause. Twenty patients had a complete response at the primary site. Two of the 20 with a complete response later had a neck recurrence and died. Five patients with palpable nodes after treatment underwent fine‐needle aspiration (FNA), one of which was positive and two suggestive of cancer. Six neck dissections were performed in this group, only two of which had positive nodes. This chemoradiation protocol may offer reasonable control of N2 and N3 neck disease in advanced head and neck squamous cell cancer. Neck dissection appeared to be necessary in only those patients with nodes 8 weeks after treatment in whom FNA was positive or suggestive of cancer. Because of the relatively small size of this series, additional accrual and monitoring of such patients is planned.
Bone Cement Reconstruction of the Ossicular Chain: A Preliminary Report
Authors: Feghali Joseph G. , Barrs David M. , Beatty Charles W. , Chen Douglas A. , Green J. Douglas , Krueger Wesley W. O. , Shelton Clough , Slattery William H. , Thedinger Bradley S. , Wilson David F. , McElveen John T. 
Published: November 2003

AbstractObjective: To determine the feasibility and efficacy of using a bone cement, Oto‐Cem, to reconstruct the ossicular chain.Study Design: Prospective clinical trial on nine consecutively chosen adult patients with ossicular chain defects.Patients and Setting: Nine patients with ossicular chain defects involving the long process of the incus were treated at the Carolina Ear and Hearing Clinic. The ossicular chain was reconstructed using bone cement by itself or in conjunction with a stapes prosthesis.Main Outcome Measures: Preoperative audiograms were compared with audiograms 3, 6, and 12 months after reconstruction.Results: There was a mean pure‐tone average (PTA) improvement of 15 dB in patients undergoing incus to stapes suprastructure reconstruction with the bone cement. The incus to mobile footplate reconstruction (using a stapes prosthesis attached to the newly reconstructed incus) resulted in a 34‐dB PTA postoperative improvement. Two of the three patients with incus to oval window repairs experienced a 10‐dB improvement in PTA. One of the three patients experienced a loss in speech discrimination and a 2‐dB loss in PTA.Conclusions: Despite the limited number of patients, this preliminary study demonstrates the effectiveness of Oto‐Cem in reconstructing a foreshortened incus. There was a substantial hearing improvement in all but one patient in the incus to stapes or the incus to footplate categories.
Surgical Variables Affecting Speech in Treated Patients With Oral and Oropharyngeal Cancer
Authors: Pauloski Barbara Roa , Logemann Jerilyn A. , Colangelo Laura A. , Rademaker Alfred W. , McConnel Fred M. S. , Heiser Mary Anne , Cardinale Salvatore , Shedd Donald , Stein David , Beery Quinter , Myers Eugene , Lewin Jan , Haxer Marc , Esclamado Ramon 
Published: November 2003

AbstractPostoperative speech function may be influenced by a number of treatment variables. The objective of this study was to examine the relationships among various treatment factors to determine the impact of these measures on speech function. Speech function was tested prospectively in 142 patients with surgically treated oral and oropharyngeal cancer 3 months after treatment. Each patient's speech was recorded during a 6‐ to 7‐minute conversation and while performing a standard articulation test, producing speech outcome measures of percent correct consonant phonemes and percent conversational understandability. Correlational analyses were used to determine the relationships among the speech outcome measures and 14 treatment parameters. Speech function was mildly to moderately negatively correlated with most surgical resection variables, indicating that larger amounts of tissue resected were associated with worse speech function. Overall measures of conversational understandability and percent correct consonant phonemes were related to extent of oral tongue resection, floor of mouth resection, soft palate resection, and total volume of tissue resected. These relationships varied depending on the method of surgical closure. Method of surgical reconstruction had a profound impact on postoperative speech function 3 months after treatment and was an important factor in determining how oral tongue resection influenced articulation and intelligibility. The combination of closure type, percent oral tongue resected, and percent soft palate resected had the strongest relationship with overall speech function for patients with surgically treated oral and oropharyngeal cancer 3 months after treatment.
Radiologic percutaneous gastrostomy: Results in 56 patients with head and neck cancer
Authors: Righi Paul D. , Reddy Deepkaran K. , Weisberger Edward C. , Johnson Matthew S. , Trerotola Scott O. , Radpour Shokri , Johnson Paul E. , Stevens Christopher E. 
Published: November 2003

AbstractObjective: The establishment of a direct enteral feeding route is critical in the overall treatment of many patients with head and neck cancer. Use of radiologic percutaneous gastrostomy (RPG), the newest technique for gaining enteral access, has not been studied in such patients extensively. This study evaluated the indications, technique, success rate, and complications associated with RPG in patients with head and neck cancer. Study Design: Retrospective. Methods: A comprehensive chart review was undertaken of 56 patients with head and neck cancer treated at a tertiary care institution who had undergone successful or attempted RPG at some point during their treatment course. Results: Most study patients had advanced oropharyngeal squamous cell carcinoma. The most frequent indications for RPG were dysphagia/aspiration following tumor resection (n = 26) and dysphagia following completion of single‐ or combined‐modality therapy (n = 22). The success rate of attempted RPGs was 98.2%. The overall complication rate for RPG was 12.7% (10.9% minor and 1.8% major). Conclusions: RPG is a valuable tool for establishing enteral nutrition in patients with head and neck cancer. Advantages of RPG include high success rate despite obstructing lesions, low complication rate, time efficiency and scheduling ease compared with intraoperative percutaneous gastrostomy (PEG) by a second team, no reported tumor seeding of the tube site, and the fact that postoperative RPG allows for more accurate selection of patients who require a gastrostomy tube.
Physiologic assessment of botulinum toxin effects in the rat larynx
Authors: Inagi Katsuhide , Connor Nadine P. , Ford Charles N. , Schultz Edward , Rodriquez Arthur A. , Bless Diane M. , Pasic Thomas , Heisey Dennis M. 
Published: November 2003

AbstractObjective: Botulinum toxin (BT) is a currently used treatment for spasmodic dysphoria (SD) and other related focal dystonias. The goal of this study is to provide a basis for using the rat larynx to objectively assess physiological and histological effects of BT. Study Design: Dosages and volumes of BT injection were varied and three physiological parameters were measured. These measures included: optical density of PAS‐stained laryngeal muscle after electrical stimulation, which is an indirect measure of denervation, spontaneous laryngeal muscle activity, and laryngeal movement. Methods: A new microlaryngoscopic technique was developed, which made it possible to observe and manipulate the rat larynx endoscopically. Laryngeal movement and electromyographic (EMG) measures were made prior to injection and 3 days following BT injections of various dosages and volumes. Optical density measures were made 3 days after injection. Results: Significant reductions in vocal fold motion and spontaneous laryngeal muscle activity as a function of increased BT dosage were observed. In addition, the optical density of PAS‐stained laryngeal muscle after electrical stimulation was increased following BT injection. Significant volume effects in optical density were observed in the lateral thyroarytenoid and lateral cricoarytenoid muscles on the contralateral side. Conclusions: The rat laryngeal model is suitable for assessing BT effects. In addition, the three physiological variables provided useful and reliable measures of laryngeal function. It is the authors' intention to use the rat laryngeal model to further examine the physiological and histological effects of BT with the goal of developing new methods for the treatment of patients with SD and other focal dystonias.
Tumor necrosis factor‐α response and herpesvirus infection in bell's palsy
Authors: Larsson Christina , Bernström‐Lundberg Christina , Edström Staffan , Bergström Tomas 
Published: November 2003

AbstractObjectives: To attempt early diagnosis of patients with Bell's palsy by detection of herpesviral DNA in body fluids, and to investigate whether tumor necrosis factor‐α (TNF‐α), a cytokine associated with demyelination, is involved in the inflammatory response in this disease. Study Design: Eleven patients with acute facial palsy admitted within 1 week after onset of the disease were followed in a consecutive prospective study. Methods: Antibodies reactive to herpesviruses were determined by enzyme‐linked immunosorbent assay in serum samples from acute and convalescent (> 2‐week interval) cases. Intrathecal antibody response was investigated by immunoblotting. Polymerase chain reaction amplification of herpesviral DNA was attempted from samples of serum, cerebrospinal fluid, tear fluid, and saliva. TNF‐α and its soluble receptors (types I and II) were assessed in serum and cerebrospinal fluid samples. Results: Ten of the 11 patients demonstrated serologic evidence of herpesviral primary infection or reactivation, supporting the evidence that herpesviruses are the most prevalent etiologic agents in Bell's palsy. Despite this, DNA amplifications by polymerase chain reaction were negative for herpesviruses in the body fluids tested. TNF‐α concentrations were significantly elevated in serum, as compared with controls. Only one patient had a remaining facial nerve dysfunction at follow‐up after 3 months. Conclusion: The absence of herpes DNA in body fluids in the acute stage of serologically confirmed Bell's palsy suggests that viral replication is transient in cases with an early restoration of the facial nerve function. The elevated serum levels of TNF‐α indicate that this cytokine might be a pathogenetic factor related to the demyelination in this disease.
Molecular temporal bone pathology: III. Genotyping of the ΔF508 deletion in the DNA of patients with cystic fibrosis
Authors: Wackym Phillip A. , Kerner Marc M. , Grody Wayne W. 
Published: November 2003

AbstractGenomic DNA from a single celloidin‐embedded archival temporal bone section was used to identify a specific genetic mutation. The polymerase chain reaction was used to amplify and detect the ΔF508 deletion, a common molecular genetic defect in cystic fibrosis. This mutation, present in more than 70% of white patients and carriers with cystic fibrosis, results in the deletion of codon 508, which specifies the amino acid phenylalanine of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. When this technique was applied to archival specimens from four patients with cystic fibrosis, all expressed the carrier state of this defective gene. These data demonstrate the feasibility of identifying genetic mutations in archival temporal bone specimens.
Quality of life after acoustic neuroma surgery
Authors: Nikolopoulos Thomas P. , Johnson Ian , O'Donoghue Gerard M. 
Published: November 2003

AbstractObjective: To assess how surgery affected the quality of life of patients with acoustic neuromas and to investigate possible predictors of the functional outcome following surgery.Study Design: A questionnaire based on the Glasgow Benefit Inventory was completed by patients randomly selected following acoustic neuroma surgery.Setting: Skull base surgery unit of a university teaching hospital (tertiary referral center).Patients: Fifty‐three patients with acoustic tumors (follow‐up, 1 to 3 y).Results: With regard to overall quality of life, nine patients (17.4%) reported that it became better, 28 patients (53.8%) worse, and 15 patients (28.8%) that it remained the same. Four patients (7.8%) became better off financially, 15 patients (29.4%) worse, and 32 (62.8%) remained unchanged. Forty‐one patients (78.8%) did not change their occupation, and 11 (21.2%) had to change their occupation, mainly because of the adverse effects of the operation. With regard to the age at operation, older patients were found to have better overall quality of life. Moreover, younger patients had worse postoperative financial status and they were more likely to change their occupation after the operation. The tumor size did not significantly affect the overall postoperative quality, but it did affect the postoperative financial status (patients with larger tumors were more likely to have worse postoperative financial status).Conclusion: Acoustic neuroma surgery has a significant impact on patients' overall quality of life. Surgeons proposing to operate on small tumors should not assume that the impact on patients' life will be necessarily less than that following the removal of larger tumors. All patients, especially in the younger age group, should be prepared and thoroughly informed about the consequences of the operation on their quality of life.
Use of fibrin glue to protect tissue during CO2 laser surgery
Authors: Menovsky Thomas , De Vries Joost 
Published: November 2003

AbstractObjective: Accidental injury of tissues during CO2 laser irradiation can lead to serious morbidity, especially during ear, nose, and throat, neurosurgical, and plastic‐reconstructive procedures. This experimental study describes a new technique in which vital structures are coated with a thin layer of fibrin glue to protect them from accidental CO2 laser irradiation. Study Design/Materials and Methods: The femoral neurovascular bundles (femoral artery, vein, and nerve) of 12 rats were exposed. On one side the bundle was coated with fibrin glue, which is a biological two‐component glue consisting of fibrinogen solution and thrombin. Upon application, an elastic mass on the neurovascular bundle was formed. The contralateral neurovascular bundle was left uncoated. Subsequently both bundles were subjected to CO2 laser irradiation at different powers (5, 7, and 9 W), with an irradiation time of 0.1 seconds. Light microscopy was performed at 30 minutes and 2 days after surgery. Results: No macroscopic visible hemorrhages occurred during laser irradiation in the glue‐coated bundle. Light microscopic evaluation revealed an undamaged neurovascular bundle without any signs of thermal damage. In the uncoated bundles intraoperative hemorrhages resulting from laser energy occurred in all specimens. Furthermore, severe thermal damage was present in arteries, veins, and nerves. Conclusions: Intraoperative coating with fibrin glue can serve as a shield to protect vital structures such as arteries, veins, and nerves from accidental CO2 laser exposure. Key Words: Arteries, CO2 laser, fibrin glue, peripheral nerve, veins.
Use of glycopyrrolate in the treatment of meniere's disease
Authors: Storper Ian S. , Spitzer Jaclyn B. , Scanlan Mark 
Published: November 2003

AbstractObjectives/Hypothesis: The objective of this study was to determine whether glycopyrrolate is useful as a vestibular suppressant in patients with Meniere's disease. The tested hypotheses were that glycopyrrolate would decrease the perception of dizziness measured by the Dizziness Handicap Inventory in patients with Meniere's disease and that placebo would cause no such decrease. Study Design: Randomized, prospective. Methods: Thirty‐seven subjects with a diagnosis of Meniere's disease were administered either 2 mg of glycopyrrolate or placebo twice daily as needed for vertigo. All were also administered the regimen of 1500 mg sodium/day diet and diuretic. The following indices were examined: Dizziness Handicap Inventory, Tinnitus Handicap Inventory, Modified Somatic Perception Questionnaire, Beck Depression Inventory, hearing examination, and electronystagmography. After 4 to 6 weeks of the drug regimen, Dizziness Handicap Inventory, Tinnitus Handicap Inventory, Modified Somatic Perception Questionnaire, and Beck Depression Scale were reexamined. Paired t tests were performed to verify the significance of improvement before and after treatment. Results: Subjects who received glycopyrrolate had statistically significant reduction in Dizziness Handicap Inventory, Beck Depression Score, and Modified Somatic Perception Score. In the placebo group, no improvement in any index was found. Conclusions: The hypothesis that glycopyrrolate is a useful vestibular suppressant in patients with Meniere's disease was statistically verified. Laryngoscope, 108:1442–1445, 1998
Effects of hemimandibulectomy on quality of life
Authors: Wilson Keith M. , Rizk Nabil M. , Armstrong Shanna L. , Gluckman Jack L. 
Published: November 2003

AbstractObjective: To assess the quality of life and functional status of patients who have undergone hemimandibulectomy based on the type of reconstructive procedure performed. Study Design: Survey, retrospective. Methods: Twenty‐one patients who had undergone hemimandibulectomy and had similar defects were divided into two groups based on the reconstructive technique utilized. Eleven patients were placed in the soft tissue reconstruction group. Ten patients were placed in the mandible reconstruction group. All patients were assessed for: function, utilizing the Performance Status Scale, and quality of life, using a general cancer questionnaire (FACT‐G) and a series of questions specific for head and neck cancer patients. Results: Mandible reconstruction produced a perceived better physical appearance (P = .02), better eating ability (P = .04), and a better overall quality of life (P = .002). The mandible reconstruction cohort consistently outscored the soft tissue cohort on all questionnaires. Conclusion: Restoration of mandibular continuity after hemimandibulectomy leads to improved function and a superior quality of life in appropriately selected patients. Laryngoscope, 108:1574–1577, 1998
Role of videoendoscopy in assessment of pharyngeal function in oropharyngeal dysphagia: Comparison with videofluoroscopy and manometry
Authors: Périé Sophie , Laccourreye Laurent , Flahault Antoine , Hazebroucq Vincent , Chaussade Stanislas , Guily Jean Lacau St. 
Published: November 2003

AbstractObjective: The purpose of the current report is to evaluate the ability of videoendoscopic swallowing study in assessing pharyngeal propulsion and aspiration episodes when compared with videofluoroscopy and manometry. Study Design: Prospective study. Methods: Thirty‐four patients with oropharyngeal dysphagia underwent videoendoscopy of swallowing to assess pharyngeal propulsion as pathologic or non‐pathologic, and aspiration. These features were compared with those found on manometry and videofluoroscopy, which were considered as the reference examinations. Sensitivity, specificity, and positive and negative predictive values of videoendoscopy were estimated, with their 95% confidence intervals. Results: A total agreement between videoendoscopy and videofluoroscopy was found in 76.4% of cases for pharyngeal propulsion and in 82.3% for aspiration. This rate for pharyngeal propulsion reached 82.3% between videoendoscopy and manometry. Moreover, in 24 cases (70.5%) in which videofluoroscopy and manometry agreed for pharyngeal propulsion, 22 were assessed similarly through fiberoscopy. When using fluoroscopy and manometry as reference examinations, videoendoscopy detected nearly 90% (95% confidence interval [CI] = 0.80, 1.0) of impaired pharyngeal propulsion. Concerning aspiration, 70% (95% CI = 0.54, 0.85) of events detected by videoendoscopy were also observed on videofluoroscopy. Sensitivity, specificity, and positive and negative predictive values of videoendoscopy reached a higher rate (90% to 92.8%) when agreement was found between fluoroscopy and manometry. Conclusions: Videoendoscopy is an examination that can be used to detect inexpensively pharyngeal propulsion disorders and aspiration episodes. Laryngoscope, 108:1712–1716, 1998