bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival, Function, and Quality of Life After Total Glossectomy
Authors: Ruhl Charles M. , Gleich Lyon L. , Gluckman Jack L. 
Published: November 2003

AbstractAdvanced tongue cancer is associated with poor survival despite aggressive therapy. In an attempt at cure, many patients undergo total glossectomy, which significantly affects function and quality of life (QOL). This study was designed to determine the survival rate and QOL of patients who had undergone total glossectomy. A total of 54 patients underwent total glossectomy, with or without total laryngectomy, for advanced tongue cancer from 1970 to 1996. Patient outcomes were assessed for the following: 1. disease‐free survival, 2. function, utilizing the Performance Status Scale (PSS), and 3. QOL, using two general cancer questionnaires (FACT‐G and EORTC QLQ‐C30) and a series of questions specific for head and neck cancer patients. Corrected actuarial survival was 51% and 41% at 3 and 5 years, respectively. Functional assessment using the PSS demonstrated significant deficits in speech and deglutition. QOL questionnaires revealed problems with eating, speaking, socializing, and shoulder function. However, the over‐all responses demonstrated that these patients have adjusted to their deficits and have a good QOL. It was concluded that total glossectomy, with or without total laryngectomy, can result in meaningful survival and an adequate QOL can be achieved in selected patients.
Fibrous Dysplasia of the Temporal Bone: Reversal of Sensorineural Hearing Loss After Decompression of the Internal Auditory Canall
Authors: Morrissey David D. , Michael Talbot J. , Schleuning Alexander J. 
Published: November 2003

AbstractWhen fibrous dysplasia affects the temporal bone, it most often presents with conductive hearing loss attributable to stenosis of the external auditory canal. Sensorineural hearing loss has usually been attributed to involvement of the otic capsule. We present a patient with bilateral fibrous dysplasia of the temporal bones who complained of unilateral hearing loss, facial tingling, and facial twitching. The audiogram showed severe sensorineural hearing loss. The hearing markedly improved and facial twitching and tingling ceased after decompression of the internal auditory canal via a middle fossa approach. This is the only case of which we are aware showing reversal of sensorineural hearing loss caused by fibrous dysplasia.
Inner and Middle Ear Hyperbaric Oxygen‐Induced Barotrauma
Authors: Beuerlein Matthew , Nelson Richard N. , Bradley Welling D. 
Published: November 2003

AbstractPatients receiving hyperbaric oxygen (HBO) therapy can sustain inner and middle ear barotrauma. The purpose of this study is to define the incidence and significance of HBO‐related barotrauma, in addition to establishing guidelines for prophylactic myringotomy or tympanostomy tube placement. Thirty patients were stratified into two groups (those able to autoinflate and those unable to autoinflate the middle ear) and barotrauma was assessed by otoscopy, tympanometry, high‐frequency audiometry, and distortion product otoacoustic emission (DPOAE) testing. Ten of 11 patients (91%) from the noninflater group suffered middle ear barotrauma, and seven of 19 patients (37%) from the autoinflater group sustained middle ear barotrauma. Patients unable to autoinflate the middle ear were shown to have a higher incidence and greater severity of barotrauma than patients able to autoinflate. Pretreatment pressure‐equalizing tubes or myringotomies should be considered for patients undergoing HBO therapy who have an artificial airway or have eustachian tube dysfunction and have failed conservative medical intervention. A significant change in DPOAEs (loss of emissions over a 1‐kHz range) was found in four of 15 autoinflaters (27%) and two of seven noninflaters (29%). There was no significant difference between the groups. The decrease in DPOAEs was not associated with a change in conventional audiometry.
Translacrimal Transnasal Laser‐Assisted Dacryocystorhinostomy
Authors: Pearlman Steven J. , Michalos Peter , Leib Martin L. , Moazed Kambiz T. 
Published: November 2003

AbstractChronic dacryocystitis is due to an obstruction in the nasolacrimal duct, with subsequent infection of the lacrimal sac. The goal of surgery is to reestablish intranasal drainage of the lacrimal sac. Classic dacry‐ocystorhinostomy (DCR) requires an external incision and drilling through the lacrimal bone into the middle meatus. In our study a 600‐micron neodymium:YAG (Nd:YAG) fiber with a blunt hemispherical tip is inserted via the lacrimal puncta. An intranasal ostium is created with the laser under intranasal endoscopic control. Silicon tubes are then left in place for 6 months. We have performed 49 procedures over the past 2 1/2 years, with a success rate of 85% after one surgical procedure, which is commensurate with standard DCR. This procedure provides a simple, bloodless, incisionless alternative to standard DCR.
Effects of Systemic Hyperoxia on Eustachian Tube Ventilatory Function
Authors: Shupak Avi , Tabari Reza , Swarts Douglas J. , Bluestone Charles D. , Doyle William J. 
Published: November 2003

AbstractMiddle ear negative pressure and effusions, decreased middle ear compliance, and abnormal tympanometry results have been described after diving on oxygen. Middle ear gas hyperoxia has been shown to down‐regulate the eustachian tube ventilatory function (ETVF). The purpose of the present study was to investigate to what extent systemic hyperoxia in the face of air‐equivalent middle ear gas composition might interfere with the ETVF. ETVF was investigated in four young adult female cynomolgus monkeys by the forced‐response and inflation‐deflation tests using air while the animals breathed either room air or 100% normobaric oxygen. Higher opening, closing, and steady‐state pressures were observed under systemic hyperoxia. The percentage of the applied pressure equalized, and the maximal pressure change on a single swallow in the deflation test were both lower under hyperoxic conditions. The results show that systemic hyperoxia might impair ETVF. This observation adds to our understanding of the pathophysiology of middle ear dysfunction observed after diving on oxygen.
Sphenopalatine Blocks in the Treatment of Pain in Fibromyalgia and Myofascial Pain Syndrome
Authors: Janzen Victor D. , Scudds Roger 
Published: November 2003

AbstractSphenopalatine blocks have been used to treat pain for more than 80 years. Anecdotal support for sphenopalatine ganglion blocks has been very strong in those who believe in the technique, but the research results have been inconclusive. Therefore, a double blind, placebo‐controlled study was performed on 61 patients, 42 with fibromyalgia and 19 with myofascial pain syndrome. Pain was measured using visual analogue scales prior to treatment, during treatment, and 28 days after the treatment. Headaches were evaluated in frequency and location prior to and after treatment. Sphenopalatine ganglion blocks were performed under direct vision using 4% lidocaine and sterile water as a placebo. Analysis of the results showed no statistical differences between the lidocaine and the placebo groups.
A Classification Scheme for Paradoxical Vocal Cord Motion
Authors: Maschka Donald A. , Bauman Nancy M. , McCray Paul B. , Hoffman Henry T. , Karnell Michael P. , Smith Richard J.H. 
Published: November 2003

AbstractParadoxical vocal cord motion (PVCM) is characterized by the inappropriate adduction of the true vocal cords during inspiration. Multiple causes have been proposed for this group of disorders, which share the common finding of mobile vocal cords that adduct inappropriately during inspiration and cause stridor by approximation. Management of this group of disorders has been complicated by the lack of a classification scheme to include all types of PVCM. We propose that PVCM be classified according to its underlying etiology and recognize the following causes of the disorder:
1
. brainstem compression;
2
. cortical or upper motor neuron injury;
3
. nuclear or lower motor neuron injury;
4
. movement disorder;
5
. gastroesophageal reflux;
6
. factitious or malingering disorder;
7
. somatization/conversion disorder. Case reports are presented to illustrate the characteristic features and diagnostic evaluation used in assessing patients with PVCM. Management varies depending on the cause of PVCM and entails speech therapy, pharmacologic therapy, behavioral modification, and/or surgical intervention. Recognition of the multiple causes of PVCM allows otolaryngologists to formulate well‐directed diagnostic evaluation and treatment.
Stapedectomy Training With the Carbon Dioxide Laser
Authors: Beatty Todd W. , Haberkamp Thomas J. , Khafagy Yasser W. , Bresemann Jon A. 
Published: November 2003

AbstractAll primary carbon dioxide (CO2) laser stapedectomies supervised by the senior author since 1986 were retrospectively reviewed and reported according to 1995 American Academy of Otolaryngology‐Head and Neck Surgery Committee on Hearing guidelines. Sixty‐three cases had more than 6 weeks of follow‐up with an average residual gap of 6.49 dB (SD = 5.55 dB) and an 89% success rate. Thirty cases had more than 1 year of follow‐up with the average hearing result of 6.58 dB (SD = 5.93 dB) and an 87% success rate. In 11 cases, 14 operative problems or complications occurred. Suctioning the vestibule occurred in five cases. Because suction is required to evacuate laser smoke, these cases are attributed to the laser. One of these patients had delayed sensorineural hearing loss. One patient had profound delayed sensorineural hearing loss as a result of granuloma formation. These were the only major complications. The laser is a tool that gives reproducible technique and good success rates.
Thermal Effects of Laser Stapedectomy in an Animal Model: CO2 Versus KTP
Authors: Kodali Satish , Harvey Steven A. , Prieto Thomas E. 
Published: November 2003

AbstractAlthough use of the laser for stapedectomy has become common in recent years, controversy remains regarding whether the CO2 or visible‐spectrum lasers (argon and KTP) are best suited for this operation. The main concern has been the potential for thermal injury to the inner ear with the visiblespectrum lasers attributable to their absorption characteristics. To further investigate this issue, the author performed 20 laser stapedectomies on adult chinchillas. Following placement of a 0.127‐mm‐diameter copper/constantan thermocouple (sampling at 12 Hz) beneath the footplate on the medial wall of the vestibule via a distant fenestration site, thermal changes with a micromanipulator‐based CO2 and fiberoptic KTP system were compared. This was the first live animal model comparison of these two lasers. There was no statistical difference in the mean temperature elevation between the two systems (
P
= 0.395).
Validation of the Charlson Comorbidity Index in Patients With Head and Neck Cancer: A Multi‐institutional Study
Authors: Singh Bhuvanesh , Bhaya Mahesh , Stern Jordan , Roland J. Thomas , Zimbler Marc , Rosenfeld Richard M. , Har‐El Gady , Lucente Frank E. 
Published: November 2003

AbstractComorbid conditions are medical illnesses that accompany cancer. The impact of these conditions on the outcome of patients with head and neck cancer is well established. However, all of the comorbidity studies in patients with head and neck cancer reported in the literature have been performed using the Kaplan‐Feinstein index (KFI), which may be too complicated for routine use. This study was performed to introduce and validate the use of the Charlson comorbidity index (CI) in patients with head and neck cancer and to compare it with the Kaplan‐Feinstein comorbidity index for accuracy and ease of use. Study design was a retrospective cohort study. The study population was drawn for three academic tertiary care centers and included 88 patients 45 years of age and under who underwent curative treatment for head and neck cancer. All patients were staged by the KFI and the CI for comorbidity and divided into two groups based on the comorbidity severity staging. Group 1 included patients with advanced comorbidity (stages 2 or 3), and group 2 included those with low‐level comorbidity (stages 0 or 1). Outcomes were compared based on these divisions. The KFI was successfully applied to 80% of this study population, and the CI was successfully applied in all cases (
P
< 0.0001). In addition, the KFI was found to be more difficult to use than the CI (
P
< 0.0001). However, both indices independently predicted the tumor‐specific survival (
P
= 0.007), even after adjusting for the confounding effects of TNM stage by multivariate analysis. Overall, the CI was found to be a valid prognostic indicator in patients with head and neck cancer. In addition, because comorbidity staging by the CI independently predicted survival, was easier to use, and more readily applied, it may be better suited for use for retrospective comorbidity studies.
Lost Airway During Anesthesia Induction: Alternatives for Management
Authors: Sofferman Robert A. , Johnson David L. , Spencer Robert F. 
Published: November 2003

AbstractPediatric and adult patients with upper airway obstruction pose several challenges to the anesthesiologist and otolaryngologist‐head and neck surgeon. The initiation of general anesthesia and endotracheal intubation may progress to complete life‐threatening respiratory decompensation with failure to achieve endotracheal intubation or mask ventilation. Hurried invasive maneuvers such as large‐bore needle tracheal entry and cricothyrotomy are recognized salvage techniques, but other modes of extratracheal ventilation are now possible before surgical airway procedures are required. The laryngeal mask airway and esophagotracheal Combitube (Kendall Sheridan Health Care Products Co., Argyle, NY) are described, with examples of their clinical application. The combined technique of anterior commissure laryngoscopy and intubation with the gum elastic bougie is the preferred alternative for achieving tracheal entry when extratracheal ventilation cannot be accomplished. An algorithm for joint management of the problem airway by anesthesiologist and otolaryngologist‐head and neck surgeon is illustrated.
Interaction Between Hypertension and Diabetes Mellitus in the Pathogenesis of Sensorineural Hearing Loss
Authors: Duck Sigsbee W. , Prazma Jiri , Bennett P. Scott , Pillsbury Harold C. 
Published: November 2003

AbstractThe purpose of this study is to support the hypothesis that diabetic end‐organ damage of the cochlea is augmented in the setting of hypertension. A historical perspective reviewing the effects of diabetes and hypertension as causative factors in the development of sensorineural hearing loss, as well as the basic epidemiology and pathophysiology of the renal and vascular effects of diabetes and hypertension, is presented. The results of audiologic findings in insulin‐dependent diabetic patients, both normotensive and hypertensive, were analyzed and correlated with the results of animal studies to support the hypothesis that sensorineural hearing loss in patients and cochlear hair cell loss in animal studies result from the effects of hypertension in conjunction with insulin‐dependent diabetes mellitus.
Cerebellopontine Angle Tumor Outcomes in Patients With Hazardous Occupations
Authors: Yu Kenneth C.Y. , Arriaga Moisés A. , Chen Douglas A. 
Published: November 2003

AbstractCerebellopontine angle (CPA) tumor surgery can produce a spectrum of sensory and motor deficits that can alter a patient's lifestyle and occupation. An important consideration is whether patients can return to full occupational status especially when hazardous duties are involved. Outcome data in CPA tumor surgery usually report that most patients are able to return to preoperative function; however, whether these patients can return to hazardous duties is not specified. A retrospective study of 380 consecutive, operated CPA tumor patients was performed and 37 were identified who engaged in hazardous occupations including active military service, working at dangerous heights, piloting jet aircraft, aircraft navigating, and factory work with high‐impact machinery. Overall, patients were able to resume full‐time work in their previous occupations and 86% of patients reported that they were able to resume hazardous duties. CPA tumor surgery is compatible with continued full occupational duties after surgery, even for patients employed in hazardous situations.
Complications of Gold Weight Eyelid Implants for Treatment of Fifth and Seventh Nerve Paralysis
Authors: Dinces Elizabeth A. , Mauriello Joseph A. , Kwartler Jed A. , Franklin Mark 
Published: November 2003

AbstractComplications occurred in six patients after gold weights were implanted into the upper eyelid tissues for fifth and seventh nerve palsies. These complications included implant infection without extrusion (in one patient); entropion with trichiasis and presumed inflammatory reaction to the gold weight material (in one patient); upper eyelid distortion and poor eyelid contour with corneal ulceration and scarring (in one patient); significant residual lagophthalmos with exposure keratitis (in one patient); and blepharoptosis obscuring the pupillary access (in two patients). Resolution of the complications required 1. implant removal in four of six patients without reinsertion of a second weight, 2
. recession of the retractors of the upper eyelids with medial and lateral canthoplasty (in four patients), and
3
. permanent tarsorrhaphy (in one patient). The authors conclude that complications may be minimized by careful preoperative determination of the optimum implant size, weight, and placement within the eyelid as well as meticulous attention to the surgical technique of implantation. The use of other eyelid protective procedures is often necessary to augment corneal protection especially in patients with combined fifth and seventh cranial nerve palsies. Endogenous implant infection without extrusion of the gold weight may be distinguished from presumed inflammation due to gold allergy by clinical response to antibiotics in the former and requirements of steroids or removal of the implant in the latter.
Evaluation of the Bone Resistance of the Sphenoid and Ethmoid Sinuses
Authors: Waridel François , Monnier Philippe , Agrifoglio Arido 
Published: November 2003

AbstractFunctional endoscopic sinus surgery can be associated with iatrogenic complications. Some anatomical structures have been identified this clinically as specific danger sites. The aim of this study was to confirm and to compare these clinical data with measurements of the bone resistance of the sphenoid and ethmoid walls and to point out regions that have increased bony fragility. Critical dynamometric evaluation of the resistance to breakage of these bony structures was made on 21 anatomic specimens. This study allowed the authors to localization of surgical complications, to demonstrate that other regions renowned for their fragility can be relatively robust, and to point out that robust sites can be dangerously fragile as a result of individual morphological variations. Results from this study provide a supplement to the guidelines for novice surgeons to use in identifying dangerous areas.
Needle Placement With Transtympanic Electrocochleography
Authors: Krueger Wesley W.O. , Wagner Allison P. 
Published: November 2003

AbstractElectrocochleography (ECoG) is an objective, electrophysiologic test useful in the clinical diagnosis of endolymphatic hydrops, or Meniere's disease. The purpose of this study was to determine if the position of the needle, using transtympanic methodology, gives a variable SP/AP (summating potential/action potential) response. SP/AP ratios were obtained during routine tympanoplasty procedures. After the tympanic membrane remnant was removed using a lateral graft technique, precise needle placement was obtained at the medial and lateral round window niches, as well as on the promontory. SP/AP ratios were obtained in these three needle positions. There was no significant difference in the SP/AP ratio responses despite the location of needle placement. The use of transtympanic electrocochleography can give very good wave form morphology and consistent results. Therefore, if elevated SP/AP ratios do occur, they are thought to be due to a pathologic process of the ear and not needle placement.
Overlay Versus Underlay Tympanoplasty. Part II: The Study
Authors: Rizer Franklin M. 
Published: November 2003

AbstractThis report compares two contemporary techniques of tympanic membrane repair. The prospective comparison study included 712 cases over 9 years. Whether the tympanic membrane was repaired by an underlay or an overlay technique, results were reliable. By making a postauricular incision, greater visibility of the operative site can be obtained. Larger perforations can be closed more reliably when greater exposure is obtained. The placement of the graft above or below the annulus is not the issue. Careful technique and precise work are the keys to successful tympanoplasty. Thus otologic surgeons should cultivate effective techniques, attempting to continuously improve their results to achieve perfection.
Glottographic Signal Perturbation in Biomechanically Different Types of Dysphonia
Authors: Lin Emily , Jiang Jack , Hanson David G. 
Published: November 2003

AbstractGlottographic signals may be superior to acoustic signals for tracking glottal source perturbations, since supraglottal vocal tract effects on glottographic signals are relatively minimal compared with the acoustic signal as measured beyond the lips. This study compared the ability of differing signals to differentiate among normal voices and abnormal voices that were due to two categories of biomechanical disease. Acoustic, electroglottographic, and photoglottographic signals recorded during vowel phonation sustained by 26 normal subjects and 65 patients were measured for perturbations of frequency and amplitude. One‐way analysis of variance (ANOVA) revealed that amplitude perturbation measures from photoglottographic signals significantly differentiated neuromuscular from mass lesion sources of dysphonia. Acoustic and electroglottographic signal perturbations differentiated between normal and abnormal voices but did not distinguish between the dysphonic characteristics of neuromuscular disorders and those of mass lesions of the vocal folds.
Age‐Related Glycine Receptor Subunit Changes in the Cochlear Nucleus of Fischer‐344 Rats
Authors: Krenning Judyann , Hughes Larry F. , Caspary Donald M. , Helfert Robert H. 
Published: November 2003

AbstractPrevious studies have shown that levels of binding for the strychnine‐sensitive glycine receptor in the cochlear nucleus (CN) of Fischer(F344) rats decrease with age. Given the major role glycine plays in normal CN function, changes in glycine‐receptor activity may contribute to central presbycusis. To further evaluate the impact of age on glycine receptors, in situ hybridization was used to assess, in three age groups of F344 rats, changes in levels of gene expression for four of its subunits. When compared with the 3‐month‐old rats, expression of mRNAs for α1 and β subunits in the anteroventral CN decreased significantly in the 18‐ and 27‐month‐old age groups, while mRNA expression for the α2 subunit increased. If protein expressions are similar, these subunit changes may alter the function of glycine receptors, thereby affecting binding to its ligands.