bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acuteness of Preoperative Factors to Predict Hearing Preservation in Acoustic Neuroma Surgery
Authors: Ferber‐Viart Chantal , Laoust L. , Boulud B. , Duclaux R. , Dubreuil C. 
Published: November 2003

AbstractObjectives: To determine in patients with acoustic neuromas the predictive factors of hearing preservation according to clinical, radiological, and electrophysiological parameters and to evaluate, for each of these predictive factors, the percentage of patients with preserved hearing.Study Design: The study involved 107 candidates for hearing preservation attempt. Mean age was 49.7 ± 11.4 years. Quantitative and qualitative parameters were prospectively studied. Quantitative parameters were age, duration of functional complaints, hearing loss assessed by pure tone and speech audiometry, and auditory brainstem responses (ABRs). Qualitative parameters (expressed in percentage of presence) were sex, functional complaints, vestibular deficit revealed by vestibular testings, well‐shaped ABRs, wave I, III, or V of ABRs, and transient evoked otoacoustic emissions (TEOAEs).Methods: Patients were divided into two groups according to whether their hearing was preserved (52.3%) or not preserved (47.7%). First, quantitative and qualitative factors were compared between both groups to identify predictive factors. Second, all patients were considered together and the percentage of hearing preservation was determined according to the presence of each predictive factor.Results: The results confirmed the predictive value of classic parameters such as preoperative hearing level, radiological data, and trace of ABRs. They also emphasized the predictive role of other parameters such as short duration of hearing loss, presence of wave III in ABRs, and presence of TEOAEs.Conclusions: The size of the tumor and the preoperative hearing levels are longstanding predictive factors of hearing preservation in acoustic neuroma surgery, and candidates for hearing preservation are therefore now selected according to these factors. This study added more recent predictive factors and, among the 10 factors identified as predictive, the most relevant to hearing preservation were the presence of TEOAEs (69.7%), short duration of hearing loss (66.7%), and presence of wave III in ABRs (66.7%).
Levels of Intracellular Protein and Messenger RNA of Mucin and Lysozyme in Normal Human Nasal and Polyp Epithelium
Authors: Kim Sung‐Shik , Kim Kyung‐Su , Lee Jeung‐Gweon , Park In Yong , Koo Ja Seok , Yoon Joo‐Heon 
Published: November 2003

AbstractObjectives: Mucus hypersecretion is a characteristic feature in chronic sinusitis with nasal polyps. The objective of this study is to examine whether the polyp epithelium itself contributes to a certain extent to the increased mucous secretions in chronic sinusitis with nasal polyps, and if it does, to determine which mucin genes are responsible for the increased mucin secretion.Methods: Three pooled samples of normal nasal epithelial cells from each subject were obtained by scrapings from the inferior turbinates of 30 healthy adult volunteers and nasal polyps from 6 patients who underwent intranasal ethmoidectomy and polypectomy. Isolated epithelial cells were used for total RNA isolation for reverse transcriptase polymerase chain reaction and cell lysates for immunoblotting.Results: The intracellular level of mucin from polyp epithelium was 2.9 times higher than that of normal nasal epithelium (P < .05). Interestingly, MUC2 and MUC8 messenger RNA (mRNA) levels were clearly upregulated in polyp epithelium compared with those of normal turbinate epithelium.Conclusions: Polyp epithelium can be considered to contribute in part to increased secretion in chronic sinusitis with polyps, and increased mucous secretion might be related to the increased mRNA level of MUC2 or MUC8 or both.
Percutaneous Magnetic Resonance Image–Guided Biopsy and Aspiration in the Head and Neck
Authors: Merkle Elmar M. , Lewin Jonathan S. , Aschoff Andrik J. , Stepnick David W. , Duerk Jeffrey L. , Lanzieri Charles F. , Strauss Melvin 
Published: November 2003

AbstractObjective/Hypothesis To test the hypotheses that 1) magnetic resonance imaging (MRI)–guided biopsy and aspiration with an open 0.2‐T system (Magnetom Open, Siemens, Erlangen, Germany) in the head and neck is feasible and successful and 2) procedure times can be sufficiently short to be well tolerated by the patient.Methods Sixty‐one MRI‐guided procedures were performed in 47 patients (ages, 6 mo–88 y) in the head and neck, including the mucosal sites and masticator and parapharyngeal spaces (n = 23), parotid space (n = 6), submandibular space (n = 2), cervical vertebral column/paraspinal tissues (n = 8), skull base (n = 3), larynx or hypopharynx (n = 3), and infrahyoid nodal chains and surrounding tissues (n = 16). A clinical C‐arm imaging system was used, supplemented by an in‐room radiofrequency–shielded liquid crystal monitor, rapid gradient echo sequences for needle guidance, and MRI‐compatible anesthesia, monitoring, and surgical lighting equipment. Tissue sampling included fine‐needle aspiration (n = 58) and cutting‐needle core biopsy (n = 27), with 24 patients undergoing both procedures. Procedures were evaluated for success of needle placement, procedure time, and complications.Results Successful needle placement was accomplished in all cases without complication, with tissue sufficient for pathological diagnosis obtained for all but five patients with an average of 2.1 passes per patient. For fine‐needle aspiration, average instrument time was 7.8 minutes per pass, and average cutting‐needle core biopsy time was 9.2 minutes.Conclusions Interactive MRI guidance for needle biopsy and aspiration of deep head and neck lesions is feasible, successful, and safe. Procedure times are sufficiently short to be well tolerated by the patient.
Peripheral Blood T‐Lymphocyte and Monocyte Function and Survival in Patients With Head and Neck Carcinoma
Authors: Heimdal John H. , Aarstad Hans J. , Olofsson Jan 
Published: November 2003

AbstractObjectives/Hypothesis To determine if the T‐lymphocyte and monocyte functions of peripheral blood mononuclear cells (PBMCs) from patients with head and neck squamous cell carcinomas (HNSCC) are predictive factors for outcome.Study Design A prospective study describing the outcome, as to total survival and death by disease after at least 40 months observation, of 81 previously untreated male HNSCC patients in relation to PBMC T‐lymphocyte and monocyte function.Methods T‐lymphocyte mitogenesis and the cytokine level in culture supernatants of PBMC as well as monocytes were analyzed. These parameters were related to survival by Cox regression and Kaplan‐Meier survival analysis.Results When patients with high versus low T‐lymphocyte mitogen–stimulated proliferations were compared, a decreased proliferation was seen to be related to worse outcome. The predictive value of T‐lymphocyte proliferation was shown to be an independent prognostic factor when adjusted for stage and stratified for anatomic location in survival analysis. The predictive value was also retained when the serum values of the major serum proteins and hormones and scores based on the smoking and alcohol history were added to the survival analysis with lymphocyte proliferation. Supernatant levels of γ‐interferon, interleukin (IL)‐2, or IL‐4 in PBMC cultures were not related to outcome. Monocyte function measured by endotoxin‐stimulated IL‐1β, IL‐6, IL‐12, and tumor necrosis factor‐α secretion did not relate to outcome of the patients.Conclusion The PBMC T‐lymphocyte–stimulated proliferation is an independent prognostic factor for male HNSCC patients.
Conservative Surgery in T3–T4 Pharyngolaryngeal Squamous Cell Carcinoma: An Alternative to Radiation Therapy and to Total Laryngectomy for Good Responders to Induction Chemotherapy
Authors: Lecanu Jean‐Baptiste , Monceaux Guy , Périé Sophie , Angelard Bruno , St. Guily Jean Lacau 
Published: November 2003

AbstractObjective To evaluate the possibility of preservation of the larynx after neoadjuvant chemotherapy by performing a conservative surgery instead of total laryngectomy initially planned, in patients with previously untreated laryngeal and piriform sinus squamous cell carcinoma (SCC).Study Design Retrospective study.Methods A total of 115 patients treated at Tenon Hospital with induction chemotherapy from 1985 to 1995, all with initial indication of radical surgery, were available for the study. The clinical tumor response was evaluated after three cycles of chemotherapy. According to this response, to preserve laryngeal functions, some patients had a modification of the treatment initially planned: radiation therapy essentially for complete responders, and conservative surgery for some partial responders.Results Of 69 patients with laryngeal cancer, 14 were treated by partial laryngectomy and 19 by radiation therapy; of 46 patients with piriform sinus cancer, 8 were treated by partial surgery and 12 by radiation therapy; the other patients were treated as was initially planned (total laryngectomy with partial pharyngectomy). Overall survival rates, estimated by the Kaplan‐Meier method, were not statistically different between the three treatment groups. The laryngeal functions were preserved in 54% of the patients who were alive at 3 years.Conclusion This report is a retrospective study, but these results suggest the possibility of using conservative surgery, instead of initially planned total laryngectomy, for good responders to induction chemotherapy with a small residual tumor.
Lateral Thyrotomy Approach on the Paraglottic Space for Laryngocele Resection
Authors: Thomé Robert , Thomé Daniela Curti , De La Cortina Rodrigo A. C. 
Published: November 2003

AbstractObjective To report on the results of using a lateral thyrotomy approach on the paraglottic space to gain greater access for laryngocele resection under direct vision.Study Design A 26‐year prospective and retrospective study. The study was conducted on 10 adult patients (5 men and 5 women) who had laryngocele of varying size on the paraglottic space. Six of the patients had internal laryngocele and four had exteriorized laryngocele. Five laryngoceles were left‐sided, three were right‐sided, and two were bilateral.Methods A V‐shaped, full‐thickness thyroid lamina resection with the triangle base at the superior border and the apex at a point midway of the thyroid lamina vertical extent was performed.Results A V‐shaped lateral thyrotomy made exposure to the paraglottic space possible for direct submucosal laryngocele dissection. This approach has presented no complications to date. Postoperative minor edema or hematoma was found in the aryepiglottic and ventricular folds, but this disappeared within a few days. There was no recurrence; the minimum follow‐up was 1 year.Conclusion The triangular lateral thyrotomy approach provided access to the paraglottic space and superb visibility for resection of laryngocele of any size under direct vision, thus avoiding recurrence, morbidity, and complications.
Quality of Life in Head and Neck Cancer
Authors: Weymuller Ernest A. , Yueh Bevan , Deleyiannis Frederic W.‐B. , Kuntz Alice L. , Alsarraf Ramsey , Coltrera Marc D. 
Published: November 2003

AbstractBecause treatments for patients with cancer of the head and neck can have major impact on physical, social, and psychological function, the collection of quality of life (QOL) data in this group of patients is critical for our specialty. The University of Washington Quality of Life data have been collected and analyzed on three subsets of cancer patients. Information learned from these patients is summarized and strategies for future projects are outlined.
Calciphylaxis: Is There a Role for Parathyroidectomy?
Authors: Kriskovich Mark D. , Holman John M. , Haller Jeffrey R. 
Published: November 2003

AbstractObjective Calciphylaxis, a rare disorder typically affecting renal failure patients, results in vascular calcification with subsequent skin necrosis, gangrene, and often death from sepsis. Parathyroid hormone is thought to act as a tissue sensitizer leading to these soft tissue changes. As such, parathyroidectomy is often advocated to control this complicated condition. A discussion of calciphylaxis does not exist in the otolaryngology literature, and head and neck surgeons performing parathyroidectomy should be aware of this phenomenon. This study evaluates the success of parathyroidectomy in reversing the ill effects of calciphylaxis in both our patient population and the literature.Study Design Retrospective study and review of the literature.Methods Five patients with calciphylaxis treated at our institution were evaluated for mortality, surgical and perioperative complications, wound healing, and predictors of patient outcomes.Results Two patients died from sepsis and infectious complications of their calciphylaxis shortly after surgery. Of the three survivors, two later died (15 and 18 mo after surgery) from causes not directly related to calciphylaxis. The other long‐term survivor required partial amputation of a leg for osteomyelitis. There was one operative complication— a wound infection requiring antibiotic therapy, drainage, and packing. Postoperative hypocalcemia required treatment in two patients. Immediate perioperative survival was more likely in patients with leukocyte counts less than 20,000 cells/mL.Conclusions Calciphylaxis is a serious disease and patients often succumb to sepsis and infectious complications. Patients with extremely high leukocyte counts from coexistent infections may have a worse prognosis. Although a conclusive effective therapy does not exist, parathyroidectomy can be safely performed and may benefit some patients with what is often an otherwise fatal disease. The literature to date generally confirms our findings.
Past History of Otitis Media and Balance in Four‐Year‐Old Children
Authors: Casselbrant Margaretha L. , Furman Joseph M. , Mandel Ellen M. , Fall Patricia A. , Kurs‐Lasky Marcia , Rockette Howard E. 
Published: November 2003

AbstractObjectives/Hypothesis To obtain normative data for a population of children 4 years of age with respect to standard vestibular and balance test protocols and to determine, in the absence of concurrent middle ear effusion (MEE), the possible changes caused by a history of recurrent or persistent MEE.Study Design Comparative studies of the results of vestibular and balance tests in a cohort of young children with and without a history of MEE.Methods Seventy‐one children, 4 years of age, with a well‐documented history since early infancy regarding the presence or absence of MEE were evaluated using pneumatic otoscopy, tympanometry, audiometry, and vestibular and balance (rotational and moving platform posturography) tests. For the results of the vestibular and balance tests, comparisons were made between the group of 31 children (43.7%) without and the group of 40 children (56.3%) with a history of recurrent or persistent MEE, when a positive disease history was defined as at least a 10% cumulative percentage of time with MEE between early infancy and time of testing.Results When compared with children with a negative history of significant MEE, children with a positive history had a lower average gain to a rotational stimulus of 0.1 Hz, 150°/s (0.57 vs. 0.44;P = .007). There were no significant differences between groups with respect to other measures.Conclusions These results suggest that a history of recurrent or persistent MEE affects the vestibular and/or balance function of 4‐year‐old children when tested in the absence of a concurrent episode of MEE. The possible sequelae of the disease should be weighed in future considerations of early intervention for MEE.
Laser‐Assisted Endoscopic Stapedectomy: A Prospective Study
Authors: Poe Dennis S. 
Published: November 2003

AbstractObjective To improve the techniques required to perform a stapedotomy without prosthesis (stapedioplasty).Study Design New infrared lasers were evaluated for potential use in otological surgery in guinea pigs. A prospective human trial of 34 primary stapes operations using the Argon ion laser was performed, with 11 stapedioplasties and 23 conventional stapedotomies as controls.Methods Laser–tissue interactions were evaluated for temporal bone and live guinea pig tissues, measuring crater histology and labyrinthine temperature elevations. Patients undergoing stapedioplasty had Argon ion laser cuts with endoscopic assistance made in the anterior crus and footplate to mobilize the posterior segment of the stapes while the anterior portion remained fixed.Results Diode laser (808‐nm) vaporization craters and temperature elevations in the vestibule were suitable for clinical use. Overall, stapedioplasty patients' hearing was improved with air‐bone gap closure to a mean of 8.3 dB (SD ± 9.8 dB).Conclusions Patients with anterior footplate otosclerosis are candidates for stapedioplasty preserving the annular ring and stapes tendon and eliminating prosthesis complications. High‐resolution small endoscopes, coupled with Argon ion or diode lasers promise to improve stapes visualization, enhancing the ability to perform minimally invasive surgery on the stapes footplate.
Antisense RNA to eIF4E Suppresses Oncogenic Properties of a Head and Neck Squamous Cell Carcinoma Cell Line
Authors: DeFatta Robert J. , Nathan Cherie‐Ann O. , De Benedetti Arrigo 
Published: November 2003

AbstractObjective The translation initiation factor eIF4E is elevated in all head and neck squamous cell cancers (HNSCCs) and appears to be essential in the progression of solid tumors. Overexpression of eIF4E results in preferential upregulation of two angiogenic factors, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF‐2). We wanted to determine whether reducing eIF4E in a HNSCC cell line could suppress its oncogenic properties and in turn decrease expression of VEGF and FGF‐2.Methods Levels of eIF4E protein expression were determined in a panel of HNSCC cell lines. An episomal vector containing antisense RNA to eIF4E was used to reduce the eIF4E level in one of these cell lines, FaDu. After a stable transfection, Western blot analysis was performed to determine the level of eIF4E and FGF‐2 reduction, while an enzyme‐linked immunosorbent assay (ELISA) was used to determine the level of VEGF reduction. In vitro and in vivo experiments were performed to determine whether there was a reversion in the tumorigenic properties of the FaDu cells.Results All six cell lines had elevated levels of eIF4E compared with Detroit 551, a normal cell line. Reducing eIF4E expression via antisense RNA suppressed both the tumorigenic and angiogenic properties of the FaDu cells, as demonstrated by loss of capacity to grow in soft agar, reduced expression of angiogenic factors, and loss of tumorigenicity in nude mice.Conclusions Antisense RNA therapy to eIF4E can potentially be used as adjuvant therapy for head and neck cancers, particularly in cases in which elevated eIF4E is found in the surgical margins.
A Retrospective Analysis of Temporomandibular Joint Reconstruction With Free Fibula Microvascular Flap
Authors: Wax Mark K. , Winslow Catherine P. , Hansen Juliana , MacKenzie Douglas , Cohen James , Andersen Peter , Albert Thomas 
Published: November 2003

AbstractObjectives The temporomandibular joint is occasionally encountered in extirpative surgery of the head and neck. It presents a difficult management issue. Little has been reported on functional outcomes after resection and reconstruction of the temporomandibular joint.Design A retrospective analysis consisting of chart reviews and phone interviews was performed on 17 patients who underwent fibular free flap reconstruction of the temporomandibular joint from 1993 to 1998.Results Mean follow‐up in surviving patients (10) was 41.3 months. Mean age of the group was 62; male‐to‐female ratio was 11:6. Average hospital stay was 11.6 days. Four patients had no radiation therapy, 2 had preoperative and 11 had postoperative treatment. Five patients had one osteotomy, seven had two, one had three, and one had four. Ten patients could chew, one could not, and none were recorded for the remaining. Diet consisted of regular food for two patients, soft food for seven, full liquids for four, and tube feeds for four. Cosmesis was judged as excellent by eight patients, acceptable by two, and unacceptable by two. Five patients did not describe cosmesis. Most patients stated that bony contour was excellent, but that the soft tissue defect was noticeable. Speech was judged as intelligible by seven and moderately understandable by one. Nine patients did not describe speech. Two patients had postoperative displacement of the fibular head out of the fossa.Conclusion Primary reconstruction of the temporomandibular joint with microvascular fibular flaps is a viable and effective means of restoring function. The majority of patients are able to resume oral feeds, obtain excellent or pleasing cosmetic results, and maintain intelligible speech.
Nasal Interleukin‐5, Immunoglobulin E, Eosinophilic Cationic Protein, and Soluble Intercellular Adhesion Molecule‐1 in Chronic Sinusitis, Allergic Rhinitis, and Nasal Polyposis
Authors: Kramer Matthias F. , Ostertag Peter , Pfrogner Elisabeth , Rasp Gerd 
Published: November 2003

AbstractObjective To compare concentrations of interleukin‐5 (IL‐5), immunoglobulin E (IgE), eosinophilic cationic protein (ECP), and soluble intercellular adhesion molecule‐1 (sICAM‐1) in nasal secretion and serum of patients with chronic nonallergic sinusitis, allergic rhinitis, and nonallergic nasal polyposis to obtain information about the pathogenesis of these diseases.Methods Nasal secretion and serum were analyzed by routine enzyme‐linked immunosorbent assay techniques. Nineteen patients with chronic nonallergic sinusitis, 24 patients with seasonal allergic rhinitis, and 18 patients with nonallergic nasal polyposis were included in the study. Eight healthy, nonallergic probands served as control subjects.Results Significantly elevated concentrations of IL‐5 (5‐fold, P < .05) and IgE (15‐fold, P < .01) were detected in nasal secretion of patients with allergic rhinitis (IL‐5, 51.8 ± 13.2 pg/mL; IgE, 41.9 ± 20.9 kU/L) or nonallergic nasal polyposis (IL‐5, 57.9 ± 36.9 pg/mL; IgE, 40.5 ± 20.2 kU/L) compared with controls (IL‐5, 10.6 ± 7.8 pg/mL; IgE, 2.8 ± 0.5 kU/L) or with patients with chronic nonallergic sinusitis (IL‐5, 16.5 ± 13.2 pg/mL; IgE, 5.4 ± 3.1 kU/L). There were no significant differences between patients with allergic rhinitis and those with nonallergic nasal polyposis. Concentrations of ECP were significantly elevated (sixfold, P < .01) in patients with allergic rhinitis (297.8 ng/mL ± 173.1) compared with controls (52.4 ± 28.0 ng/mL) or patients with chronic nonallergic sinusitis (44.8 ± 40.1 ng/mL), whereas twofold higher concentrations (not significant) of ECP were observed in patients with nonallergic nasal polyposis (107.1 ± 26.6 ng/mL). Significantly elevated concentrations of sICAM‐1 in nasal secretion (threefold, P < .05) were detected only in patients with chronic nonallergic sinusitis (79.4 ± 45.6 ng/mL). The elevated sICAM‐1 nasal secretion values in this group correlated significantly (P < .05) to the serum values.Conclusions Equally elevated concentrations of IL‐5 and IgE in patients with allergic rhinitis and nonallergic nasal polyposis implicated similar pathogenic processes in both diseases. Whereas the pathogenesis of allergic rhinitis is IgE‐specific, the pathogenesis of nasal polyps is not as clear. IL‐5 was suggested to play a pivotal role in tissue eosinophilia, which was confirmed by data in the present study. Elevated concentrations of ECP were suggested to result from tissue eosinophilia—a characteristic of both diseases. Elevated concentrations of sICAM‐1 in patients with chronic nonallergic sinusitis pointed to its key role in the recruitment of neutrophils into the inflamed tissue, whereas an important role in eosinophil recruitment was ruled out.