bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative Identification of Laryngeal Nerves With Laryngeal Electromyography
Authors: Mermelstein Mariana , Nonweiler Rebecca , Rubinstein Eduardo H. 
Published: November 2003

AbstractThe laryngeal nerves are at risk during thyroid surgery, and several techniques have been described for their intraoperative identification to minimize potential damage. Nerve protection is based on the electromyographic recording from the muscles innervated by the laryngeal nerves, and that electrical activity is picked up by various techniques. We evaluated an electrode attachment to the endotracheal tube that provides a stable method for continuous recording of the laryngeal electromyogram. In addition, we tested various modalities of electrical stimulation in the region where the nerves are located, identified the most reliable evoked electromyographic activity, and characterized the wave form and latency. The results, obtained in 28 patients scheduled for thyroid and parathyroid surgery, indicate that the technique of recording from electrodes attached to the endotracheal tube is safe and reliable. Insulated bipolar forceps or a monopolar electrode was used to deliver low‐voltage pulses (1 to 3 V) at 1 to 2 pulses/s generated by either battery‐operated or optically isolated stimulators. The most unequivocal recordings were obtained with the monitoring equipment set to the nerve‐conduction velocity modality, with the sweep set at 2 msec/cm. The technique clearly differentiated the evoked electromyographic responses obtained from the superior or recurrent laryngeal nerve and was easily performed with no perioperative complications.
Nasofrontal Duct Reconstruction With Silicone Rubber Sheeting for Inflammatory Frontal Sinus Disease: Analysis of 164 Cases
Authors: Amble Finn R. , Kern Eugene B. , Neel H. Bryan , Facer George W. , McDonald Thomas J. , Czaja Judith M. 
Published: November 2003

AbstractThe authors reviewed their experience in reconstructing the nasofrontal duct with thin silicone rubber sheeting in patients who had chronic inflammatory frontal sinus disease. The 164 patients were divided into four groups. The patients in group 1 had the traditional modified Lynch procedure, while those in group 2 had certain technical variations of the modified Lynch operation. The patients in the other two groups had major technical variations: those in group 3 had a primary osteoplastic flap approach and those in group 4 had revisions of failed osteoplastic flap with fat obliteration operations.Surgical indications included mucopyocele (87 patients), chronic frontal sinusitis (71 patients), osteomyelitis (2 patients), acute sinusitis (2 patients), and subacute sinusitis (2 patients). Follow‐up averaged 47 months. At their last clinic visit, 157 patients (96%) were asymptomatic. Forty‐six revision procedures were performed in 30 patients (18% of initial cases). There were no major complications. Nasofrontal duct reconstruction using thin silicone rubber sheeting is technically straightforward, safe, and effective.Laryngoscope, 106:809‐815, 1996
Cost Utility of the Multichannel Cochlear Implant in 258 Profoundly Deaf Individuals
Authors: Wyatt J. Robert , Niparko John K. , Rothman Margaret , deLissovoy Gregory 
Published: November 2003

AbstractCost utility analysis is a method of cost‐effectiveness analysis which provides results in terms of cost per quality‐adjusted life‐year (QALY). Cost utility for the multichannel cochlear implant was calculated using Ontario Health Utilities Index data from 229 Nucleus 22‐channel implant users and 32 cochlear implant candidates awaiting surgery.The health utility of the implanted group was greater than that of the candidate group by 0.204 (P<.0001). Use of this figure in a cost utility calculation indicates that cochlear implantation costs approximately$15,928 per QALY provided. Sensitivity analysis, a technique which systematically varies the assumptions underlying the calculations, suggests a range for the true value of between $12,000 and $30,000. This compares very favorably with other medical interventions.It is concluded that profound hearing loss has a significant effect on quality of life, and measurement of the changes that result from cochlear implant use indicates that this technology provides significant improvements and is quite cost‐effective.Laryngoscope, 106:816‐821, 1996
Criteria for Success in Pediatric Functional Endonasal Sinus Surgery
Authors: Younis Ramzi T. , Lazar Rande H. 
Published: November 2003

AbstractFunctional endonasal sinus surgery (FESS) is widely used in the treatment of chronic sinusitis in adults and children. Although success rates of 80% to 93% have been reported, no criteria for success or improvement have been suggested. Standardized measures are needed to assess the outcome of FESS and to compare the results obtained by different surgical teams and for various patient groups. After reviewing the charts of 500 pediatric patients who underwent FESS between July 1987 and June 1992, the authors of this study formalized criteria for assessing the outcome of surgery.Laryngoscope, 106:869‐873, 1996
Transpharyngeal Approach to Base of Tongue Tumors: A Comparative Study
Authors: Nasri Sina , Oh Young , Calcaterra Thomas C. 
Published: November 2003

AbstractTumors of the tongue base have been traditionally removed by resecting the mandible or using a translabial transmandibular approach. These procedures involve significant morbidity including lip and chin scars, malocclusion, compromised deglutition, chronic aspiration, and altered speech articulation. Therefore alternative techniques have been described to minimize the morbidity associated with transmandibular tongue resection.A retrospective analysis of patients with base of tongue tumors treated at the University of California, Los Angeles, Medical Center between 1981 and 1994 was undertaken. Thirteen patients were treated using a transpharyngeal approach compared with 18 patients who underwent a transmandibular resection. There was no difference in terms of survival or tumor‐free margins. However, there was a significant difference in function (P<.05). Patients who underwent transpharyngeal resection had significantly better speech and swallowing and less aspiration compared with those who underwent transmandibular resection of tumors.
Effect of Hyperbaric Oxygenation on Existing Oral Mucosal Carcinoma
Authors: McDonald Kathleen R. , Bradfield Joseph J. , Kinsella John K. , Kumar Druv , Mader Jon A. , Hokanson James A. , Calhoun Karen H. 
Published: November 2003

AbstractHyperbaric oxygen therapy (HBO) is used to treat some complications of head and neck carcinoma treatment. Several patients treated with HBO have had rapid growth of a clinically cured squamous cell carcinoma. Prior studies have produced conflicting evidence about the effect of HBO on tumor growth. This study was undertaken to determine the effects of HBO on established squamous cell carcinoma. Forty Golden Syrian hamster cheek‐pouch carcinomas were induced with the established chemical carcinogen 9,10‐dimethyl‐1,2‐benzanthracene. Twenty hamsters underwent 30 HBO dives for 60 minutes each to 2.81 atm, while 20 served as controls. At necropsy, animals receiving HBO therapy had significantly smaller tumors (P<.05) and showed a trend toward fewer cervical metastases (P<.06). HBO therapy with coexistent carcinoma inhibited the established tumor's growth.
Microsporidian Sinusitis in Patients with the Acquired Immunodeficiency Syndrome
Authors: Rossi Renée M. , Wanke Christine , Federman Micheline 
Published: November 2003

AbstractSinusitis in patients with human immunodeficiency virus (HIV) infection usually arises from the same organisms that are infective in the nonimmunosuppressed population. The authors of this article report that optimal antimicrobial treatment and functional endoscopic sinus surgery failed to eradicate sinonasal disease in three of five patients with acquired immunodeficiency syndrome (AIDS) and refractory sinusitis. The sinonasal disease was manifested by congested, edematous, and polypoid mucosa, often with a superimposed bacterial infection from ostial obstruction. After tissue was sent for electron microscopy (EM), the patients were eventually diagnosed with microsporidiosis of the sinonasal cavities.Microsporidia are obligate intracellular protozoans that have been seen in AIDS patients with diarrhea. These protozoans have only recently been identified in sinonasal tissue. Microsporidia are often missed on routine histopathology.The authors present case reports on their five AIDS patients with refractory sinusitis. The management of refractory sinusitis in the HIV‐infected population, including mandatory EM of sinonasal tissue, is also discussed.
Hearing Loss in Turner Syndrome
Authors: Sculerati Nancy , Oddoux C. , Clayton C. Mark , Lim Jessica W. , Oster Harry 
Published: November 2003

AbstractA retrospective study was undertaken to answer the following questions: Is the sensorineural hearing loss (SNHL) in Turner syndrome progressive? Can the occurrence of hearing loss be explained by the parental origin of the intact X chromosome? Twenty‐four individuals recruited through the Turner Syndrome Society completed a questionnaire and submitted sufficient medical records to determine their otologic status. The majority (21/24) have had problematic otitis media (OM), and two thirds (16/24) have SNHL.In seven of the Turner subjects (age range: 12 to 51 years), gradual progressive SNHL began in late childhood or early adulthood. Molecular techniques showed no correlation between parental origin of the retained X chromosome and hearing status in 17 Turner subjects and at least one of their parents. SNHL and frequent OM appear to be independent variables that are both present in Turner syndrome. It is postulated that the presence of unpaired genes on the X chromosome may account for hearing loss and other phenotypic abnormalities seen in this syndrome.
Management of Airway Obstruction in Cicatricial Pemphigoid
Authors: Lazor John B. , Varvares Mark A. , Montgomery William W. , Goodman Max L. , Mackool Bonnie T. 
Published: November 2003

AbstractCicatricial pemphigoid is a chronic vesiculobullous disease of the mucosal epithelium that primarily involves the oral cavity and the eyes. The clinical and histologic features are identical to those of bullous pemphigoid, and these features often can be nonspecific for other disease processes. It is not unusual for a period of 1 year or more to elapse before a diagnosis is made. The diagnosis of cicatricial pemphigoid requires characteristic lesions and histopathologic evidence of immunoglobulin deposition along the basement membrane, as well as a high index of suspicion. The authors detail a case of cicatricial pemphigoid resulting in airway obstruction and present the treatment required for both stabilization of the airway and resolution of the disease process.
Age‐related Alterations in the Auditory Brainstem Responses and the Compound Action Potentials in Guinea Pigs
Authors: Nozawa Izuru , Imamura Shun‐ichi , Fujimori Isao , Hashimoto Kaori , Shimomura Shin‐ichi , Hisamatsu Ken‐ichi , Murakami Yoshihiko 
Published: November 2003

AbstractThe auditory brainstem response (ABR) and the eighth nerve compound action potential (CAP) were measured using click stimuli to investigate the agerelated alteration in the auditory function in 66 guinea pigs consisting of four age groups. With advancing age, a gradual elevation of the thresholds in both the ABR and CAP was clearly seen, together with the prolonged latencies for waves I, II, III, and IV to clicks at 95 dBpeSPL in the ABR. There were some individual differences in either threshold elevation or latency prolongation of both the ABR and CAP in aged guinea pigs. These findings suggest that the effect of individual differences on degenerative aging processes of the auditory system should be considered in selected aged animals, although a significant elevation of the neural auditory threshold is clearly found with advancing age as a whole.
Factors Related to Quality of Life and Functional Status in 50 Patients With Head and Neck Cancer
Authors: Long Steven A. , D'Antonio Linda L. , Robinson Ernest B. , Zimmerman Grenith , Petti George , Chonkich George 
Published: November 2003

AbstractQuality of life (QOL) and functional status (FS) have become important outcome measures in cancer therapy. Valid and reliable instruments recently have been developed for examining QOL and FS in patients with head and neck (HN) cancer. The present study evaluated the relationships of QOL and FS to physical and psychological variables assumed to affect QOL and FS. Fifty patients were evaluated up to 6 years after HN cancer surgery using one general QOL instrument and three HN‐specific instruments. Analysis of variance showed physical variables such as tumor site to be related to HN‐specific scores, while psychosocial variables such as marital status were related to general QOL scores (P≤.05). Several relationships were seen between physical or psychosocial variables and FS or QOL measures; however the relationships were not as strong or direct as expected.
Early Eyelid Rehabilitation in Facial Nerve Paralysis
Authors: Linder Thomas E. , Pike Virginia E. , Linstrom Christopher J. 
Published: November 2003

AbstractUpper‐lid gold‐weight insertions and lowerlid‐shortening procedures are standard surgical techniques used to restore eyelid function and protect the cornea in patients with facial nerve paralysis. Different opinions exist in the literature regarding the correct timing and the morbidity of these interventions. The retrospective analysis of 45 patients over a 5‐year period revealed extrusion of the gold weight in one (2.2%) patient and delayed infections in three (6.6%). Sixty percent of all gold‐weight insertions were performed within 4 weeks after the onset of facial nerve paralysis. We strongly favor gold‐weight insertion, often combined with lower‐lid‐shortening procedures, as a simple, reliable, reversible, and successful technique for early rehabilitation of the paralyzed eyelid. Using these guidelines, we have markedly reduced the need for tarsorrhaphies.
Association of Otitis Media With Effusion and Allergy as Demonstrated by Intradermal Skin Testing and Eosinophil Cationic Protein Levels in Both Middle Ear Effusions and Mucosal Biopsies
Authors: Hurst David S. 
Published: November 2003

AbstractThis study was performed to ascertain the role of allergy, as defined by skin testing and histochemical markers, in the pathogenesis of otitis media with effusion (OME). A historical perspective of allergy as it relates to OME is presented. The study included 89 patients: 48 with persistent effusion but no recent acute infection, 25 with purulent OME complicated by a superimposed infection, and 16 control subjects. All 89 patients had persistent effusion for more than 2 months and subsequently required the placement of tympanostomy tubes.Allergy was defined using the radioallergosorbent test (RAST), serum immunoglobulin E (IgE) levels, and skin tests. Allergies were present in 97% of the patients with nonacute OME. The relationship between allergy and OME was corroborated clinically in 89% of patients and was also substantiated by elevated levels of effusion eosinophil cationic protein (ECP) in 87.5% of OME patients. Histologically, polyclonal antibody staining for ECP demonstrated the presence of eosinophils in middle ear mucosal biopsy specimens.This study confirms that OME is a sign of allergic inflammation in the middle ear that is associated with an increase in eosinophils and a concomitant release of ECP into the effusion in individuals with allergy demonstrated by skin testing.
Acquired Maxillary Sinus Hypoplasia: A Consequence of Endoscopic Sinus Surgery?
Authors: Kosko James R. , Hall Bruce E. , Tunkel David E. 
Published: November 2003

AbstractThe effects of functional endoscopic sinus surgery (FESS) on sinus and midfacial development remain unclear. The authors report five children who, at a median age of 30 months, underwent FESS for refractory sinusitis. Three of the children had cystic fibrosis, and two had asthma. Preoperative computed tomographic (CT) scanning showed symmetric maxillary sinus development with varying degrees of mucosal disease.At a mean of 42 months after surgery, CT scans were obtained to evaluate recurrent symptoms in the five children. The scans showed unilateral maxillary hypoplasia in four children and bilateral maxillary sinus hypoplasia in one child. No child had clinically apparent facial asymmetry or midfacial hypoplasia.The authors also discuss the factors involved in maxillary sinus pneumatization, the possible effects of sinus surgery on sinus development, and the clinical implications of “acquired” maxillary sinus hypoplasia.Laryngoscope, 106:1210‐1213, 1996
Nasal Septal Squamous Cell Carcinoma: A Chart Review and Meta‐analysis
Authors: DiLeo Michael D. , Miller Robert H. , Rice Janet C. , Butcher R. Brent 
Published: November 2003

AbstractSquamous cell carcinoma of the nasal septum occurs infrequently and is often misdiagnosed because its symptoms are similar to everyday rhinologic complaints. The published series have been too small to determine the best form of treatment for this cancer. The authors of this study retrospectively reviewed nasal septal squamous cell carcinomas treated at three university‐affiliated hospitals over a 30‐year period. Sixteen primary tumors were identified and reviewed for presentation, staging, treatment, recurrence patterns, and risk factors. The authors then combined their findings with those of suitable literature series and performed a meta‐analysis to evaluate predictors of survival.There were too few patients in each stage and treatment group to significantly determine the optimal treatment for nasal septal squamous cell carcinoma. However, based on the present study and the literature series, the authors suggest that small lesions may be confidently treated with either radiation or surgery and that combined therapy may be reserved for more advanced tumors.Laryngoscope, 106:1218‐1222, 1996
Absorption of Topical Cocaine in Rhinologic Procedures
Authors: Greinwald John H. , Holtel Michael R. 
Published: November 2003

AbstractAlthough topical intranasal cocaine remains a common anesthetic in nasal surgery, controversy surrounds its dosage and mucosal absorption. A prospective study of 12 patients undergoing nasal surgery was performed to evaluate the absorption of cocaine solution from standard cotton pledgets. Of a 160‐mg cocaine solution applied, a mean amount of 102 mg or 63.8% was recovered by gas chromatography/mass spectrometry analysis. Similar analysis of nasopharyngeal packs revealed less than 1.5% cocaine loss in the nasopharynx. Serum levels of cocaine were rarely detectable and did not correlate with either the amount of nasal absorption or time of mucosal contact. These results indicate that less than 37% of cocaine is absorbed from cotton pledgets during nasal surgery. The cocaine dose of 160 mg, used by many otolaryngologists, did not result in significant plasma levels.Laryngoscope, 106:1223‐1225, 1996
Laryngeal Tuberculosis in HIV‐Infected Patients: A Difficult Diagnosis
Authors: Singh Bhuvanesh , Balwally Atul N. , Nash Michael , Har‐El Gady , Lucente Frank E. 
Published: November 2003

AbstractUnrecognized laryngeal tuberculosis (TB) poses a significant hazard to otolaryngologists. However, the changing manifestations of TB in patients with human immunodeficiency virus (HIV) infection can make its diagnosis difficult. In our population of 146 patients with TB involving the head and neck, HIV infection was present in 70 cases (48%). The prevalence of laryngeal TB in this population was 5.5% (8 patients). Concomitant HIV infection was present in 2 (25%) of 8 patients with laryngeal TB. A delay in the diagnosis of laryngeal TB occurred in 100% of patients with HIV infection, compared with 17% of non‐HIV‐infected patients (P = .055). The cause of the delayed diagnosis was multifactorial, mainly the presence of multiple confounding variables and the carcinoma‐like appearance of the laryngeal TB lesions in HIV‐infected patients. To reduce risk for transmission of TB to health care providers, a high level of suspicion must be present for all patients with laryngeal lesions, especially those with HIV infection.Laryngoscope, 106:1238‐1240, 1996
Tracheobronchography in Children
Authors: Deutsch Ellen S. , Smergel Eleanor , Crisci Kristin , Panitch Howard 
Published: November 2003

AbstractTracheobronchography (TBG) can provide anatomic information supplementing endoscopy in evaluating complex congenital and acquired tracheal abnormalities. With the use of modern non‐ionic contrast agents and flexible fiberoptic bronchoscopes, TBG can be performed safely and comfortably in children. As some tracheal lesions have a significant risk of mortality, obtaining maximum definition of the abnormality is imperative prior to attempting surgical management.Twenty‐two patients underwent TBG at St. Christopher's Hospital for Children(Philadelphia) from July 1990 through June 1995. With the use of iohexol as a contrast agent, flexible bronchoscopes and adequate sedation and analgesia, without the need for intubation or general anesthesia, there were no significant complications or discomfort during or after the procedure.Techniques and illustrative radiographs are presented. TBG provides a useful adjunct to endoscopy.Laryngoscope, 106:1248‐1254, 1996
Indirect Larynx and Pharynx Surgery: A Replacement for Direct Laryngoscopy
Authors: Bastian Robert W. , Delsupehe Kathelijne G. 
Published: November 2003

AbstractDuring a 2‐year period, 192 indirect surgeries on the laryngopharynx were performed in an outpatient videoendoscopy laboratory under topical anesthesia with or without intravenous sedation. These procedures included cancer staging and biopsy; vocal fold injections of Teflon, Gelfoam, botulinum toxin, or steroids; glottic web lysis; and granuloma removal. The techniques used to perform these procedures are elucidated. Careful chart review of these patients shows that indirect surgery was performed successfully in 96% of cases. Intravenous conscious sedation was utilized in 39% of patients. No significant complications were encountered. By avoiding the need for an operating room, hospitalization, or general anesthesia, this technique was clearly as safe or safer, more convenient for surgeon and patient, and more cost‐effective than the same procedure would have been via the traditional direct laryngoscopy. As the authors have already done in their practices, the indirect method should therefore be reinstated as the preferred approach to the clinical circumstances described here.Laryngoscope, 106:1280‐1286, 1996