bluuebunny/crossref_metadata_2025_split huggingface dataset:
Localization of Inducible Heat Shock Protein mRNA in the Guinea Pig Cochlea with a Nonradioactive In Situ Hybridization Technique
Authors: Gower Verlia C. , Thompson Ann M. 
Published: November 2003

AbstractCell types of the guinea pig cochlea that contain mRNA of the inducible heat shock protein (HSP72) were determined with an in situ hybridization technique, using a biotinylated oligonucleotide probe. Staining was present in the spiral limbus, spiral prominence, stria vascularis, and organ of Corti (supporting, pillar, outer hair, and interdental cells). In sections digested with pepsin, only spiral ganglion cells stained. The pattern of staining was similar in normal and heat‐stressed animals. Therefore, HSP72 mRNA is present in many guinea pig cochlear cell types, some of which have not previously been shown to contain HSP72 protein. Differences in HSP72 mRNA and protein staining may be attributable to stress or processing techniques, but they may also suggest mechanisms unique to guinea pigs and primates, who normally express the inducible form of HSP.
In Situ Hybridization for Aspergillus and Penicillium in Allergic Fungal Sinusitis: A Rapid Means of Speciating Fungal Pathogens in Tissues
Authors: Perez‐Jaffe Liza A. , Lanza Donald C. , Loevner Laurie A. , Kennedy David W. , Montone Kathleen T. 
Published: November 2003

AbstractAllergic fungal sinusitis (AFS) is a serious form of sinonasal fungal disease that is commonly associated with Aspergillus or Dematiaceous fungi. This study was performed to determine the incidence ofAspergillus or Penicillium in AFS by using in situ hybridization (ISH) for Aspergillus and Penicillium ribosomal RNA (rRNA). The Fontana‐Masson melanin stain (FMMS) was also used to detect pigmented fungi (A. niger and Dematiaceous fungi). ISH was performed on 26 patients: 17 AFS cases with histologic evidence of fungi, 5 AFS cases without histologic evidence of fungi, 3 cases of invasive fungal sinusitis (IFS), and 1 case of fungus ball. Nine AFS specimens with histologic evidence of fungi were ISH positive. Positivity was also noted in two of three IFS cases, while no staining was seen in the fungus ball and in six AFS specimens without fungi demonstrable by silver stains. Six ISH‐positive cases were FMMS positive, suggestingA. niger. Five ISH‐negative AFS specimens were FMMS positive, suggesting Dematiaceous fungi. In summary, many AFS patients in our institution demonstrate Aspergillus/Penicillium organisms. Ancillary techniques may help identify fungi responsible for AFS if cultures are negative or not performed. ISH for rRNA is a useful means for rapidly speciating fungi in human tissues.
Endoscopic CO2 Laser Excision of Large or Recurrent Laryngeal Saccular Cysts in Adults
Authors: Hogikyan Norman D. , Bastian Robert W. 
Published: November 2003

AbstractSaccular cysts are uncommon disorders that represent cystic dilatation of the laryngeal saccule. They are distinguished from laryngoceles by their lack of lumenal continuity with the endolarynx, and the fact that they are not air filled. Voice change is the most common clinical presentation in adults, whereas airway compromise is more common in infants. Management recommendations range from observation of asymptomatic lesions, to endoscopic marsupialization or excision, to excision through a laryngotomy or the thyrohyoid membrane. The literature states that large or recurrent saccular cysts require the exposure afforded by a transcervical approach. This report describes complete endoscopic laser excision of large, symptomatic saccular cysts in seven adults. Four of the seven patients were referred with recurrent cysts after the failure of endoscopic marsupialization procedures. None required tracheotomy, and only three of seven were observed overnight in the hospital. Surgical technique with emphasis on complete excision, pre‐ and postoperative radiographic and surgical anatomy, and treatment outcome are discussed.
Benign Osteonecrosis of the External Ear Canal
Authors: Wolf Michael , Nusem‐Horowitz Sima , Zwas S. Tzila , Horowitz Ada , Kronenberg Jona 
Published: November 2003

AbstractBenign osteonecrosis (BON) of the external ear canal (EEC), also termed as focal or circumscribed necrotizing lesion, is an infrequent phenomenon with distinctive features and of an obscure origin. Five patients with BON of the EEC presented with aggressiveness and extension of varying degree including involvement of the middle ear. It seems that the disease might have a self limited course (two patients) though, at times, extensive measures including hyperbarric oxygen therapy (one patient) should be applied.
Surgical Outcome in 87 Patients With Zenker's Diverticulum
Authors: Bonafede Joseph P. , Lavertu Pierre , Wood Benjamin G. , Eliachar Isaac 
Published: November 2003

AbstractSurgical treatment of Zenker's diverticulum is controversial because many different procedures exist. We retrospectively reviewed 87 consecutive patients surgically treated for Zenker's diverticulum at a tertiary care institution from 1976 through 1993. Four surgical procedures were performed: cricopharyngeal myotomy alone (n = 16), excision (hand‐sewn) plus myotomy (n = 51), excision (stapler) plus myotomy (n = 11), and diverticulopexy plus myotomy (n = 9). There were three surgical mortalities (3.5%) and a complication rate of 24%. Eighty patients (92%) were available for follow up. Sixty‐eight patients (78%) reported excellent relief of symptoms, 10 (13%) reported improvement with occasional symptoms, and two (3%) described persistent dysphagia. No statistical difference in complication rate was found among surgical groups (P = 0.15). Myotomy alone patients had worse outcomes (P = 0.04) compared with the other surgical groups. Median follow‐up was 7.5 months.
Nasal Dermoid Sinus Cysts in Children
Authors: Denoyelle F. , Ducroz V. , Roger G. , Garabedian  
Published: November 2003

AbstractThirty‐six children with nasal dermoid sinus cysts were treated in the Department Pediatric Otolaryngology, Armand Trousseau's Children's Hospital (Paris, France) between 1974 and 1994. Ten of the patients presented with a midline cyst only, eight had nasal pits only, and 18 had combined cases. In six of the 36 patients, presurgical imagery indicated signs of intracranial extension of the tract, reaching the foramen caecum without intracranial mass. Three surgical techniques were used: an external rhinoplasty approach with medial crura section in 23 cases, a direct median approach in seven cases, and a paracanthal approach in six cases. Only two cases had meningeal adherences. Two superficial recurrences occurred within the 7‐year follow‐up period. Widening of the scar occurred in four children after verticomedian approach or nasal pit excision. The external rhinoplasty procedure with medial crura section results in a wide surgical approach, low recurrence rate, and good aesthetic results.
Preoperative Embolization in the Management of Neck Paragangliomas
Authors: Tikkakoski Tapani , Luotonen Jukka , Leinonen Sami , Siniluoto Topi , Heikkilä Outi , Päivänsalo Markku , Hyrynkangas Kalevi 
Published: November 2003

AbstractSurgery of neck paragangliomas carries inherent risks of excessive blood loss and cranial nerve injury. Preoperative embolization has been used to lessen the morbidity of surgery. We sought to characterize our experience with preoperative embolization by evaluating safety, efficacy, and surgical data. During a period of 22 years (1974 to 1996), 19 consecutive patients with 27 histopathologically confirmed neck paragangliomas were surgically treated at the Oulu University Hospital. All patients underwent preoperative arteriography and 17 patients had cervical ultrasonography (US). Eleven patients with 15 tumors were operated on without embolization and nine patients with 12 tumors were preoperatively embolized with 150‐ to 250‐μm polyvinyl alcohol (PVA) particles. The mean blood loss during surgery in the nonembolized group was 1374 mL (range, 100 to 4500 mL) and the mean operation time was 4 hours and 48 minutes (range, 1.5 to 9 hours). In the embolized group the mean blood loss was significantly less (588 mL; range, 100 to 1800 mL; P = 0.04) and the mean operation time shorter (3 hours 24 minutes; range, 2 to 5 hours; P = 0.05). No embolic complications were recorded after the embolization. We conclude that preoperative embolization of neck paragangliomas 3 cm or greater in diameter with PVA particles is safe. Embolization to minimize operative bleeding facilitates surgery, shortens the operation time, and lessens the surgical risks.
Periauricular Cysts and Sinuses
Authors: Nofsinger Yoon Choi , Tom Lawrence W.C. , LaRossa Donato , Wetmore Ralph F. , Handler Steven D. 
Published: November 2003

AbstractPeriauricular cysts, sinuses, and fistulas occur commonly in the pediatric population. They arise from developmental defects of the first branchial cleft and first branchial arch. In most instances the diagnosis and management of these conditions are straightforward, but exceptional presentations sometimes occur. Failure to recognize these unusual cases may result in inadequate treatment and subsequent recurrence, and even if the correct diagnosis is made, surgical management of these lesions may be complicated. A series of 15 cases of periauricular congenital lesions is reviewed, of which three cases illustrating a diagnostic or surgical challenge are presented. The embryology, presentation, and management of these anomalies are discussed. This is one of the largest series of first branchial cleft anomalies reported in the literature, and our paper uniquely discusses first branchial cleft anomalies and preauricular sinuses together, with an emphasis on the surgical management of facial nerve, external ear, and middle ear involvement.
Midline Mandibular Osteotomy: An Analysis of Functional Outcomes
Authors: Riddle Seth A. , Andersen Peter E. , Everts Edwin C. , Cohen James I. 
Published: November 2003

AbstractAlthough the oncologic validity and perioperative complications of midline mandibular osteotomy are well described, little attention has been directed toward the long‐term functional problems that may be associated with its use. Thirty‐one patients who had undergone this procedure were examined to assess postoperative sensation, temporomandibular joint (TMJ) function, occlusion, and cosmesis. The majority (27 of 31) patients had some sequclae but these were minor in nature. Twenty of 31 patients had abnormal sensation, 24 of 31 noted a changed occlusion, and 15 of 31 had signs or symptoms of TMJ myofascial pain. Although patients should be advised of the potential for functional problems with this procedure, they can be reassured that these are likely to be relatively minor in significance. If technically feasible and if an exact restoration of occlusion is a priority, a prefabricated lingual splint should be used.
Myofibroblast Accumulation Induced by Transforming Growth Factor‐β Is Involved in the Pathogenesis of Nasal Polyps
Authors: Wang Qiu Pin , Escudier Estelle , Roudot‐Thoraval Françoise , Samad Issam Abd Al , Peynègre Roger , Coste Andre 
Published: November 2003

AbstractMyofibroblasts that express α‐smooth muscle actin(α‐SMA) are detected in many chronic inflammatory diseases. Transforming growth factor‐β (TGF‐β) is a potent inducer of myofibroblast accumulation in tissues. In this study, scattered myofibroblasts and TGF‐β were quantified and localized in nasal polyps (NPs) and normal nasal mucosa(NM). NPs were sampled in 16 patients during ethmoidectomy and NM was obtained from 10 control subjects during rhinoplasty. α‐SMA and TGF‐β were detected using immunohistochemistry and the numbers of labeled cells were quantified (α‐SMA and TGF‐β indices) and compared between NPs and NM. In eight NPs, in which the pedicle was preserved, α‐SMA and TGF‐β were evaluated and compared in the pedicle, central, and tip areas. Finally, TGF‐β expression was compared between low (zone 1), moderate(zone 2), and high (zone 3) zones of α‐SMA positivity. α‐SMA and TGF‐β indices were significantly higher in NPs than in NM. In the eight selected NPs, α‐SMA‐positive cells were significantly more abundant in the pedicle than in the central and tip areas, whereas TGF‐β‐positive cells were significantly more numerous in the pedicle than in the tip area. The number of TGF‐β‐positive cells was significantly higher in zone 3 than in zone 1 of α‐SMA positivity. Myofibroblasts, which are abundant in NPs but rare in NM, could be involved in the growth of NPs by inducing extracellular matrix accumulation. The local development of myofibroblasts in NPs could be controlled by TGF‐β, locally produced by inflammatory cells.
Hypopharyngeal Cancer Patient Care Evaluation
Authors: Hoffman Henry T. , Karnell Lucy H. , Shah Jatin P. , Ariyan Stephan , Brown G. Stephen , Fee Willard E. , Glass Andrew G. , Goepfert Helmuth , Ossoff Robert H. , Fremgen Amy M. 
Published: November 2003

AbstractA survey was conducted to identify demographics and standards of care for treatment of hypopharyngeal squamous cell carcinoma in the United States. Data were accrued from voluntary submission of cancer registry and medical chart information from 769 hospitals representing 2939 cases diagnosed from 1980 to 1985 and 1990 to 1992. Clinical findings, diagnostic procedures employed, treatment practices, and outcome are presented. Overall, 5‐year disease‐specific survival was 33.4%, which segregated to 63.1% (stage I), 57.5%(stage II), 41.8% (stage III), and 22% (stage IV). Survival was best for patients treated with surgery only (50.4%), similar with combined surgery and irradiation (48%), and worse with irradiation only (25.8%). This analysis provides a standard to which current treatment practice and future clinical trials may be compared.
Anatomic Location of the Tongue Base Neurovascular Bundle
Authors: Lauretano Arthur M. , Li Kasey K. , Caradonna David S. , Khosta Rohit K. , Fried Marvin P. 
Published: November 2003

AbstractKnowledge of the location of the hypoglossal/lingual artery neurovascular bundle (HLNVB) is essential in performing tongue base resections for neoplasm and for obstructive sleep apnea. Transoral and transcervical resections of the tongue base may be performed with greater exposure and certainty when the relationship of the HLNVB to local landmarks is understood; knowledge of the HLNVB allows resection of a larger amount of contralateral tongue base during partial glossectomy without violating the contralateral remnant tongue's blood supply. Ten cadaver heads were dissected to determine the position of the HLNVB with respect to soft tissue and bony landmarks at the tongue base. Our results indicate the position of the tongue base HLNVB is significantly inferior and lateral, that is, 2.7 cm inferior and 1.6 cm lateral to the foramen cecum, 0.9 cm superior to the hyoid bone, and 2.2 cm medial to the mandible. This inferolateral location allows the potential for aggressive tongue base resection without neurovascular compromise.
Nasal Reconstruction Using a Combination of Alloplastic Materials and Autogenous Tissues: A Surgical Alternative
Authors: Bikhazi Nadim B. , Chow Albert W. , Maas Corey S. 
Published: November 2003

AbstractRe‐creation of a functional and aesthetically acceptable nose after partial nasal defect requires accurate reproduction of nasal lining, support, and coverage. Most authors recommend an approach to reconstruction with cantilevered bone grafting and paramedian forehead flap placement. The authors propose an alternative approach for selected patients with total or near‐total nasal defects combining both alloplastic and autogenous tissues. This method uses vitallium or titanium mesh for the dorsal framework formation, tissue‐expanded paramedian forehead flap for soft tissue coverage, and composite chondrocutaneous auricular grafts for tip reconstruction. Nine individuals underwent nasal reconstruction using this method. The indications, details, and potential advantages of this technique are described with accompanying photographic results. A flexible approach using a combination of alloplastic materials and autogenous tissues provides additional reconstructive options for individuals with total or near‐total nasal defects.
Hearing Results With Cartilage Tympanoplasty
Authors: Dornhoffer John L. 
Published: November 2003

AbstractCartilage has shown promise as a graft material to close perforations in the tympanic membrane (TM), particularly in cases of advanced middle ear pathology. Although it is similar to fascia, its more rigid quality tends to resist resorption and retraction. However, it is this rigid quality that has led many to anticipate a significant conductive hearing loss when using cartilage to reconstruct the TM. Because little has been reported in the literature comparing hearing results using cartilage with results using other grafting materials, this retrospective study was conducted to compare the hearing results of patients with cartilage tympanoplasty with results in patients who underwent revision tympanoplasty using perichondrium. Both series of patients had undergone type I tympanoplasty, and the middle ear pathology was considered to be similar between the two groups. TM closure was achieved in all 22 patients undergoing cartilage reconstruction, but three of the 20 patients undergoing perichondrium reconstruction had a recurrent perforation during the follow‐up period (approximately 1 year). The average pre‐ and postoperative puretone average air‐bone gap (PTA‐ABG) was 21.1 dB and 6.8 dB for the cartilage group and 17.9 dB and 7.7 dB for the perichondrium group, respectively. These gains in hearing were statistically significant (P < 0.001 in each case), but there was no statistically significant difference in hearing results between the two groups. Analysis of the PTA‐ABG as a function of percentage of TM reconstructed showed no statistically significant difference in hearing results due to percentage of cartilage used. These results indicate that cartilage tympanoplasty offers the possibility of a rigorous TM reconstruction with excellent postoperative hearing results.
Preoperative Temporal Bone Computed Tomography Scan and Its Use in Evaluating the Pediatric Cochlear Implant Candidate
Authors: Woolley Audie L. , Oser Allen B. , Lusk Rodney P. , Bahadori Robert S. 
Published: November 2003

AbstractPreoperative computed tomography (CT) scan evaluation of the temporal bones in cochlear implant candidates plays a crucial role in determining candidacy and the side of implantation. The CT scans allow the surgeon to carefully review the anatomy of the inner ear and mastoid cavity in order to predict any potential difficulties or complications that may be encountered during the implant insertion. We retrospectively reviewed 50 preoperative CT scans of the temporal bone in children who have been successfully implanted. In these scans, we assessed the degree of mastoid pneumatization, cochlear anatomy and patency, size of the vestibular aqueduct, cochlear aqueduct, and internal auditory canal. We analyzed our findings and measurements and compared our results with the degree of difficulty noted in the insertion of the implant, the number of electrodes inserted in each case, and the overall complication rate. From this radiographic review, we have created a checklist for cochlear implant surgeons in order to highlight key features that need to be recognized in the temporal bone scan in preoperative evaluation of cochlear implant candidates.
Hearing Preservation After Acoustic Neuroma Resection With Tumor Size Used As a Clinical Prognosticator
Authors: Hecht Craig S. , Honrubia Vincent F. , Wiet Richard J. , Sims H. Steven 
Published: November 2003

AbstractThree hundred sixty‐four patients referred to the Chicago Otology Group for acoustic tumor removal between 1981 and 1995 were reviewed in a retrospective fashion. Of this group, 60 patients were candidates for hearing preservation surgery and thus underwent one of two surgical approaches to remove the tumor and preserve hearing. Eighteen patients had tumor removal via the middle cranial fossa approach, and 42 patients had tumor removed via the retrosigmoid approach. Of the 42 patients who underwent retrosigmoid removal, 33% had hearing preserved overall. Of the 18 patients in the middle fossa group, 44% had hearing preserved overall. The average tumor size of patients with preserved hearing in the retrosigmoid group was 1.4 cm, and in the middle fossa group was 0.74 cm. Of significance was the fact that in both groups of patients with a tumor of 1.5 cm or less there was a 50% chance of hearing preservation. In the group of patients with tumors larger than 1.5 cm there was only a 16% chance of preserving hearing. We propose that these data can be used for better counseling of patients preoperatively as to the chances of hearing preservation and the type of approach appropriate for each case.
Sustained Release of Antibiotic From a Fibrin‐Gelatin‐Antibiotic Mixture
Authors: Park Moon Suh , Kim Yong Bok 
Published: November 2003

AbstractTo improve the therapeutic effect of antibiotics in the ear cavity postoperatively, a fibrin‐ and gelatin‐based drug delivery system was designed and in vitro efficacy was evaluated. Four kinds of fibrin clot were made from ampicillin, gentamicin, and ofloxacin, and biologic assay was performed usingBacillus subtilis. The fibrin‐gelatin‐gentamicin mixture demonstrated antibiotic activity for up to 120 hours against B subtilis. Gentamicin was found to be released more slowly from the fibrin‐gelatin mixture than from the fibrin mixture in this experiment. These results suggest that this device can be clinically used in a limited field such as postoperative care of ear infection.
Zenker's Diverticulum
Authors: Nguyen Hoang C. , Urquhart Andrew C. 
Published: November 2003

AbstractSymptomatic Zenker's diverticula are usually treated with diverticulectomy and myotomy. Other, more conservative open procedures consist of diverticulopexy, imbrication, and myotomy alone. These more conservative procedures do not result in a breach of esophageal mucosa and should have more rapid postoperative recovery. We performed a retrospective chart review of all open surgical procedures performed at the Marshfield Clinic and St. Joseph's Hospital between 1975 and 1996. Using Wilcoxon's rank sum test, the conservative procedures were compared with the standard diverticulectomy for duration of hospitalization and length of time to resumption of oral intake. Fifty‐nine patients are reported. Statistically significant differences between the surgery groups were found for hospitalization (
P
< 0.001) and days to resumption of oral intake (
P
< 0.001). Conservative open surgical procedures for repair of Zenker's diverticula result in decreased hospitalization and earlier resumption of oral diet compared with diverticulectomy.
Perioperative Complications of Percutaneous Dilational Tracheostomy
Authors: Berrouschot Jörg , Oeken Jens , Steiniger Lutz , Schneider Dietmar 
Published: November 2003

AbstractPercutaneous dilational tracheostomy (PDT) has replaced conventional tracheostomy for long‐term intubated patients in many intensive care units (ICUs). In a prospective study carried out between September 1994 and August 1996, 76 patients underwent PDT. In 41 patients, PDT was performed “blind.” In 35 patients it was executed with simultaneous bronchoscopic monitoring. The type and rate of complications of the two techniques were compared. Comparing the groups with and without bronchoscopy, the perioperative complication rate was equivalent (7% vs 6%); however, more severe complications occurred in the group without bronchoscopy (one death due to tension pneumothorax, two cases of perforating the rear tracheal wall) than in the group with bronchoscopy (two cases of intratracheal hemorrhage). PDT is a suitable bedside method for ICU patients undergoing long‐term ventilation. Simultaneous endoscopy minimizes the severity of complications.