bluuebunny/crossref_metadata_2025_split huggingface dataset:
Certain Anatomical Relations and the Precise Morphometry of the Infraorbital Foramen–Canal and Groove: An Anatomical and Cephalometric Study
Authors: Kazkayasi Mustafa , Ergin Ahmet , Ersoy Mehmet , Bengi Osman , Tekdemir Ibrahim , Elhan Alaittin 
Published: November 2003

AbstractObjectives To determine and to standardize the certain anatomical relations, and the precise size, course, and location of the infraorbital foramen, canal, and groove for facilitating surgical and invasive procedures.Study Design This anatomical study consisted of two main steps, namely, the examination of skulls and the cephalometric analysis of the skulls. Measurements of the skulls and of the radiograms were performed.Methods Thirty‐five adult bony heads (70 sides) were studied regarding the localization and dimensions of the infraorbital groove (IOG), infraorbital canal (IOC), and infraorbital foramen (IOF) as well as their relationships with different anatomical landmarks. The cephalometric analysis of the skulls was measured for evaluating the relationships of certain anatomical points and the distances of the skulls in the cephalometric analysis. For this purpose, 13 different distances and two angles were measured on anteroposterior and lateral craniographies. Differences between data of skull and cephalogram measurements were analyzed by the Student t test. The Pearson correlation test was used in the statistical analysis of the 15 values in the cephalogram.Results Examination of the 70 sides of the 35 bony heads revealed that the shape of the IOF was oval in 34.3%, round in 38.6%, and semilunar in 27.1% of all skulls. The IOF was single in 94.3% and double in 5.7% of the cases. The average distance from the IOF to the infraorbital margin and to the lateral process of the canine tooth in vertical direction and to the lateral nasal border in horizontal direction were 7.19 ± 1.39 mm, 33.94 ± 3.15, and 17.23 ± 2.64 mm, respectively. In cephalometric analysis, when S‐N (the distance between the center of the sella turcica and the nasion) and N‐ANS (the distance between the nasion and the anterior nasal spine) distances were used as independent parameters for the linear analysis, the correlation of the three values for both independent parameters were statistically significant.Conclusion While the IOF has no statistically significant changes with regard to the size of the skull, expressive changes take place in the course and the length of the IOG and IOC. Meticulous preoperative evaluation of the IOF and the route of the infraorbital nerve are necessary in patients who are candidates for maxillofacial surgery and regional block anesthesia. If these measurements are taken into account, there will be little surgical risk, and this will be helpful in identifying the extent of the operative field.
Laryngotracheal Anastomosis: Primary and Revised Procedures
Authors: Wolf Michael , Shapira Yisgav , Talmi Yoav P. , Novikov Ilia , Kronenberg Jona , Yellin Alon 
Published: November 2003

AbstractObjectives Acquired upper airway stenosis is usually associated with a complex of pathological conditions at the high tracheal and the subglottic levels. Reported reconstructive techniques include widening by incorporation of grafts, segmental resection, and anastomosis or combined procedures. The management of recurrent stenosis after reconstructive surgery is a major challenge and has rarely been discussed in the literature. The purposes of the present study are to compare the clinical course of primary versus revised reconstructive procedures and to analyze the effect of age, diabetes, chronic lung disease, grading of stenosis, extent of resection, and revised procedures on the operative rate of success.Study Design A cohort study in a tertiary referral medical center.Methods The clinical course of 23 consecutive patients undergoing laryngotracheal anastomosis was studied comparing a group of 13 primary with 10 revision procedures. Seventeen patients underwent cricotracheal and six patients thyrotracheal anastomoses. All patients but one were tracheotomized before the definitive reconstructive procedure. Suprahyoid release was routinely performed except for two cases, and only one patient required sternotomy. The Wilcoxon test was used to examine the relationship between preoperative clinical parameters and the postoperative success (i.e., airway patency).Results Twenty‐two of 23 patients (95.6%) had successful decannulation. Four patients required a revision procedure because of repeat stenosis at the site of the anastomosis (2) or distal tracheal malacia (2). Residual airway stenosis of less than 50% was noted in six patients, although only three complained of dyspnea during daily‐activity exertion. There was no associated mortality. Complications included subcutaneous emphysema (4), granulation tissue formation (3), pneumonia (2), cardiac arrhythmia (2), and one each of pneumomediastinum, neck hematoma, and urosepsis. Protracted aspirations were noted in one patient who had revision surgery. Age was the only parameter that correlated with postoperative airway patency (P <.07), whereas the presence of chronic obstructive lung disease and diabetes, grade of stenosis, type of surgery, and revision surgery were found to be insignificant.Conclusions The clinical course of laryngotracheal anastomosis in primary and revised procedures was similar in our group of patients. The operation can be performed safely, with an expected high rate of success and acceptable morbidity.
Learning Curve for Translaryngeal Tracheotomy in Head and Neck Surgery
Authors: Giugliano Gioacchino , Venturino Marco , DePaoli Fiora , Andrle Jan , Calabrese Luca , Tradati Nicoletta , Chiesa Fausto , Scarpa Daniela , Susini Giuseppe 
Published: November 2003

AbstractObjectives Translaryngeal tracheotomy (TLT) is a widely accepted procedure in intensive‐care units for its simplicity of execution, low morbidity, rapid wound closure after cannula removal, good esthetic results, and lack of long‐term sequelae. The aim of this study was to evaluate the feasibility and use of adopting TLT in patients with cancer undergoing major head and neck surgery.Study Design Prospective analysis of learning curve and incidence of complications in 41 patients with cancer who underwent TLT at the Division of Head and Neck Surgery of the European Institute of Oncology from November 1997 to June 1999.Methods Patient characteristics, pathology, anatomic characteristics of the neck, and surgical short‐term and long‐term complications were noted. The patients were divided into consecutive groups of six or seven patients, and time trends in occurrence of complications and time to execute the procedure were assessed.Results TLT performance time decreased from 50 minutes in the first seven patients to 24 minutes in the last group. The technique was easy to perform and safe, with only two minor complications during surgery. However, minor complications occurred in three and major complications in 17 patients in the days immediately following surgery, almost entirely attributable to lack of counter‐cannu1a and stylet.Conclusions In view of the high proportion of major complications, TLT using the presently available kit is unsuitable for major head and neck surgery. However, the considerable advantages of the technique would recommend it as a valid alternative to surgical tracheotomy if the kit included a counter‐cannu1a and stylet.
Fascia Augmentation of the Vocal Fold: Graft Yield in the Canine and Preliminary Clinical Experience
Authors: Duke Sanford G. , Salmon Jay , Blalock P. David , Postma Gregory N. , Koufman James A. 
Published: November 2003

AbstractIntroduction Glottal insufficiency resulting from vocal fold bowing, hypomobility, or scar is frequently treated by injection augmentation. Injection augmentation with fat, collagen, gel foam, polytef, and recently, fascia lata has been previously reported. Variable graft yield and poor host‐tissue tolerance have motivated the continued search for an ideal graft substance.Study Design A prospective trial of autologous fascia augmentation of the vocal cord in the human and in an animal model.Methods Autologous fascia injection augmentation (AFIA) was evaluated in 8 canines and 40 patients at our institution between 1998 and 2000. The animal study compared graft yield from AFIA with autologous fat yield. The outcome measure was graft yield calculated from histological examination of larynges 12 weeks after injection augmentation. Clinical trial outcome measures included symptom surveys, acoustical voice analyses, and subjective voice assessments. Mean follow‐up was 9 months.Results In the canine larynx, the mean graft yield for AFIA was 33% (range, 5%–84%) compared with autologous lipoinjection (47%; range, 7%–96%;P = .57). Subjective improvement in vocal quality was reported by 95% of patients (38 of 40) after AFIA. Preoperative and postoperative voice analysis data were obtained from 26 patients. Subjective voice rating demonstrated a significant improvement after AFIA (P <.0001). Acoustical parameters of jitter, shimmer, noise‐to‐harmonic ratio, phonatory range, and degree unvoiced improved significantly (P <.05) in all patients after fascia augmentation.Conclusions Based on the animal study, we concluded that graft yields are excellent but variable for AFIA. The result is similar in variability and overall yield to autologous lipoinjection. Subjective and objective analyses of voice outcomes after AFIA are universally improved. Fascia appears to be an excellent alternative to lipoinjection in properly selected cases of glottic insufficiency.
Cochlear Structures After Implantation of a Perimodiolar Electrode Array
Authors: Richter Bernhard , Jaekel Katrin , Aschendorff Antje , Marangos Nikolaos , Laszig Roland 
Published: November 2003

AbstractObjective A perimodiolar prototype electrode array has been evaluated on 12 human temporal bone specimens. To achieve modiolar proximity, a fine Teflon™ positioner is attached to the tip and base of a conventional Nucleus 22 electrode array.Methods Intracochlear electrode position was examined by macroscopic preparation and confirmed by a cochlear view x‐ray after insertion into human temporal bones. The temporal bones were examined with light microscopy for intracochlear trauma after insertion, explantation, and re‐implantation of the perimodiolar array.Results Macroscopic preparation and x‐ray confirmed close proximity of the intracochlear electrodes to the modiolar wall. In some bones, electrode insertion and positioning was performed without significant damage to intracochlear structures, but explantation caused varying degrees of trauma depending on the explantation technique used. Re‐implantation and repeat explantation appeared to destroy most of the intracochlear architecture.Conclusions The perimodiolar electrode array prototype with Teflon positioner cannot be recommended for clinical use, especially in children in whom the possibility for re‐implantation is high.
Radiofrequency Is a Safe and Effective Treatment of Turbinate Hypertrophy
Authors: Coste André , Yona Laurent , Blumen Marc , Louis Bruno , Zerah Francoise , Rugina Michel , Peynègre Roger , Harf Alain , Escudier Estelle 
Published: November 2003

AbstractObjective To evaluate the safety and efficacy of radiofrequency for reduction of inferior turbinate volume.Study Design Prospective before‐and‐after trial.Methods Fourteen patients complaining of chronic nasal obstruction and failing to respond to medical treatment were prospectively enrolled. All patients presented with inferior turbinate hypertrophy and no septal deformity. Radiofrequency inferior turbinate tissue reduction with three punctures in each turbinate (mean energy/puncture: 342 ± 36 J, mean duration: 69 ± 17 s, plateau tissue temperature: 75 ± 6.4°C). Patients were evaluated before and on days 3, 7, and 60 after intervention.Results No postoperative pain or complications were reported. Evaluation of nasal obstruction, quantified by visual analogue scale, showed a significant decrease of day time and nighttime obstruction after surgery. Acoustic rhinometry measurements showed that turbinate hypertrophy was significantly reduced in the sitting and supine positions on day 60 after surgery. Saccharin transit times decreased significantly on day 60 compared with preoperative measurements. Ciliary beat frequency, measured in vitro in nasal epithelial cells sampled from the inferior turbinate by brushing, was not significantly different before surgery and on day 60 after surgery. In the same samples, ciliated cells were the most abundant epithelial cell type before and after surgery, although in five cases, moderate numbers of squamous cells were detected on either day 7 or day 60 after surgery.Conclusion Radiofrequency is a safe surgical procedure capable of reducing turbinate volume without altering the nasal mucosa, and causing minimal discomfort for the patient.
Improved Postoperative Pain Control in Pediatric Adenotonsillectomy With Dextromethorphan
Authors: Dawson G. Stephen , Seidman Peggy , Ramadan Hassan H. 
Published: November 2003

AbstractDesign A prospective, randomized, double‐blinded, placebo‐controlled protocol.Setting An academic, tertiary care referral center.Patients Forty randomly selected children, ages 3 to 13 years, scheduled for adenotonsillectomy without other simultaneous procedures.Intervention A single, oral dose of dextromethorphan pediatric cough syrup (1 mg/kg) or placebo given 30 minutes before surgery.Main Outcome Measure Total dose requirement of intravenous morphine within a 6‐hour postoperative observation period.Results During routine postoperative observation, significantly fewer patients in the dextromethorphan group required no intravenous morphine compared with the placebo group (P = .03). Of those children requiring morphine, the mean dose requirement was significantly lower in the dextromethorphan group (P = .02). There was no known drug‐related morbidity.Conclusion Dextromethorphan syrup is a safe, non‐narcotic medication that significantly reduced the requirement of intravenous morphine after pediatric adenotonsillectomy. Its routine use in this manner is recommended.
Decreased Cochlear DNA Receptor Staining in MRL.MpJ‐Faslpr Autoimmune Mice With Hearing Loss
Authors: Kaylie David M. , Hefeneider Steven H. , Kempton J. Beth , Siess Don C. , Vedder Colleen T. , Merkens Louise S. , Trune Dennis R. 
Published: November 2003

AbstractObjectives Previous studies of decreased cochlear DNA binding in autoimmune mice suggested that antibodies against a cochlear cell surface DNA receptor cause autoimmune hearing loss. However, the presence of a cochlear DNA receptor has not been determined. Therefore, immunohistochemistry with an anti‐DNA receptor antibody was performed on MRL.MpJ‐Faslpr (MRL/ lpr) autoimmune mice to determine 1) which inner ear structures contain DNA receptors and 2) whether the receptor staining pattern changes as autoimmune disease progresses and hearing thresholds increase.Study Design A prospective study of the progression of hearing loss in autoimmune mice and correlated alterations in immunostaining for the inner ear DNA receptor.Methods One group of MRL/ lpr mice (n = 10) was allowed to develop autoimmune disease, and auditory brainstem response (ABR) audiometry was performed at 4, 6, and 9 months of age to measure the progression of hearing loss. A second group (n = 5) was tested for ABR thresholds at 2 months of age and immediately killed to assess receptor staining before the onset of autoimmune disease and hearing loss. The inner ears from all mice were immunohistochemically stained with an anti‐DNA receptor antibody, and a qualitative analysis of the staining of cochlear structures was performed.Results Auditory brainstem response audiometry revealed a significant 20‐ to 30‐dB elevation of thresholds as systemic disease progressed. Anti‐DNA receptor staining was heaviest in the spiral ligament and less intense in the spiral ganglion and cochlear nerve. Both groups showed a similar pattern of staining in these structures. The stria vascularis and hair cells also stained in both groups. However, the stria cells of normal‐hearing mice showed diffuse intracellular immunoreactivity, whereas older mice displayed less staining that was confined to the cell membranes.Conclusions The inner ears of MRL/ lpr mice contain DNA receptors. Autoimmune hearing loss was correlated with weaker overall intracellular staining in the stria vascularis and hair cells but increased staining of the cell membranes. This suggested DNA receptors have impaired endocytosis and more receptors remain on the cell membrane, possibly as a result of binding by circulating autoantibodies.
Adenovirus Calcium Phosphate Coprecipitates Enhance Squamous Cell Carcinoma Gene Transfer
Authors: Min P. Yi Su , Lee John H. , Graham Scott , Zabner Joseph , Welsh Michael J. 
Published: November 2003

AbstractObjectives/Hypothesis Adenoviral‐mediated gene transfer offers a potential new treatment strategy for squamous cell cancer of the head and neck (SCCHN). Initial studies on some SCCHN cell lines have shown that these cells can be resistant to adenovirus‐mediated gene transfer, requiring large amounts of vector and long infection times. The objectives of this study were to identify the barriers to gene transfer in three SCCHN lines, FaDu, SCC‐9, and SCC‐15, and to develop a method to circumvent the obstacles. We hypothesized that a low expression of adenovirus receptors may limit adenovirus infection and this may be overcome by using adenovirus complexed with calcium phosphate coprecipitates.Methods Using standard cell and molecular biology techniques, infectively of SCCHN cells was investigated.Results Using Cy3‐labeled adenovirus, we found minimal binding of adenovirus to FaDu cells and variable levels of binding among SCC‐9 and SCC‐15 cells. Northern blot analysis indicated that messenger RNA (mRNA) transcripts for coxsackie‐adenovirus receptor, which binds adenovirus, were absent in FaDu cells but present in SCC‐9 and SCC‐15 cells. Integrin αvβ5, which binds and facilitates internalization of adenovirus, were expressed at low levels in all three cell types. We overcame these barriers by using adenovirus complexed with calcium phosphate precipitates. Total transgene expression and the number of cells expressing transgene were increased in all three cancer lines using adenovirus complexed with calcium phosphate precipitates compared with adenovirus that was not complexed.Conclusions Data in the present study suggest that adenovirus‐mediated gene transfer to SCCHN cell lines is a result of limited viral receptors. Delivering adenovirus in a calcium phosphate coprecipitate enhanced gene transfer and, perhaps, the therapeutic index.
Variability of Genetic Alterations in Different Sites of Head and Neck Cancer
Authors: Rodrigo Juan P. , Suárez Carlos , González Maria V. , Lazo Pedro S. , Ramos Sofía , Coto Eliecer , Alvarez Ignacio , García Luis A. , Martínez José A. 
Published: November 2003

AbstractObjective Tumors arising from different sites of the head and neck area have different clinical behavior. However, most of the studies on genetic alterations in head and neck squamous cell carcinomas do not make a distinction between the sites within this area. The objective of this study is to compare the genetic alterations in three different sites of the head and neck (larynx, oropharynx, and hypopharynx).Study Design Prospective study.Methods Thirty‐eight laryngeal, 29 oropharyngeal, and 37 hypopharyngeal carcinomas were studied. DNA from tumor and healthy tissue was evaluated for amplification of the oncogenes at 11q13 region (CCND1, FGF3, FGF4 and EMS1) and of the oncogenes MYC and ERBB1; for integration of the human papillomavirus (HPV) types 6b and 16; for loss of heterozygosity (LOH) at p53 and NAT2; and for the cellular DNA content.Results FGF3 and FGF4 showed a significantly higher frequency of amplification in hypopharyngeal tumors (P = .006 and P = .0002, respectively). CCND1 amplification had a nearly statistically significant (P = .072) higher frequency of amplification in hypopharyngeal tumors. Aneuploid tumors were found in a significantly lower proportion in the larynx (P = .03) compared with the other sites. For the other genetic alterations, no significant differences among the three sites were found.Conclusions These results suggest that cancers originating from different sites in the head and neck may have different tumor biology. Therefore, they should be considered as different entities.
Complications of Type I Thyroplasty and Arytenoid Adduction
Authors: Abraham Manoj T. , Gonen Mithat , Kraus Dennis H. 
Published: November 2003

AbstractObjectives/Hypothesis Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralyzed vocal fold but must be evaluated in light of potential complications following laryngeal framework surgery.Study Design and Methods The charts of 237 patients who underwent unilateral vocal fold medialization surgery between July 1, 1991, and August 30, 1999, at a tertiary care cancer referral center were retrospectively reviewed.Results There were 98 cases of type I thyroplasty alone and 96 cases of type I thyroplasty with arytenoid adduction. The two groups had similar patient characteristics. Mean time of surgery (45 vs. 73 min, P <.0001) and length of hospital stay (1.1 vs. 1.8 d, P <.0001) were increased when arytenoid adduction was performed. Overall improvement of symptoms was similar in both groups (93%–94%), but posterior glottic closure appeared subjectively improved when arytenoid adduction was used (P = .0054). Overall complication rates were slightly higher in the arytenoid adduction group (14% vs. 19%), primarily because of transient vocal fold edema and wound complications (9 vs. 19 cases), but the increase was not statistically significant (P = .1401). Complications warranting medical or surgical intervention occurred in 8% of cases. Two patients who underwent type I thyroplasty with arytenoid adduction required tracheotomy as a consequence of postoperative complications. The three patients who had extrusion of the implant underwent type I thyroplasty alone.Conclusion Using the appropriate technique, the potential benefits of improved glottic function following type I thyroplasty with arytenoid adduction outweigh the small risk of significant complications observed.