bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Criteria for Predicting Thyroplasty Type I Outcome
Authors: Omori Koichi , Slavit David H. , Kacker Ashutosh , Blaugrund Stanley M. 
Published: November 2003

AbstractThe purpose of this study was to ascertain the relation between preoperative glottal gap and postoperative vocal function in thyroplasty type I. Twenty‐two of 64 patients who underwent thyroplasty type I between 1987 and 1994 were studied. In preoperative digitized laryngostroboscopic images, the glottal‐gap width (GGW), shape, and area were examined at the maximum closure of vibration and normalized by membranous vocal‐fold length (MVFL). Postoperative vocal function analysis was performed with aerodynamic and acoustic measurements and compared with preoperative videostroboscopic images. In patients with preoperative posterior GGW of less than 10% of MVFL, postoperative vocal function was significantly better than in other patients. Although thyroplasty type I is an excellent medialization technique, it may need to be combined with a posterior closure procedure in patients with large posterior gaps.
Growth Rate Characteristics of Acoustic Neuromas Associated With Neurofibromatosis Type 2
Authors: Abaza Mona M. , Makariou Erini , Armstrong Mark , Lalwani Anil K. 
Published: November 2003

AbstractNeurofibromatosis type 2 (NF2) is a dominantly inherited disorder characterized by the occurrence of bilateral acoustic neuromas (ANs) and other central nervous system tumors. Magnetic resonance images and audiologic data on 22 patients with NF2 who underwent multiple studies at the National Institutes of Health between 1983 and 1993 were reviewed to determine the growth characteristics of ANs in these patients.The average growth rate of ANs in NF2 patients was 0.30 cm3 per year and was significantly higher in older patients (0.75 cm3 per year) than in younger ones (0.12 cm3 per year). Larger ANs were more commonly found in patients with concomitant spinal tumors or meningiomas. NF2 patients with spinal tumors but not meningiomas demonstrated faster growth rates than patients without additional tumor burden. The data from this study suggest that older patients or patients with associated spinal tumors have faster growing ANs and therefore should be followed closely and treated aggressively.
Laser‐Assisted Uvulopalatoplasty: Postoperative Complications
Authors: Walker Regina Paloyan , Gopalsami Chellam 
Published: November 2003

AbstractLaser‐assisted uvulopalatoplasty (LAUP) has become a widely used procedure for the treatment of snoring and mild sleep apnea in the United States. Between July 1993 and December 1994, the authors of this study prospectively evaluated 541 consecutive patients referred to their hospital for possible LAUP to treat loud disruptive snoring.Of the 541 patients, 275 patients had a total of 754 LAUP procedures. There were 26 complications (3.45%). These complications included postoperative hemorrhage in 16 patients (2.12%), local infection in 4 patients (0.53%), temporary palatal incompetence in 4 patients (0.53%), and temporary loss of taste in 2 patients (0.27%). None of the 16 patients with postoperative hemorrhage required a blood transfusion. Only 10 patients (1.3%) had hemorrhage that required medical attention; in the other patients, the bleeding stopped spontaneously. There were no cases of hypernasal speech, permanent palatal incompetence, nasopharyngeal stenosis, airway compromise, or death.Laryngoscope, 106:834‐838, 1996
Thermal Injury Patterns and Tensile Strength of Canine Oral Mucosa After Carbon Dioxide Laser Incisions
Authors: Speyer Matt , Joe John , Davidson Jeffrey M. , Ossoff Robert H. , Reinisch Lou 
Published: November 2003

AbstractThe amount of collateral damage in laser surgery is affected by the precision of the beam delivery. To test a new control system, the authors of this study produced surgical incisions in the canine oral mucosa and then documented histologic and tensile strength changes during the wound healing process. The incisions were made by three different methods: scalpel, manually controlled carbon dioxide (CO2) laser, and computer‐controlled CO2 laser.Both types of laser incisions took longer to heal than the scalpel incisions. The laser incisons were accompanied by a zone of thermal damage lateral to the incision. With the computer‐controlled laser incision, the area of thermal damage was reduced, the laserinduced delay in wound healing was less, and tensile strength was relatively greater. The data indicate that surgical performance is improved by critical beam control.Laryngoscope, 106:845‐850, 1996
Genotype‐Phenotype Correlations in Type 1 Waardenburg Syndrome
Authors: Lalwani Anil K. , Mhatre Anand N. , San Agustin Theresa B. , Wilcox Edward R. 
Published: November 2003

AbstractType 1 Waardenburg syndrome (WS1) is an autosomal dominant disorder characterized by dystopia canthorum, sensorineural deafness, and pigmentary disturbances. Previous work has linked the disease to PAX3, a transcription factor with two highly conserved DNA binding motifs: a paired box and a homeobox. Several mutations within the paired box of PAX3 have been reported. We have identified the first two mutations within the homeobox in two different families. Herein, we report the phenotypic expression of WS1 in these two families and explore the implications for possible genotype‐phenotype correlations. The phenotypic expression was variable within and between the families. Sensorineural hearing loss was present in 71% of affected individuals. Spectrum of hearing loss included unilateral high frequency(>4000 Hz), profound unilateral hearing loss, and bilateral profound hearing loss. The severity of hearing impairment varied significantly within and among families. Phenotypically, these two WS1 families with mutations within the PAX3 homeobox could not be differentiated from those families with paired box mutations. More precise genotype/phenotype correlation may be possible when additional mutations are described throughout the PAX3 gene.Laryngoscope, 106:895‐902, 1996
Familial Large Vestibular Aqueduct Syndrome
Authors: Griffith Andrew J. , Arts H. Alexander , Downs Catherine , Innis Jeffrey W. , Shepard Neil T. , Sheldon Susan , Gebarski Stephen S. 
Published: November 2003

AbstractThe large vestibular aqueduct syndrome (LVAS) is a distinct clinical entity characterized by stepwise progressive sensorineural hearing loss associated with isolated enlargement of the vestibular aqueduct.A correlative clinical, audiologic, vestibular, cytogenetic, and radiographic analysis of a family with inherited LVAS was performed. The male proband and his affected brother are offspring of unaffected parents, and have no other abnormalities. Pedigree analysis suggests autosomal recessive or X‐linked inheritance with variable expressivity of LVAS in this family.This study is the first description of familial inheritance of LVAS. LVAS may account for a significant number of patients with nonsyndromal, genetic sensorineural hearing loss. Future molecular analyses of this study family may identify the causative gene(s) in LVAS.
Transnasal Endoscopic Repair of Cranionasal Fistulae: A Refined Technique With Long‐term Follow‐up
Authors: Burns James A. , Dodson Edward E. , Gross Charles W. 
Published: November 2003

AbstractAlthough the management of cranionasal fistulae has historically plagued otolaryngologists, recent reports of endoscopic techniques for repair of these lesions offer promising results. We present our series of 42 patients whose cranionasal fistulae were managed endoscopically between December 1989 and August 1995. Follow‐up ranged from 5 to 68 months, thereby including long‐term results from our previously reported series of 29 cases. Resolution of cerebrospinal fluid rhinorrhea was achieved in 35 (83.3%) of 42 patients with one endoscopic procedure, and 3 patients had successful closure at a second surgery. All five cephaloceles were successfully treated with one procedure. We have refined our technique to include specific indications for the use of free grafts depending on the location and size of the cranionasal fistula.
Cochlear Implantation in a Pacemaker Patient
Authors: Triglia Jean‐Michel , Beliaeff Michel , Faugere Gerard 
Published: November 2003

AbstractThe authors present their experience with cochlear implantation in a 22‐year‐old patient who had a cardiac pacemaker because of complete atrioventricular block. The question of compatibility between the cochlear implant (multichannel Digisonic DX10Æ®) and the pacemaker (Biotronik Nanos‐01Æ®) was raised. After consulting the two manufacturers regarding the risk of electrical interference, the authors decided to program the pacemaker in a locked mode (VOO) and then perform cochlear implantation. When the cochlear implant was switched on for the first time, electrocardiograms were obtained to ensure that the two devices were compatible. Absolutely no interference was detected. After a 3‐year follow‐up, cochlear implant performance remains excellent.
Antifungal Activity Against Allergic Fungal Sinusitis Organisms
Authors: Bent John P. , Kuhn Frederick A. 
Published: November 2003

AbstractA review of more than 50 allergic fungal sinusitis (AFS) patients indicates that most patients experience postoperative recurrences once weaned from oral steroids, leaving a glaring need for improved treatment. Topical antifungal therapy has not been described for AFS, but it could potentially lower fungal antigen loads via postoperative irrigations. No information exists to direct the choice of antifungal agent. The purpose of this study was to identify the appropriate drug to use for postoperative irrigations in AFS patients.Twenty‐two fungal cultures grown from 15 AFS patients were studied for in vitro susceptibility to five common antifungal drugs: ketoconazole, amphotericin B, itraconazole, nystatin, and fluconazole. Results demonstrated that ketoconazole and amphotericin B were the most effective. Clinical trials are indicated to evaluate the efficacy of these drugs as a supplement to current AFS treatment.
Prognostic Factors Affecting Outcome in Lower Gingival Carcinoma
Authors: Overholt S. Mark , Eicher Susan A. , Wolf Pat , Weber Randal S. 
Published: November 2003

AbstractSquamous cell carcinoma of the lower gingiva is a rare lesion that frequently invades the mandible. To determine the factors that affect local disease control and overall survival, a retrospective review of 155 previously untreated patients was performed. Primary lesions larger than 3 cm (P = .021) and persistently disease‐positive surgical margins (P = .027) were found to be associated with decreased local control rates. Survival was adversely affected by advanced T stage (P =.001), positive initial and final surgical margins (P = .004), mandibular invasion (P = .014), and cervical metastases (P<.001). Extent of mandibular resection, tumor extension beyond the lower gingiva, recent dental extractions in the region of the primary, perineural invasion, and histologic grade did not affect local control or survival. Although lower gingival carcinoma tends to involve the mandible, our findings indicate that tumor size is more important than mandibular invasion in predicting local disease control. Larger tumors that have a greater propensity for local recurrence and poorer survival require a more extensive surgical resection.
Otitis Media in Children With Cochlear Implants
Authors: Luntz Michal , Hodges Annelle V. , Balkany Thomas , Dolan‐Ash Shelly , Schloffman Jerry 
Published: November 2003

AbstractFifty children who received a cochlear implant between 1991 and 1995 were evaluated for incidence of acute otitis media (AOM). Thirty‐seven (74%) children had AOM before implantation and 8 (16%) after implantation. All children who had AOM after implantation had a history of AOM. A subgroup of 14 children required ventilating tubes for recurrent AOM before implantation. Five(35.7%) in this group had AOM after implantation. The incidence and severity of AOM decreased after implantation. All episodes of postimplant AOM were successfully treated with routine oral antibiotics, and no infectious complications occurred. A history of recurrent AOM should not inordinately delay cochlear implantation.
The Learning Curve for Acoustic Tumor Surgery
Authors: Buchman Craig A. , Chen Douglas A. , Flannagan Patrick , Wilberger Jack E. , Maroon Joseph C. 
Published: November 2003

AbstractAlthough operative experience is considered to be critically important in the surgical management of acoustic tumors, little objective evidence substantiates this claim. The present study was undertaken to determine whether a learning curve exists for acoustic tumor surgery.The first 96 acoustic tumor patients managed surgically by a new neurotologic team were retrospectively reviewed. A significant improvement (P<.0003; F=6.32) in the ability to achieve good(grade II or better) postoperative facial nerve function was identified. Improving trends for complete resection rate and hearing preservation were documented, and the incidence of cerebrospinal fluid (CSF) leaks declined; however, statistical significance was not achieved.For postoperative facial nerve function, approximately 60 cases were necessary before the new team achieved results similar to those of highly experienced surgeons. The frequencies of complete resection, CSF leaks, hearing preservation, stroke, and mortality were comparable to those of experienced neurotologic teams. The findings of this study may have implications for both patient care and physician training.
Optimal Concentration of Epinephrine for Vasoconstriction in Neck Surgery
Authors: Dunlevy Timothy M. , O'Malley Timothy P. , Postma Gregory N. 
Published: November 2003

AbstractThe addition of epinephrine to local anesthetics decreases bleeding, reduces systemic toxicity, and increases duration of action. However, epinephrine has significant side effects. Four concentrations of epinephrine were compared to determine the minimum concentration required for maximal vasoconstriction. Eighty‐one subjects undergoing surgical procedures with general anesthesia were injected with 1% lidocaine containing varying concentrations of epinephrine. Blood flow measurements were then made at 1‐minute intervals for 10 minutes using a laser Doppler flowmeter. There were no differences in blood flow reduction between epinephrine concentrations of 1:100,000, 1:200,000, and 1:400,000. However, epinephrine 1:800,000 provided significantly less vasoconstriction. We recommend using an epinephrine concentration of 1:200,000 or 1:400,000 to provide optimal initial hemostasis while minimizing potential side effects.
Stapedectomy in the Pediatric Patient
Authors: Murphy Terrence P. , Wallis Donna Lynn 
Published: November 2003

AbstractThe purpose of this study was to evaluate and compare the results of stapedectomy in pediatric patients with otosclerosis and tympanosclerosis.A retrospective review of 14 patients (15 ears) who underwent stapedectomy from 1993 to 1995 was conducted. In 5 ears stapedectomy for tympanosclerosis was performed; 9 patients had otosclerosis and 1 had Treacher Collins syndrome.Patients were evaluated for preoperative and postoperative air‐bone gaps, preoperative and postoperative speech reception thresholds, postoperative air conduction hearing improvement, and preoperative and postoperative speech discrimination.Children with otosclerosis who underwent stapedectomies had an average postoperative airbone gap of 16 dB with an average air conduction hearing improvement of 17.6 dB. Children with tympanosclerosis who underwent stapedectomies had an average air‐bone gap of 14 dB with an average air conduction hearing improvement of 28 dB.Stapedectomy is a safe and effective treatment for otosclerosis and tympanosclerosis in pediatric patients.
Lipoid Meningitis Due to Aseptic Necrosis of a Free Fat Graft Placed During Neurotologic Surgery
Authors: Hwang Peter H. , Jackler Robert K. 
Published: November 2003

AbstractWe present two unusual cases of aseptic postoperative lipoid meningitis resulting from necrosis of a free fat graft placed into a skull base craniotomy defect. Two patients underwent translabyrinthine resection of acoustic neuroma and received abdominal fat grafts to ablate the surgical defect. Both patients presented postoperatively with persistent cerebrospinal fluid (CSF) wound leak and severe headache. Computed tomography demonstrated hydrocephalus and widely dispersed intracranial fat droplets throughout the CSF circulation. Both patients ultimately required CSF diversion for management of persistent communicating hydrocephalus. The clinical and radiographic correlates of lipocephalus and lipoid meningitis are presented, and a review of free fat graft physiology is discussed.
Paroxysmal Laryngospasm Secondary to Gastroesophageal Reflux
Authors: Loughlin Christopher J. , Koufman James A. 
Published: November 2003

AbstractOver a 2‐year period (1992 to 1994), 12 consecutive adult patients with paroxysmal laryngospasm were prospectively studied. All had had other symptoms of gastroesophageal reflux (GER); however, only 4 (33%) experienced symptoms of heartburn. Each patient underwent fiberoptic laryngeal examination, barium swallow/esophagography, and ambulatory, 24‐hour, double‐probe pH monitoring(pH‐metry).Eleven (92%) of the 12 patients had evidence of GER on examination, and 10(83%) had abnormal pH‐metry, including 3 who demonstrated pharyngeal reflux while having normal total acid exposure times in the esophageal probe. All the patients responded to antireflux treatment, using dietary and lifestyle modifications and omeprazole, with complete cessation of the laryngospastic episodes.This study documents the role of GER in the etiology of paroxysmal laryngospasm, it highlights the advantages of double‐probe pH‐metry in diagnosing this extraesophageal manifestation of GER, and it demonstrates that antireflux therapy with omeprazole is effective in controlling GER‐induced laryngospasm.
Intratympanic Gentamicin for Treatment of Intractable Meniere's Disease: A Preliminary Report
Authors: Rauch Steven D. , Oas John G. 
Published: November 2003

AbstractTopical administration of aminoglycoside antibiotics in the middle ear can achieve “chemical labyrinthectomy” in patients with intractable Meniere's disease. Herein we report our results of intratympanic gentamicin therapy in 21 patients using two different dosing protocols, twice weekly and twice daily(b.i.d.). Both hearing and vertigo outcome were evaluated. Complete control of episodic vertigo was achieved initially in 20 of 21 patients (95.2%). However, 6 of 20 responders (30%) developed relapsing symptoms within 12 months. Retreatment was successful in 75% of these patients. Overall, hearing was preserved or improved in 62% of cases, worse in 24%, and not yet tested in 14%. When the cumulative dose of gentamicin was ≤4 injections in the first week, only 1 of 14 (7.1%) lost hearing. Intratympanic gentamicin offers better risk/benefit outcome than other invasive therapies for intractable Meniere's disease.
Influence of Age on the ‘Nasal Cycle’
Authors: Mirza Natasha , Kroger Hans , Doty Richard L. 
Published: November 2003

AbstractThe nasal cycle is classicially defined as a side‐to‐side fluctuation in nasal engorgement and airflow, with period lengths ranging from approximately 1 to 5 hours. This cycle, as well as its variants (e.g., cyclic changes on one side of the nose only), is produced by alterations in autonomic tone of the nasal vasculature and reportedly correlates with a number of ultradian rhythms, including asymmetries in left:right cerebral electroencephalographic (EEG) activity and differential performance on visual/spatial psychological tasks. Since the pacemaker for the nasal cycle is believed to lie within the suprachiasmatic nucleus of the hypothalamus, and this nucleus evidences degeneration in later life, we sought to determine whether the nasal cycle or its variants changes with age. To achieve this end, we used a liquid crystal thermography exhalation monitor to measure relative airflow of the two nasal chambers at 15‐minute intervals for 6 hours in 60 people representing four age categories: 18 to 29 years (n=12); 30 to 49 years (n=15); 50 to 69 years(n=13); and 70 to 85 years (n=20). Overall, the proportion of subjects exhibiting the alternating rhythmicity associated with the classic nasal cycle decreased with age. No association was present between nasal cycle parameters and scores on the Mini‐Mental State Examination (MMSE). The results suggest that the classic nasal cycle may be a marker for age‐related central nervous system changes.
Otolaryngologic Manifestations of Sarcoidosis: Presentation and Diagnosis
Authors: Shah Udayan K. , White Judith A. , Gooey John E. , Hybels Roger L. 
Published: November 2003

AbstractNeuro‐otologic manifestations of sarcoidosis are rare. Dizziness in particular is a rare presenting complaint of the patient afflicted with this systemic granulomatous disorder. Head and neck and sinonasal presentations of this disease are more common. We reviewed our experience with six such patients who presented for management of their otolaryngologic (ORL) manifestations in order to delineate the involvement of the otolaryngologist in the treatment and diagnosis of these patients, with a focus upon the relevant tests and procedures in the otolaryngologist's de novo diagnosis of sarcoidosis. Studies ordered in the course of otolaryngologic evaluation and their utility in the diagnosis of sarcoidosis by the otolaryngologist are reviewed and classified into useful, supportive, and ancillary. The otolaryngologist played an important role in diagnosis, with four of six patients diagnosed to have sarcoidosis on the basis of their otolaryngologic presentations. Biopsy was performed by the otolaryngologist for diagnosis of sarcoidosis in all four of these cases. Steroids were central to treatment. Oral steroid therapy was the principal treatment: both patients with neuro‐otologic sarcoid were sucessfully managed with oral steroids. Intralesional steroids were necessary to treat the skin lesion. One of six patients patients experienced complications related to steroid use.
Uvulopalatopharyngoplasty Versus Laser‐Assisted Uvulopalatoplasty for the Treatment of Obstructive Sleep Apnea
Authors: Walker Regina Paloyan , Grigg‐Damberger Madeleine M. , Gopalsami Chellam 
Published: November 2003

AbstractUvulopalatopharyngoplasty (UPPP) was the first surgical procedure specifically designed to address the palatal abnormalities seen in many patients with obstructive sleep apnea syndrome (OSAS). For adult apneic patients, UPPP remains the most commonly performed operation. Beginning in 1993, laser‐assisted uvulopalatoplasty (LAUP) was introduced for the treatment of snoring and sleep apnea. LAUP differs from UPPP because it is performed in the office using only local anesthesia, thus being very cost‐effective.Seventy‐nine patients with OSAS underwent surgical treatment: 38 treated with LAUP and 41 with UPPP. The overall surgical response rate, defined as a>50% reduction in the postoperative respiratory disturbance index (RDI), was achieved in 21 (51.2%) of UPPP‐treated and 18 (47.4%) of LAUP‐treated patients. The RDI decreased from 30.3 ± 3.7 to 22.2 ± 4.4 events/h in the LAUP patients and from 52.1 ± 5.0 to 25.5 ± 2.7 events/h in the UPPP patients. The lowest oxyhemoglobin saturation (LSaO2) increased from 72.8 ± 2.1 to 80.9 ± 1.3% in the UPPP patients; there was no change in the LAUP patients.Postoperative complications in this series included minor bleeding, oral candidiasis, and temporary velopalatal insufficiency in both groups. In the carefully selected OSAS patient, LAUP should be considered a surgical alternative to UPPP. LAUP may actually be preferable to UPPP in certain cases because LAUP is cost‐effective, does not require a general anesthetic or hospitalization, has very few associated complications, and time lost at work is minimal.