bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Vivo Measurements of Temporal Bone on Reconstructed Clinical High‐Resolution Computed Tomography Scans
Authors: Chan Ling‐Ling , Manolidis Spiros , Taber Katherine H. , Anne Hayman L. 
Published: November 2003

AbstractPurpose To retrospectively assess the accuracy of measurements of temporal bone anatomy made from reconstructed clinical high‐resolution computed tomography (HRCT) scans.Methods Nine HRCT scans were performed on unselected clinical cases in which the subjects had a temporal bone study judged to be normal. The orbitomeatal line was prescribed for the direct axial sections. Variations in head position (rotation at the neck and lateral bending of the neck) were corrected by using the software supplied by the manufacturer. All measurements were done on standard 1‐mm axial sections and axial reconstructions obtained from 1‐mm coronal slices. The images were viewed at 4000 Hounsfield units (HU) window width and 1000 HU window level. Measurements (n = 3) made on 1‐mm direct axial HRCT scans were compared with the measurements made on reconstructed axial HRCT images from the same nine patients. These values were also compared with published cadaver data.Results The measurements obtained from axial reconstructed and direct HRCT series approximated each other in each of the nine individual studies and also fell within the range of published cadaver values. They demonstrated the expected normal temporal bone variability between individuals.Conclusion Useful anatomic approximations can be measured in vivo from reconstructed clinical HRCT images. Pitfalls are improper window settings, head tilt, and rotation. This protocol is widely available and can be implemented retrospectively from clinical HRCT scans.
DFNA9 Is a Progressive Audiovestibular Dysfunction With a Microfibrillar Deposit in the Inner Ear
Authors: Khetarpal Umang 
Published: November 2003

AbstractObjectives Several mutations in the COCH gene were recently identified in American and European families with DFNA9, an autosomal dominant progressive sensorineural hearing loss with onset in high frequencies. Our preliminary vestibular studies in one American family indicated progressive vestibular dysfunction. More complete vestibular studies in European families have shown vestibular abnormalities in the affected individuals. Our temporal bone studies on two families with DFNA9 revealed, in addition to neurosensory degeneration, a unique acidophilic deposit in the membranous labyrinths of the affected individuals. The purposes of this study were 1) to further investigate the vestibular abnormalities in members of one American family for the purposes of genotype‐phenotype correlation and 2) to investigate the electron microscopic structure of the acidophilic deposit to obtain further insights into the pathogenesis of DFNA9.Study Design Prospective analysis.Methods Extensive vestibular testing was performed in some unaffected and affected members of a family with DFNA9. One temporal bone was analyzed by electron microscopy of celloidin‐embedded tissue.Results and Conclusions The findings indicate progressive vestibular dysfunction in many of the patients affected with hearing loss. Thus, despite different mutations in the COCH gene , the American and European families manifest auditory and vestibular dysfunction. Electron microscopic analysis shows the spiral ligament to be enriched for a highly branched non‐banded microfibrillar substance that is decorated with glycosaminoglycan granules. Additionally, the spiral ligament lacks the 67‐nm‐thick straight periodically banded bundles of type II collagen that are normally abundant in this structure. A speculative pathogenetic model is proposed for this unique disease and its relationship with other late‐onset or adult‐onset audiovestibular diseases and Meniere's disease is investigated.
An Animal Model for the Study of Genetic Predisposition in the Pathogenesis of Middle Ear Inflammation
Authors: Madison Clark J. , Brinson George , Newman Michael K. , Jewett Brian S. , Sartor Balfour R. , Prazma Jiri , Pillsbury Harold C. 
Published: November 2003

AbstractObjectives Chronic otitis media with effusion (COME) is the most prevalent inflammatory disease in children and is associated with numerous adverse long‐term sequelae. Many factors have been associated with an increased risk of developing COME, one of which may be a genetic predisposition to the disease. To study the role that genetics play in the pathogenesis of COME, we used an animal model to compare the middle ear inflammatory responses in two different strains of rats (Lewis and Fisher).Methods In earlier studies, we demonstrated that exposure of the middle ear to endotoxin caused early extensive exudation and, later, goblet cell hyperplasia and mucin hypersecretion. In the present study, the animals were divided into six groups. In each group the animals were given transtympanic injection with gram‐positive bacterial cell wall product (peptidoglycan‐polysaccharide [PG‐PS]). The middle ear bullae were studied at 1 week and 3 weeks after infection, and after systemic reinfection. Comparisons were made of the quantity of mucin exudate by enzyme‐linked immunosorbent assay and by histological evaluation of the middle ear epithelial thickness.Results Our data demonstrate a statistically significant difference in middle ear inflammation and effusion formation between the two genetically different strains of rats.Conclusions These data support the hypothesis that the middle ear response to PG‐PS may be genetically determined and therefore suggest that genetic predisposition may play a role in the pathogenesis of COME.
Effects of Benzalkonium Chloride on Innate Immunity Physiology of the Human Nasal Mucosa In Vivo
Authors: Storaas Torgeir , Andersson Morgan , G. A. Persson Carl , K. Steinsvåg Sverre , Marko‐Varga Gyorgy , Greiff Lennart 
Published: November 2003

AbstractObjective Benzalkonium chloride (BC) is a preservative commonly used in nasal decongestant sprays. It has been suggested that BC may be harmful to the nasal mucosa. The present study, involving healthy volunteers, examines effects of BC on nasal mucosal end‐organ functions.Methods Isotonic saline and BC (0.1 mg/mL) were administered acutely to the nasal mucosa using a nasal pool device. Nasal symptoms were determined. Nasal lavage fluid levels of α2‐macroglobulin and fucose were measured as indices of plasma exudation and glandular secretion, respectively. In addition, BC (0.1 mg/mL) was given as single actuations of 100 μL per nasal cavity three times daily for 10 days. The ability of histamine (0.4 mg/mL) to evoke nasal symptoms and plasma exudation responses was determined before and after the repeated BC administration series.Results BC produced immediate nasal smart or pain (P < .05), but tolerance to this response developed by repeated administrations. BC increased nasal mucosal output of fucose (P < .05), whereas nasal lavage fluid levels of α2‐macroglobulin were unaffected. Histamine produced significant symptoms and mucosal exudation of α2‐macroglobulin (P values < .01), equally before and after the 10 days of BC exposure.Conclusions BC in dosages commonly used as preservative in nasal decongestant sprays produced short‐term glandular secretion and nasal smart or pain. However, 10 days' frequent exposure to BC was not associated with untoward symptomatic effects, nor was a sensitive mucosal variable such as histamine‐induced exudative responsiveness affected by this repeated exposure to BC.
Optimal Technique to Diagnose Primary Ciliary Dyskinesia
Authors: Friedman Norman R. , Pachigolla Ravi , Deskin Ronald W. , Hawkins Hal K. 
Published: November 2003

AbstractObjective To develop a cost‐effective protocol for diagnosing primary ciliary dyskinesia (PCD).Study Design Retrospective chart review in a tertiary care academic medical center.Methods A review of the electron microscopy logbook identified all patients who had a suspected diagnosis of PCD. Biopsy of respiratory tract mucosa was performed using a cytology brush or a cup forceps in the outpatient clinic or operating room (OR). Outcome measures were to determine the diagnostic adequacy of cytological evaluation compared with tissue biopsy and to determine whether an adequate nasal mucosa sample can be collected in the outpatient clinic setting as compared with the OR and the use of general anesthesia.Results Twenty‐seven patients underwent 31 biopsies. Fifteen specimens were collected with a cup forceps, and 16 with a cytology brush. The sampling sites were nasal mucosa in 28 cases and trachea in the rest. Twelve specimens (39%) were collected in the clinic; the rest were obtained in the OR in conjunction with another procedure. Neither method of specimen collection nor mode of anesthesia made a significant difference in the probability of obtaining an adequate specimen. Ten samples were nondiagnostic: cytological evaluation, 31% (n = 16); tissue biopsy, 27% (n = 15); clinic, 42% (n = 12); and OR, 31% (n = 16). The cost of evaluating ciliary motion at our institution was $150, with an additional charge of $1297 for electron microscopic evaluation. The nonprofessional fee for an outpatient nasal biopsy was $98; in the OR the cost of anesthesia supplies, surgical suite, recovery room, and day‐surgery bed was at least $1860.Conclusion Our results suggest that the optimal method for diagnosis of PCD is in the outpatient clinic with specimen collection by means of either a cup forceps or a cytology brush.
Deterioration of the Pharyngo‐UES Contractile Reflex in the Elderly
Authors: Ren Junlong , Xie Pengyan , Lang Ivan M. , Bardan Eytan , Sui Zhumei , Shaker Reza 
Published: November 2003

AbstractObjectives/Hypothesis Deterioration of aerodigestive tract reflexes such as the esophagoglottal and pharyngoglottal closure reflexes and pharyngeal swallow has been documented in the elderly. However, the effect of aging on the contractile response of the upper esophageal sphincter (UES) to pharyngeal water stimulation has not been studied. The aim of this study was to characterize the pharyngo‐UES reflex in the healthy elderly.Methods We studied nine healthy elderly (77 ± 1 y [SD]; four men, five women) and nine healthy young volunteers (26 ± 2 y [SD]; four men, five women). A UES sleeve sensor was used to measure the pressure. We tested pharyngeal stimulation induced by rapid pulse and slow continuous injection of water.Results The volume of water required to stimulate the pharyngo‐UES contractile reflex by rapid pulse injection in the elderly (0.5 ± 34 0.1 mL) was significantly higher than that in the young (0.1 ± 0.02 mL) (P < .05). In contrast to young subjects, there was no pressure increase in resting UES pressure observed in the elderly for continuous pharyngeal water infusion. In both young and elderly, the threshold volume for the pharyngo‐UES contractile reflex was significantly lower than that for pharyngeal swallows.Conclusions The pharyngo‐UES contractile reflex deteriorates with aging. This deterioration is primarily due to abnormalities of the afferent limb of the reflex.
Quantitative Study of Mucosal Wave Via Videokymography in Canine Larynges
Authors: Jiang Jack J. , Chang Ching‐I. B. , Raviv Joseph R. , Gupta Sameer , Banzali Franklin M. , Hanson David G. 
Published: November 2003

AbstractObjectives Vocal fold mucosal wave movements are thought to be important in determining voice characteristics and quality. To see these movements, high‐speed cinematography and videostroboscopy have been used clinically; however, these techniques have disadvantages that make them impractical for quantitative measurement of mucosal wave movements. This study explored the feasibility of using line‐scan cameras for mucosal wave analysis.Methods An excised larynx bench model was used to examine the effects of elongation and changes in subglottal pressure on the amplitude, frequency, and phase difference of vocal fold mucosal movements as calculated from line‐scan images.Results The data showed a positive and linear relationship between an increase in subglottal pressure and amplitude of the mucosal wave; elongation of the vocal folds appeared to decrease the amplitude of mucosal wave upheaval at each level of subglottal pressure. Similarly, increase in subglottal pressure had a positive and linear relationship with increase in frequency of vibration; elongation of the vocal folds further increased the frequency at any given subglottal pressure. Phase difference between the movements of the upper and lower margins of the mucosal lips was estimated and did not appear to be significantly affected by changes in subglottal pressure and elongation.Conclusion The data presented in this study are consistent with relationships that we would expect to be true from currently accepted models of vocal fold vibration.
Building the Powerful 10‐Minute Office Visit, Part I: Introduction to the New Section
Authors: Gail Neely J. , Hartman James M. , Wallace Mark S. 
Published: November 2003

AbstractObjective This is the first of a planned progressive series of articles entitled “Tutorials in Clinical Research” written to assist those who would become more active in the application of scientific methods to their practices and to assist those who would seek to develop and publish new discoveries of their own. On completion of Tutorials, the reader should be able to 1) critically and efficiently read the literature and 2) use his or her personal practice as a laboratory for clinical investigation.Study Design Tutorial.Methods The Journal editor agreed to launch the series “Tutorials in Clinical Research,” which was conceived out of a need for an easily understandable and accessible collection of tutorials for the busy practitioner. The Clinical Research Working Group at Washington University, Department of Otolaryngology—Head and Neck Surgery, will write, edit, and solicit additional authors for the completion of this planned 22‐article series. The intended audience includes, among other groups, practitioners without research funds who are interested in the application of scientific methods to their practices.Results This first article in the series outlines how to begin and three steps for the initial application of scientific methods to practice, including critical literature review, prospective analysis of practice, and specific project development.Conclusions The application of scientific methods to practice can be fun, educational, and effective in the enhancement of quality care. The “value added” result is the development of the powerful 10‐minute patient office visit for the busy practitioner.
Endoscopic Sinus Surgery in Patients Infected With HIV
Authors: Friedman Michael , Landsberg Roee , Tanyeri Hasan , Schults Roman A. , Kelanic Stephen , Caldarelli David D. 
Published: November 2003

AbstractObjectives To be able to plan appropriate surgical treatment for patients with HIV infection who have sinusitis refractory to medical therapy.Design We retrospectively reviewed the charts of 186 patients with HIV who required surgical treatment for sinusitis between 1987 and 1998. One hundred sicharts provided the necessary information and an adequate follow‐up to be included in the study. Collected data included preoperative and postoperative symptoms, radiographic staging, CD4 count at the time of surgery when available, and type and e‐tent of surgery.Results Surgical treatment evolved over the 12 years from limited surgery to standard endoscopic sinus surgery (ESS). Eighteen patients had invasive fungal disease or complications of sinusitis requiring radical surgery. Thirty‐six patients were treated with minimal procedures to address involved sinuses only. These patients were treated between 1987 and 1991. Recurrent disease or further complications occurred in 80.6% of the patients in this group. Since 1992, 52 patients were treated with standard ESS following the same indications for HIV− patients. This group had an improvement of symptoms in 75% of the cases, a rate comparable to the success rate in HIV− patients.Conclusions HIV+ patients undergoing standard ESS enjoy a satisfactory success rate. HIV+ patients with surgical indication for endoscopic sinus surgery should be treated as non‐HIV+ patients. Apparently, low CD4 count (< 100) does not serve as a contraindication for definitive surgery.
Prudent Management of the Mid‐Cheek Mass: Revisiting the Accessory Parotid Gland Tumor
Authors: Klotz Darrell A. , Coniglio John U. 
Published: November 2003

AbstractObjectives/Hypothesis The head and neck surgeon's fascination with parotid surgery arises from the gland's spectrum of histopathological presentations, as well as the diversity of its morphological features. A mass arising in the mid‐cheek region may often be overlooked as a rare accessory lobe parotid neoplasm. This report serves to revisit the topic of accessory parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of salivary fistula, facial nerve paralysis, and recurrence are avoided.Study Design This is a retrospective review of our experience with four accessory parotid gland neoplasms and five other masses mimicking this lesion.Methods A literature review and retrospective chart review.Results Over a 6‐year period, we have encountered four true accessory lobe tumors, all pleomorphic adenomas. These presented very similarly to four other more commonly encountered masses not of salivary origin and one normal but hyperplastic accessory parotid gland. All were removed through a wide parotidectomy‐style approach modified by extending incisions anterosuperiorly and inferoanteriorly. The only complication was a minor salivary fistula in one patient. There were no permanent facial paralyses.Conclusions Accessory parotid gland neoplasms are rare and may present as innocuous extraparotid mid‐cheek masses. A high index of suspicion, prudent diagnostic skills (including fine‐needle aspiration [FNA] biopsy followed by computed tomography [CT] imaging), and meticulous surgical approach (extended parotidectomy‐style incision and limited peripheral nerve dissection when possible) are the keys to successful management of these lesions.
Incidence of Unsuspected Metastases in Lateral Cervical Cysts
Authors: Gourin Christine G. , Johnson Jonas T. 
Published: November 2003

AbstractObjective Solitary cystic squamous cell carcinoma metastases may be difficult to distinguish clinically from a benign cervical cyst. We sought to identify the incidence of solitary cystic squamous cell carcinoma metastasis in patients presenting with apparently benign cervical cysts.Study Design Retrospective review.Methods The records of all patients who presented with isolated lateral cervical cysts between 1983 and 1999 were reviewed. Patients with a clinically apparent primary malignancy, a history of head and neck cancer, a history of irradiation, or age less than 18 years were excluded from analysis, as were patients with a histological diagnosis of nonsquamous cell malignancy or those without a final histological diagnosis.Results One hundred twenty‐one adult patients presented with an initial diagnosis of lateral cervical cyst. Metastatic squamous cell carcinoma was demonstrated histologically after surgical excision in 12 patients (9.9%). The incidence of malignancy was significantly greater in patients greater than 40 years of age (23.5%, P < .0001). Results of preoperative fine‐needle aspiration (FNA) were negative for malignancy in five cases of metastatic squamous cell carcinoma. Panendoscopy with directed biopsies revealed an occult primary in the base of tongue in three patients, tonsil in one patient, and nasopharynx in one. No primary was found in six patients, despite repeated examinations and close follow‐up.Conclusions Solitary cervical cysts in patients older than 40 years of age should be presumed to be carcinoma until proven otherwise. A negative FNA result may be misleading, because of hypocellularity of the cyst fluid. Excisional biopsy should be undertaken with provisions made for frozen‐section analysis of the specimen and contingency panendoscopy with directed biopsies of Waldeyer's ring if frozen‐section histological examination reveals malignancy.
Value of Antral Puncture in the Intensive Care Patient With Fever of Unknown Origin
Authors: Vandenbussche T. , De Moor S. , Bachert C. , Van Cauwenberge P. 
Published: November 2003

AbstractObjective To evaluate the use of maxillary sinus puncture as a routine diagnostic procedure to exclude or confirm purulent sinusitis in intensive care unit (ICU) patients presenting with fever or a septic state of unknown origin.Study Design Retrospective.Methods All patients admitted to the ICU at the University Hospital Ghent who required ENT examination to exclude acute sinusitis as possible cause of their otherwise inexplicable fever or septic state underwent maxillary sinus puncture via the inferior meatus. The results of clinical examination and the relation between the presence of foreign bodies (e.g., nasogastric tubes) and culture results from the middle meatus and sinuses were analyzed.Results One hundred five punctures were performed in 53 patients. Macroscopic purulent effusions were obtained from 25 and nonpurulent effusions from 19 sinuses. The presence of a nasogastric tube did not influence puncture results but significantly increased colonization of the middle meatus. Staphylococcus aureus and Gram‐negative agents were frequently cultured from sinus aspirates. Although purulent secretions often reveal no growth, most patients present with a multibacterial (40%) or monobacterial (28%) infection. Simple anterior rhinoscopy reduces the need for antral puncture. Only 8% of punctures in patients with a normal clinical examination were positive.Conclusions Antral puncture proves to be a simple, fast, safe, inexpensive, and effective procedure for immediate diagnosis of acute nosocomial sinusitis in ICU patients and is therefore recommended as first procedure in these patients, even when only minor clinical abnormalities are present.
Sinonasal Disease and Olfactory Impairment in HIV Disease: Endoscopic Sinus Surgery and Outcome Measures
Authors: Murphy Claire , Davidson Terence M. , Jellison William , Austin Shaun , Christopher Mathews W. , Ellison Dennard W. , Schlotfeldt Christina 
Published: November 2003

AbstractObjectives To investigate the effects of ESS (ESS) on olfactory impairment, disease‐specific symptoms, and general quality of well‐being In HIV+ patients with sinonasal disease.Study Design Study 1: Nasal cytology, rhinomanometry, nasal examination including endoscopy, disease‐specific sinonasal symptoms, olfactory threshold sensitivity, and odor identification testing were performed before and after ESS in HIV+ patients with sinonasal complaints. Study 2: Quality of well‐being was assessed before and after ESS in HIV+ patients with sinonasal complaints and controls.Results Significant olfactory sensitivity loss persisted for patients with chronic sinusitis after ESS, suggesting that the impairment in these patients may be due to viral disease rather than inflammation. Significant improvement in other disease‐specific symptom scores (nasal obstruction, nasal congestion, headache, sinus pain, etc.) and results of the general quality of well‐being assessment showed ESS to be beneficial in the extended health management of HIV illness.Conclusions The current study indicated both olfactory dysfunction and subjective negative symptoms in HIV+ patients with chronic sinusitis. Although olfactory dysfunction remained, ESS was successful in providing marked alleviation of symptomatology in HIV+ patients with chronic sinusitis. The results support ESS as an appropriate treatment option for HIV+ patients with chronic sinusitis.