bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Facial Paralysis Resulting from Temporal Bone Fractures: Our Experience in 115 Cases
Authors: Darrouzet Vincent , Duclos Jean‐Yves , Liguoro Dominique , Truilhe Yves , De Bonfils Camille , Bebear Jean‐Pierre 
Published: February 2003

OBJECTIVEThe goal of this study was to review decision factors and overall results regarding surgical and nonsurgical management of post‐traumatic facial nerve paralysis (FP).STUDY DESIGNA retrospective study and literature review were performed.METHODSBetween 1984 and 1990, 115 cases of post‐traumatic FP were handled. Patients were evaluated through clinical, audiologic, radiologic, and electromyogram assessment. Depending on examination results, patients were treated either medically or surgically through total facial nerve decompression.RESULTSForty‐nine of the 50 medically treated patients experienced a normal or subnormal facial function recovery (grade I–II). Of the 65 (56.5%) surgically treated patients, 52 (80%) had immediate, 2 had delayed, and 11 (17%) had unknown delay‐associated FP. The approaches chosen were middle fossa and transmastoid (75.3%), translabyrinthine (10.7%), or pure transmastoid according to facial nerve nonmotor branch evaluation, hearing, location of the fracture line, and the patient's general condition. Lesions were predominantly found in the geniculate ganglion area (66.2%). A nerve gap was found in only 13.8% of the cases. At 2 years after surgery, 93.8% had a grade I to III recovery. None had grade V or VI.CONCLUSIONThe rarity of severe nerve lesions encountered in surgically treated patients raises the question of better selection of candidates for surgery. Surgery is clearly indicated when FP is total, is of immediate onset, and is associated with a bad prognosis electromyogram pattern. In other settings, decisions are to be made based on high‐resolution CT data and electromyogram results, thanks to a clinical survey and second electromyogram evaluation.
The Effects of Sensitization and Hypersensitivity Reaction on Transepithelial Antigen Transport of Rat Nasal Mucosa
Authors: Yang Ping‐Chang , Zeng Hai‐Yan , Zhang Tao‐Yuan , Zheng Yi‐Qing , Chen Jie‐Zhu 
Published: February 2003

METHODSThe prevalence of airway allergy is very high. The ways that antigen passes across the airway tract epithelial barrier are not well understood. This study uses a model antigen, horseradish peroxidase (HRP), to sensitize and challenge the respiratory tract in the rat model.RESULTSThe results showed increases in HRP endosomes in nasal epithelial cells 5 minutes after HRP challenge in the sensitized rats compared with controls, which were further increased 30 minutes after HRP challenge, as well as with the paracellular region filled with HRP products. Meanwhile, mast cells were activated as shown by degranulation. Analysis of cell type showed that there were many more HRP endosomes in the nonciliated cells and there were many more nonciliated cells in the nasal mucosa of the sensitized rats.CONCLUSIONThe results demonstrate that sensitization promotes airway mucosal epithelial cells' uptake and transport of specific antigen and that mast cells may play certain roles in this process.
Prospective Analysis of Sinus Symptoms and Correlation with Paranasal Computed Tomography Scan
Authors: Kenny Thomas J. , Duncavage James , Bracikowski James , Yildirim Altan , Murray John J. , Tanner S. Bobo 
Published: February 2003

OBJECTIVESWe designed a prospective study to determine whether there is a correlation between the severity of sinus symptoms and the severity of computed tomography (CT) scan evidence of rhinosinusitis.METHODSAcute and chronic rhinosinusitis patients rated their symptoms and had a CT scan of the sinuses taken the same day. A Likert severity scale and standardized CT scoring system were used. Data were analyzed by nonparametric methods with Kendall's rank correlation coefficient.RESULTSThe severity of 5 symptoms correlated with severity of disease on CT scan. Headache and facial pain or pressure had no correlation.CONCLUSIONThe certainty of a clinical diagnosis of rhinosinusitis requiring treatment is enhanced in patients with high symptom severity scores for fatigue, sleep disturbance, nasal discharge, nasal blockage, or decreased sense of smell. Isolated headache and facial pain or pressure are less reliable predictors of CT scan findings supporting the diagnosis rhinosinusitis.
Thyroid Surgery: A Comparison of Outcomes between Experts and Surgeons in Training
Authors: Manolidis Spiros , Takashima Masayoshi , Kirby Matthew , Scarlett Matthew 
Published: February 2003

OBJECTIVESOur objective was to compare the results of thyroid surgery performed by residents in a large metropolitan public hospital (MPH) with those performed by faculty in a large private hospital (PH) setting.METHODSAll records of thyroid surgery performed by otolaryngologists for the period between 1986 and 1998 were reviewed. Inclusion criteria were adequacy of data and follow‐up. Ninety‐two thyroid procedures performed by residents in an MPH were compared with 181 thyroid operations in a PH setting performed by the faculty of these residents for differences in accuracy of diagnostic studies, operative parameters, and complication rates.RESULTSThe demographic distribution in both groups was similar. Presenting symptoms were twice as frequent in the MPH group (45% vs 22%). More total thyroidectomies were performed in the PH group (49% vs 32%). Blood loss, operative time, and hospitalization days were similar in both groups. Preoperative fine needle aspiration and intraoperative frozen section results showed sensitivities and specificities that were comparable. No permanent vocal cord paralysis was observed in either group. Permanent hypocalcemia was more frequent in the PH group (8.8%:PH vs 5.1%:MPH).CONCLUSIONSThe results of thyroid surgery performed by residents in training in an Otolaryngology‐Head & Neck Surgery program in an MPH, measured by rates of complications, length of hospitalization, and duration of surgery, are similar to those of faculty at a PH setting in groups of patients with very similar characteristics.
Time Necessary for Neovascularization of a Tracheal Segment by the Sternohyoid Muscle
Authors: Câmara Tecchio Simone A. , De Mello‐Filho Francisco Veríssimo , Mamede Rui C. Martins , Velludo Maria A. S. Llorach 
Published: February 2003

INTRODUCTIONThe reimplantation of a complete tracheal segment (CTS) as an autograft or homograft often results in total or partial necrosis of the CTS. However, previous experiments suggested that when the CTS is first vascularized by the sternohyoid muscle (SM) 21 days before the reimplantation, the CTS can be reimplanted without ischemia or stenosis. However, it is not clear if the CTS requires 21 days to attain full revascularization.GOALThis study aims to ascertain the minimum time necessary for revascularization of the 6 rings CTS by the SM allowing reimplantation free of ischemia.METHODSFifteen mongrel dogs, divided into 3 groups were submitted to 2 sequential surgical procedures. In the first procedure, a SM flap was used to envelop 6 rings CTS in all dogs. After periods of 21 days (group 1, n = 5), 14 days (group 2, n = 5) and 7 days (group 3, n = 5), the compound flaps (CTS and SM) were neovascularized. Each CTS was transected and mobilized from the trachea and then replaced again in its original site, as an autoflap.RESULTSAfter a period of at least 60 days, none of dogs presented any respiratory alteration. Macroscopic and microscopic analyses demonstrated adequate viability and no stenosis.CONCLUSIONOur findings suggest that it is possible to neovascularize the CTS using a SM flap within a period as short as 1 week.
Changes in External Ear Resonance after 3 Types of Surgery in the Patients with Chronic Otitis Media
Authors: Cho Yang‐Sun , Seo In‐Seok , Woo Hyo‐Chang , Kang Myung‐Koo , Chung Won‐Ho , Hong Sung Hwa 
Published: February 2003

OBJECTIVEThis study was designed to identify the external ear resonance characteristics of patients with tympanic membrane perforation and to investigate subsequent changes in external ear resonance, depending on the length of the postoperative period and which of 3 different types of operation was performed: tympanoplasty with canal wall‐up mastoidectomy, epitympanoplasty, and canal wall‐down mastoidectomy.STUDY DESIGN AND SETTINGA total of 227 ears of 188 patients and 96 control ears comprised the study. We measured the gain and frequency of the first peak of external ear resonance with a real ear analyzer.RESULTSGain and frequency of the first peak recorded in the preoperative group did not differ from those of the control group. However, negative peaks appeared around 1 to 1.5 kHz in half of these ears. The gain increased markedly in all 3 postoperative groups. The canal wall‐down mastoidectomy and epitympanoplasty groups showed significantly lower frequencies compared with the tympanoplasty with canal wall‐up mastoidectomy and control groups, but there was no difference between them. The increased gain diminished over time, but the peak gain did not equalize with that of the controls, even after 15 months.CONCLUSIONSAdditional gain should be considered of around 1 to 1.5 kHz for hearing aid users with tympanic membrane perforation. Postoperative changes in external ear resonance should be expected in patients with chronic otitis media, suggesting that fine readjustments of the hearing aid may be necessary.
Incidence of Pulmonary Edema after Tracheotomy for Obstructive Sleep Apnea
Authors: Burke A. J. C. , Duke S. G. , Clyne S. , Khoury S. A. , Chiles Caroline , Matthews B. L. 
Published: February 2003

OBJECTIVEThe phenomenon of postobstructive pulmonary edema (POPE) has been associated with the relief of upper airway obstruction, which itself is fundamental to the pathophysiology of obstructive sleep apnea (OSA). A review of patients with OSA undergoing tracheotomy was performed to characterize this process.STUDY DESIGNRetrospective chart review of study patients with OSA undergoing tracheotomy and of control patients without OSA undergoing tracheotomy for unrelated problems. Chest radiographs were reviewed in a double‐blind fashion to score posttracheotomy changes in pulmonary status.SETTINGAcademic tertiary referral center.RESULTSThirty (67%) of 45 OSA patients treated by tracheotomy had evidence of POPE, whereas only 5 (20%) of 25 control group patients had increased pulmonary edema. The remaining 15 (33%) of 45 OSA patients and 20 (80%) of 25 control patients had either no change or an improved pulmonary status. Those with OSA that developed POPE were mostly graded as having mild pulmonary edema (22/30, 73%). Far fewer were graded as having moderate pulmonary edema (6/30, 20%), and fewer still with severe pulmonary edema (2/30, 7%). Two (7%) of 45 patients with severe POPE died of complications related to cor pulmonale in the postoperative period.CONCLUSIONResults support maintaining a high index of suspicion for the development of postobstructive pulmonary edema in patients treated for OSA. Treatment options, such as positive pressure ventilation and diuresis, and an increased awareness of this condition may help reduce the morbidity and mortality associated with treatment of this disease.
Laryngeal Compartmentalization after Radiation Therapy in a Canine Model
Authors: Yu Larry , Iii Charles Syms , Dietz Wolfgang 
Published: February 2003

OBJECTIVEWe set out to study the effects of radiation therapy on laryngeal tissue barriers in a canine model as described by Welsh.STUDY DESIGNIndia ink was injected into 1 vocal fold on irradiated and nonirradiated canine larynges.RESULTSThe india ink dye spread more prominently into the supraglottis of the irradiated specimens by submucosal lymphatics. Larger dye volumes simulating larger tumor bulk spread to the contralateral larynx in irradiated specimens.CONCLUSIONConservation laryngeal surgery for laryngeal carcinoma is a popular method of treatment. Some surgeons advocate partial laryngectomy for radiation failures; in other instances, it is the primary modality of treatment. These findings suggest a cautious approach when planning conservative laryngeal surgery after radiation therapy failures of glottic carcinoma.
A Study of the Effect of Nasal Steroid Sprays in Perennial Allergic Rhinitis Patients with Rhinitis Medicamentosa
Authors: Ferguson Berrylin J. , Paramaesvaran Suchitra , Rubinstein Elaine 
Published: February 2003

OBJECTIVETo determine if rebound congestion can be reduced with concomitant nasal steroid spray usage.STUDY DESIGN AND SETTINGRandomized, double blind, controlled single center study.PARTICIPANTSTwenty subjects with perennial allergic rhinitis with nasal congestion.INTERVENTIONAll subjects received 3 weeks of twice‐daily oxymetazoline. After 2 weeks, subjects were randomized to 2 additional weeks of concomitant budesonide aqueous nasal spray (n = 9) or placebo (n = 10). In the sixth week, all sprays were stopped.RESULTSBoth groups showed subjective and objective evidence of rebound congestion 24 hours after cessation of oxymetazoline (P < 0.05). Subjective rebound congestion resolved in 48 hours in the budesonide aqueous nasal spray group but persisted for over 1 week in the placebo group.CONCLUSIONRebound congestion is objectively present in patients with perennial allergic rhinitis after 3 weeks of oxymetazoline spray. Rebound congestion is reduced by concomitant budesonide aqueous nasal spray use.SIGNIFICANCEThis study supports the common clinical practice of nasal steroid sprays to ameliorate rebound congestion concomitant with and after cessation of topical decongestant sprays.
Carbon Dioxide Laser and Silver Halide Infrared Transmitting Fibers for Tympanoplasty: An Experimental Animal Model
Authors: Zilkerc Zeev , Nageris Ben I. , Feinmesser Raphael , Fridman Edward , Ravid Avi , Kariv Noam , Katzir Abraham 
Published: February 2003

OBJECTIVEThis study evaluates the effectiveness and safety of fiberoptic carbon dioxide (CO2) laser welding for graft closure of tympanic membrane perforations in an animal model.STUDY DESIGN AND SETTINGTympanic membrane perforation was surgically induced in 11 eardrums of 7 given pigs. A lumbar facial graft was placed over the wound, and albumin drops served as a biologic solder. CO2laser energy, transmitted through silver halide infrared transmitting fibers, was used for „spot‐welding“ along the circumference of the graft. The welded sites were evaluated by using a surgical microscope as well as by evaluating the sites histologically.RESULTSHealing started 3 to 4 days after surgery and was completed within 3 weeks with the formation of a neotympanum. Some inflammation with granulation tissue was noted in 5 eardrums.CONCLUSIONS AND SIGNIFICANCEThese preliminary results indicate that CO2laser tympanoplasty with a fiberoptic delivery system may be a promising new technique for the clinical setting.
The Meaning of the Word “Vertigo”
Authors: Blakley Brian W. , Goebel Joel 
Published: February 2003

OBJECTIVETo determine whether otologists see a need to further define the word“vertigo” and assess the variety of meanings that are meant in using the word.METHODSA questionnaire was mailed to 720 members of the American Otological Society (AOS) and American Neurotological Society (ANS) to assess the need for further definition and the current understanding of the meaning of“vertigo.”RESULTSThe response rate was 42%. Significant variability in the intended meaning of the word“vertigo” was found suggesting that the definition is inconsistent among experts. Three quarters of the respondents indicated that the word needs further definition. The word was most commonly used to indicate sensations that include spinning or turning only.CONCLUSIONThe definition of the term“vertigo” is inconsistent among otolaryngologists. Refinement of the definition is desirable for accurate history taking and should be limited to false illusions of circular motion.
Increased Levels of Immune Inhibitory Cd34+ Progenitor Cells in the Peripheral Blood of Patients with Node Positive Headc and Neck Squamous Cell Carcinomas and The Ability of These CD34+ Cells to Differentiate Into Immune Stimulatory Dendritic Cells
Authors: Lathers Deanne M.R. , Achille Nicholas , Kolesiak Kristin , Hulett Kevin , Sparano Anthony , Petruzzelli Guy J. , Young M. Rita I. 
Published: February 2003

OBJECTIVESThis study determined whether mobilization of immune inhibitory CD34+ cells by head and neck squamous cell carcinomas (HNSCC) is most prominent in patients who are node positive and whether these CD34+ cells could differentiate into immune stimulatory dendritic cells.STUDY DESIGN AND SETTINGPeripheral blood from patients with head and neck cancer was used to measure the frequency of CD34+ cells and their capacity to differentiate into immune stimulatory dendritic cells.RESULTSThis study demonstrated that increased CD34+ cell levels were most prominent in patients who were node positive and patients with recurrent disease. These CD34+ cells differentiated into dendritic cells that were able to present tetanus toxoid to autologous T‐cells.CONCLUSIONSImmune suppressive CD34+ cells that are prominent in patients with HNSCC who are node positive are able to develop into immune stimulatory dendritic cells.SIGNIFICANCEDifferentiation of tumor‐mobilized CD34+ cells into dendritic cells may be an immuno‐therapeutic approach to stimulate antitumor reactivity.
Otologic Injuries from Airbag Deployment
Authors: Yaremchuk Kathleen , Dobie Robert A. 
Published: February 2003

Airbags became available as an optional passive restraint system in motor vehicles in 1973. The National Highway Traffic Safety Administration mandated placement of driver and right passenger airbags in all passenger vehicles and light trucks beginning in model year 1997. An estimated 2.1 million airbags have been deployed from the late 1980s until the present. There have been several case reports of hearing loss after exposure to airbag deployments in drivers and passengers since 1995. Members of the American Academy of Otolaryngology‐Head and Neck Surgery submitted case reports on 71 patients with otologic symptoms after airbag deployment.
Lack of Utility of Postoperative Chest Radiograph in Pediatric Tracheotomy
Authors: Pinto Jayant M. , Ansley John , Baroody Fuad M. 
Published: February 2003

OBJECTIVETo assess the incidence of pulmonary complications after nonemergent pediatric tracheotomy and to determine whether obtaining a routine postoperative chest radiograph is warranted.STUDY DESIGNRetrospective review of the records of 107 consecutive patients (age 1 month to 18 years) who underwent tracheotomy from October 1994 to June 2000. Main outcome measures included frequency of pulmonary complications and use of information obtained from postoperative chest radiograph for intervention.SETTINGTertiary care university children's hospital.RESULTSNo pneumothoraces or significant pulmonary complications were detected in the immediate postoperative period. No management changes were undertaken as a result of information obtained from any chest radiograph in this period.CONCLUSIONSThe incidence of significant pulmonary complications after pediatric tracheotomy is low. Little information is obtained from chest radiograph after tracheotomy, and this information does not change management.SIGNIFICANCERoutine postoperative chest radiograph after pediatric tracheotomy is not indicated in all patients.
The Effect of Esophageal Pressure Monitoring on Nasal Airway Resistance
Authors: Virkkula Paula , Silvola Juha , Lehtonen Hannu , Salmi Tapani , Malmberg Henrik 
Published: February 2003

OBJECTIVEArtificial obstruction of nasal airflow has been shown to increase the amount of apneas and arousals. An esophageal catheter inserted through the nasal cavity is used in sleep studies to show intrathoracic pressure variations as sign of obstructive apneas and increased respiratory resistance. This study evaluates the effect of transnasal esophageal catheter on nasal airflow.STUDY DESIGN AND SETTINGFifty patients with problem snoring referred to our ENT clinic underwent overnight limited sleep study with an esophageal catheter. Nasal airway resistance was measured the following morning with active anterior rhino‐manometry. After exclusion of 17 measurements, the results of 33 patients were compared with same parameters obtained earlier without nasal manipulation.RESULTS AND CONCLUSIONThe ipsilateral nasal resistance was clearly elevated when measured with a catheter used overnight compared with the control measurement (P < 0.05). However, the combined nasal resistance was not significantly increased in this material with patent nasal airways. In patients with already compromised nasal airflow, the possibility of clinically relevant changes in nasal airflow during catheter use should be taken in account.
Randomized Controlled Trial of Vestibular Rehabilitation Combined with Cognitive‐Behavioral Therapy for Dizziness in Older People
Authors: Johansson Magnus , Akerlund David , Larsen Hans Christian , Andersson Gerhard 
Published: February 2003

OBJECTIVETo evaluate the effectiveness of vestibular rehabilitation combined with cognitive behavioral therapy in the treatment of dizziness in older people.STUDY DESIGN AND SETTINGA randomized controlled design was used with patients recruited via an advertisement. Nine patients completed treatment and 10 served as waiting‐list controls. The intervention lasted 7 weeks with 5 weekly group sessions and consisted of vestibular exercises. Cognitive behavioral therapy components were added to promote relaxation, reduce anxiety, and avoidance of feared situations and movements.RESULTSStatistically significant improvements on walking time, 2 dizziness provocative movements, and on the Dizziness Handicap Inventory, but no effects on the Romberg or anxiety and depression. Of the treated patients, 89% reached statistical significant improvement on the total inventory score.CONCLUSIONCognitive behavioral therapy combined with vestibular rehabilitation decreases dizziness in older people.SIGNIFICANCEThese findings indicate that cognitive behavioral therapy can be combined with vestibular rehabilitation in the treatment of dizziness.
The External Approach for Submucosal Lesions of the Larynx
Authors: Myssiorek David , Madnani Dilip , Delacure Mark D. 
Published: February 2003

OBJECTIVEThe surgical excision of benign submucosal lesions of the larynx can be performed using a variety of techniques including direct laryngoscopy and external approaches. We propose that small submucosal lesions of the larynx can be removed via the external approach without a tracheotomy.STUDY DESIGNRetrospective chart review.SETTINGSix patients at The Long Island Jewish Medical Center and at the New York University School of Medicine underwent an external approach for the removal of benign submucosal laryngeal lesions without tracheotomies. Lesions included a mixed laryngopyocele, an internal laryngopyocele, a mixed laryngocele, a paraganglioma, a neurilemmoma and a lymphoma. Follow‐up ranged from 1 to 9 years.RESULTSAll patients were female with an average age of 72. No patient required a tracheotomy. One patient remained intubated for 24 hours postoperatively to ensure an adequate airway. Mild dysphagia was noted in all patients, but it was short‐lived and did not require alternate methods of alimentation. There have been no recurrences of disease.CONCLUSIONThe external approach without tracheotomy allows for good exposure with minimal functional disability for the removal of benign sub‐mucosal lesions of the larynx.