bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiofrequency Ablation for the Treatment of Mild to Moderate Obstructive Sleep Apnea
Authors: Blumen Marc Bernard , Dahan Serge , Fleury Bernard , Hausser‐Hauw Chantal , Chabolle Frederic 
Published: November 2003

AbstractObjectives/Hypothesis Obstructive sleep apnea syndrome is due to pharyngeal obstructions, which can take place at the level of the soft palate. Temperature‐controlled radiofrequency ablation has been introduced as being capable of reducing soft tissue volume and excessive compliance. The aim of the study was to evaluate prospectively the possible efficacy of temperature‐controlled radiofrequency ablation applied to the soft palate in subjects with mild to moderate obstructive sleep apnea syndrome.Study Design Twenty‐nine patients with a respiratory disturbance index between 10 and 30 events per hour, body mass index equal to or less than 30 kg/m2, and obstruction at the level of the soft palate were included in a pilot, prospective nonrandomized study.Methods Snoring and daytime sleepiness were evaluated subjectively. Treatment (maximum of three sessions) was discontinued when the bed partner was satisfied with the snoring level. A full night recording was performed at least 4 months after the last treatment.Results Mean snoring level decreased significantly from 8.6 ± 1.3 to 3.3 ± 2.5 on a visual analogue scale (0–10). Daytime sleepiness decreased nonsignificantly. Mean respiratory disturbance index decreased significantly from 19.0 ± 6.1 events per hour to 9.8 ± 8.6 events per hour. Mean lowest oxygen saturation value increased nonsignificantly from 85.3% ± 4.1% to 86.4% ± 4.4%. Of the patients, 65.5% were cured of their disease.Conclusions Temperature‐controlled radiofrequency ablation was effective in selected patients with mild to moderate obstructive sleep apnea syndrome. A full‐night polysomnography is required after completion of treatment to rule out residual disease.
Hurthle Cell Neoplasms of the Thyroid
Authors: Dahl Linda D. , Myssiorek David , Heller Keith S. 
Published: November 2003

AbstractObjectives/Hypothesis Hurthle cell tumors are a variant of follicular cell neoplasms. The purpose of the study was to determine the reliability of intraoperative frozen‐section analysis for diagnosing Hurthle cell carcinoma and Hurthle cell neoplasm and to evaluate age, gender, and tumor size differences in the incidence of Hurthle cell carcinoma.Study Design Retrospective chart review.Methods The records of all patients undergoing thyroid surgery at Long Island Jewish Medical Center (Long Island Campus of the Albert Einstein College of Medicine, New Hyde Park, NY) from 1990 to 2000 were reviewed. Patients were identified whose final pathological finding was Hurthle cell neoplasm or Hurthle cell carcinoma. Age at diagnosis, gender, tumor size, and correlation between frozen‐section analysis and final pathological finding was determined.Results One hundred sixteen patients had Hurthle cell tumors on final pathological finding (49 had Hurthle cell carcinoma and 67 had Hurthle cell neoplasm). Eleven of these patients had incidental papillary carcinoma. There were 24 men and 92 women. Sixty‐seven percent of the men (16 of 24) and 36% of the women (33 of 92) had Hurthle cell carcinoma on final pathological finding. The mean ages for Hurthle cell neoplasm and Hurthle cell carcinoma groups were 53 (median age, 50 y) and 58 years (median age, 61 y), respectively. One hundred eleven patients had intraoperative frozen‐section analysis. Of the 49 patients with Hurthle cell carcinoma, 9 (19%) were diagnosed by frozen‐section analysis, 36 (75%) had indeterminate frozen‐section analysis, 3 (6%) were discovered to have papillary carcinoma on frozen‐section analysis, and 1 did not have a frozen‐section analysis. Multivariate analysis indicated that size correlated with malignancy and that gender did not (P = .0015).Conclusions In the study population, only 19% of patients were discovered to have Hurthle cell carcinoma on frozen‐section analysis. Sixty‐seven percent of men with Hurthle cell neoplasm had malignancies, compared with 36% of women, and this difference was statistically significant.
Isolation of Fungi by Standard Laboratory Methods in Patients With Chronic Rhinosinusitis
Authors: Lebowitz Richard A. , Waltzman Michael N. , Jacobs Joseph B. , Pearlman Aaron , Tierno Philip M. 
Published: November 2003

AbstractObjectives/Hypothesis Allergic fungal sinusitis and the role of fungi in the pathogenesis of chronic rhinosinusitis are topics of interest and controversy in rhinology. The classification of chronic rhinosinusitis as either a bacterial infection or an allergic (eosinophilic) reaction to fungi has significant implications for treatment of this disease process. We designed a study to determine whether standard isolation techniques, as employed in a university hospital mycology laboratory, could isolate and identify fungi in the intraoperative specimens from patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis.Study Design Forty‐five random patients with a diagnosis of chronic rhinosinusitis by clinical and computed tomography criteria underwent endoscopic sinus surgery during 2001, performed by two senior surgeons (j.b.j., r.a.l.). Specimens of mucin, sinus secretions, and/or tissue were obtained intraoperatively and sent to the New York University Medical Center (New York, NY) mycology laboratory for isolation and identification of fungi.Methods Specimens were treated with Sputolysin and chloramphenicol; plated on Sabouraud, ChromAgar/Candida, Mycosel, and Niger seed agar plates; and incubated at 30°C (or 37°C) for up to 1 month.Results We were able to demonstrate the presence of fungi in 56% of intraoperative specimens obtained from patients undergoing surgery for chronic rhinosinusitis.Conclusions Using a standard hospital mycology laboratory protocol, which is relatively inexpensive and readily available, fungus can be isolated from a majority of patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. Educational statement: Discuss the possible role of fungus in chronic rhinosinusitis and evaluate the efficacy of documenting the presence of fungus in a routine fashion to encourage clinically relevant directed treatments.)
Multiple Motor Unit Recordings of Laryngeal Muscles: The Technique of Vector Laryngeal Electromyography
Authors: Roark Rick M. , Li James C. L. , Schaefer Steven D. , Adam Alexander , De Luca Carlo J. 
Published: November 2003

AbstractObjectives To display time‐series firing rate and recruitment data for multiple, simultaneously active motoneurons activating human laryngeal muscles. These data provide specific information about how laryngeal muscle force is being controlled by the central nervous system at the level of the lower motoneuron.Methods A quadrifilar needle electrode was used to record multi‐channel myoelectric signals from thyroarytenoid muscle of normal subjects during tasks ranging from quiet breathing to a short sentence. Motor unit action potentials of the signal space were identified and tracked throughout task productions using pattern recognition and Precision Decomposition software.Results We present the first recordings and analyses of multiple motor unit activations in the larynx. The firing times and mean firing rates are plotted for each identified motor unit, which reveal recruitment and decruitment information and the database from which common firing statistics across motor units may be derived.Conclusions This study provides new information about neuromuscular physiology of the larynx. Specifically, the results reveal the ordered recruitment and firing patterns of multiple motor units and the existence of common drive from the central nervous system. The technique may prove fundamental to understanding various neuromuscular pathologies such as laryngeal spasm and to assist clinical prognosis of laryngeal paresis and the diagnosis of certain neurogenic disorders.
The Role of Transnasal Esophagoscopy in Head and Neck Oncology
Authors: Postma Gregory N. , Bach Kevin K. , Belafsky Peter C. , Koufman James A. 
Published: November 2003

AbstractObjectives/Hypothesis To review the current role of transnasal esophagoscopy (TNE) in all aspects of head and neck cancer patient treatment.Study Design A retrospective database and chart review.Methods A retrospective review of head and neck cancer patients undergoing TNE for a variety of diagnostic and therapeutic indications.Results In a series of 17 patients with presumed head and neck malignancies, TNE provided 100% accuracy in biopsy results and staging of the tumor when compared with standard panendoscopy. The utility of TNE in other areas of head and neck cancer management, such as stricture dilation and secondary tracheoesophageal puncture, is demonstrated. This preliminary report strongly suggests that TNE may play a vital role in the management of head and neck oncology patients.Conclusions Transnasal esophagoscopy gives the surgeon the ability to perform a remarkable variety of procedures in the outpatient setting without sedation. It may obviate the need for routine panendoscopy in head and neck cancer patients.
Effect of Chronic and Short‐Term Erythropoietin Treatment on Random Flap Survival in Rats: An Experimental Study
Authors: Saray Aydin , Ozakpinar Rifat , Koc Can , Serel Savas , Sen Zeynep , Can Zeki 
Published: November 2003

AbstractObjective The use of perioperative erythropoietin (EPO) therapy is gaining popularity to avoid blood transfusion and correct anemia in head and neck cancer surgery. The purpose of the study was to determine the effect of various doses and durations of EPO treatment on random flap survival.Study Design A McFarlane type random and musculocutaneous (3 × 10 cm) flap were elevated on the dorsum of each rat.Methods Eighty‐four male Albino rats were randomly assigned into seven groups (2 animals in each group): group I, control animals receiving placebo; group II, chronic EPO injections (50 U/kg); group III, chronic EPO injections (100 mg/kg); group IV, chronic EPO injections (150 mg/kg); group V, short‐term EPO injections (50 mg/kg); group VI, short‐term EPO injections (100 mg/kg); and group VII, short‐term EPO injections (150 mg/kg). Rats in groups II to IV began to receive EPO 3 weeks (thrice weekly) before the construction of flaps, and rats in groups V to VII received EPO after flap elevation for 1 week (thrice) subcutaneously. Following 7 days of recovery, the area of flap survival was measured. Hematocrit and systolic blood pressure were followed weekly in all groups.Results Erythropoietin increased the hematocrit levels and systolic blood pressure in all groups, but significant increases were noted only in the long‐term treatment groups. There was a significant increase in distal necrosis of random skin flaps after long‐term EPO treatment (P <.05). However, short‐term low and therapeutic doses of EPO improved flap survival significantly (P <.05).Conclusions Long‐term EPO treatment might have impaired flap survival because of direct or prostaglandin‐mediated vasoconstriction, endothelin‐induced hypertension, increased peripheral vascular resistance, hyperviscosity, and increased thrombosis. However, EPO might have enhanced flap survival because of its antioxidant effect and modulation of nitric oxide levels. Effects of EPO are controversial, and further research is necessary to delineate the dose and duration relationship and the exact mechanism of action on flap viability.
The Treatment of Drooling by Ultrasound‐Guided Intraglandular Injections of Botulinum Toxin Type A Into the Salivary Glands
Authors: Jongerius Peter H. , Joosten Frank , Hoogen Frank J. A. , Gabreels Fons J. M. , Rotteveel Jan J. 
Published: November 2003

AbstractObjective The aim of the study was to present the background, procedure, and technique of bilateral ultrasound‐guided, single‐dose injections of botulinum toxin type A (BTX) into the salivary glands in patients with severe drooling.Study Design Clinical trial.Methods Initially, an in vitro study was performed to determine the volume of the dilution of BTX required for optimal spreading and to gain insight in the spreading pattern of the fluid in the submandibular gland. Subsequently, patients with severe drooling were included in a clinical study. Salivary flow was measured under standardized conditions, and BTX was injected into the submandibular glands with the patient under general anesthesia and with ultrasound guidance as an outpatient procedure or during a short stay at the daytime care unit.Results BTX for each gland should be diluted in a volume of 1 to 1.5 mL saline to achieve adequate spreading within the gland and to diminish the risk of diffusion into surrounding structures. With ultrasound guidance, separate structures surrounding the glands and structures within the glandular parenchyma are well recognized and injection errors can be avoided.Conclusions With the procedure described, it is possible to accurately inject BTX directly into the glandular parenchyma and to visualize spreading of the fluid in the glandular parenchyma. It is found to be a safe method that guarantees an optimal clinical effect and avoids potentially harmful side effects. We recommend ultrasound guidance if injections of BTX into the salivary glands are considered.
Delayed Optic Nerve Decompression for Indirect Optic Nerve Injury
Authors: Thakar A. , Mahapatra A. K. , Tandon D. A. 
Published: November 2003

AbstractObjective To test the efficacy of delayed optic nerve decompression in traumatic optic nerve injury.Study Design Critical analysis of Proforma‐based, prospectively accrued data of all cases with injury to surgery interval of greater than 2 weeks.Methods Thirty‐five cases with a median injury to surgery interval of 56 days (range, 16–374 d). Surgical decompression was undertaken only in cases that continued to have poor vision after treatment with steroids in conventional doses (1 mg/kg prednisolone). Pre‐ and postoperative visual acuity measurements were converted to the logMAR scale of visual acuity and the percentage of visual improvement was calculated.Results Surgery was universally unrewarding in all 9 cases with persistent and complete blindness of greater than 2 weeks and no response to steroid therapy. Of the cases with some residual vision, 20 of 26 cases improved (mean percentage improvement, 41.0 ± 5.7%). Cases were categorized on the basis of the injury to surgery interval into groups of 2 weeks to 2 months, 2 months to 4 months, and greater than 4 months. No significant difference was demonstrated in the probability or quantum of improvement in these groups (P = .97).Conclusions Optic nerve decompression remains useful as a salvage procedure for conventional dose steroid failed cases of traumatic optic neuropathy. In cases that are not completely blind, vision can be improved even when surgery is undertaken a few months after the injury.
Bipolar Radiofrequency‐Induced Thermotherapy of Turbinate Hypertrophy: Pilot Study and 20 Months' Follow‐up
Authors: Seeger Jan , Zenev Emil , Gundlach Peter , Stein Thomas , Müller Gerhard 
Published: November 2003

AbstractObjectives/Hypothesis The present report is a pilot clinical study about a new bipolar ablation technique for the treatment of turbinate hypertrophy, which offers an alternative to conventional methods.Study Design Prospective, clinical.Methods From August 1999 to March 2000, a new bipolar radiofrequency system with acoustic feedback control was submucosally applied for the treatment of 38 patients with nasal airway obstruction of vasomotor (n = 31) or allergic (n = 7) genesis. The therapy was made ambulatory with surface anesthesia. Data were collected by questionnaire and rhinomanometry preoperatively and 2 and 20 months postoperatively.Results Nearly all patients reported an improvement of their nasal breathing, with 68% of them reporting a full and 29% a partial recovery. No significant differences were reported with regard to the response of the allergic versus the vasomotor rhinitis. On average, a definite benefit was observed after 2 weeks. Side effects, such as bleeding, synechia, or atrophic changes of the mucosa, which would have to be treated, were not observed.Conclusion The new bipolar radiofrequency thermotherapy presents an efficient option for the treatment of turbinate hypertrophy, which meets the requirements for an outpatient treatment.
Microdebrider Versus CO2 Laser Removal of Recurrent Respiratory Papillomas: A Prospective Analysis
Authors: Pasquale Kimberly , Wiatrak Brian , Woolley Audie , Lewis Linda 
Published: November 2003

AbstractObjective To compare postoperative patient discomfort, voice quality, and procedure time and cost for removal of recurrent respiratory papillomas using the microdebrider versus the CO2 laser.Study Design A randomized prospective study comparing children undergoing excision of recurrent respiratory papillomas by CO2 laser versus excision by microdebrider.Methods For the 6‐month study, patients for whom removal of recurrent respiratory papillomas was indicated were randomly assigned by birth year to microdebrider or CO2 laser therapy. Disease severity was scored as the sum of ratings of 1+ (minimal), 2+ (moderate), or 3+ (severe) for involvement of 27 areas of the aerodigestive tract by direct microlaryngoscopy immediately before treatment. Parents scored patient discomfort and improvement in voice quality 24 hours after surgery, using a 5‐point (0 = no pain; 4 = worst pain) and a 10‐point (1 = minimal change; 10 = significant improvement) scale, respectively.Results Nineteen patients ranging in age from 2.5 to 20 years underwent 32 procedures in all. Groups did not differ significantly in age, sex, or severity of disease. For disease of equivalent severity, microdebrider treatment was associated with equivalent 24‐hour‐postoperative pain scores, greater improvement in voice quality, shorter procedure times, and lower overall procedure cost.Conclusions Immediate postoperative results indicate that the microdebrider may be as safe as and, at some institutions, might be more cost‐effective than the CO2 laser for removal of recurrent respiratory papillomas.
Eosinophilic Fungal Rhinosinusitis of the Lacrimal Sac
Authors: Facer Michelle L. , Ponikau Jens U. , Sherris David A. 
Published: November 2003

AbstractObjectives/Hypothesis Chronic sinusitis is a condition affecting millions of individuals each year. Recent findings indicate that chronic rhinosinusitis is a response to fungi mediated by the eosinophil in some of these individuals. We report a case of eosinophilic fungal rhinosinusitis of the lacrimal sac, an entity not previously reported.Study Design Case report.Methods A 69‐year‐old man presented with a 1‐cm cystic lesion in the right‐side medial canthal region. This lesion was fluctuant, and mucoid material was freely expressed from the medial canthal area. Endoscopic examination revealed bilateral nasal polyps anteriorly and superiorly with mucopurulent drainage from both maxillary sinuses. He had undergone three prior sinus surgeries and two prior lacrimal cannulations elsewhere. A computed tomography scan showed opacification of both maxillary sinuses, ethmoid sinuses, and the left sphenoid sinus and moderate thickening in the frontal sinuses. There was significant soft tissue prominence in the area of both lacrimal fossae with erosion into the medial orbit. The patient underwent bilateral endoscopic revision ethmoidectomies, middle meatal antrostomies, sphenoidotomies, frontal sinusotomies, and endoscopic right‐side dacryocystorhinostomy at the Department of Otorhinolaryngology, Mayo Clinic (Rochester, MN).Results At the time of surgery, massive amounts of thick mucoid material were aspirated from both lacrimal regions. The aspiration of the lacrimal duct on the left side was sufficient treatment, whereas the dacryocystorhinostomy was necessary to decompress the cyst of the face on the right side. The material aspirated was allergic mucin, and the patient met the criteria for diagnosing eosinophilic fungal rhinosinusitis. The patient was started on a regimen of antifungal nasal irrigations postoperatively and has done well in follow‐up.Conclusions Although never previously reported, eosinophilic fungal rhinosinusitis can occur in the lacrimal sac. It is important to recognize this so that the underlying disease process can be treated appropriately.
The Effect of Mitomycin on Extracellular Matrix Proteins in a Rat Wound Model
Authors: Gray Steven D. , Tritle Nathan , Li Wenhua 
Published: November 2003

AbstractObjective To evaluate the effect of topical and injected mitomycin on the expression of extracellular matrix proteins by fibroblasts in an early surgical wound model.Study Design A prospective, controlled study in a rat wound model.Methods Six linear incisions were placed on the backs of each of three Sprague‐Dawley rats, and polyvinyl alcohol sponges were implanted. Two control wounds were implanted with saline‐soaked sponges. The two topical test group wounds were treated with 0.5 mg/mL topical mitomycin for 2 minutes, followed by sponge implantation. The two injection test group wounds were injected with 0.3 mL mitomycin (0.5 mg/mL) before incision and sponge implantation. Each incision was closed uniformly with 3‐0 nylon suture. The sponges were harvested on the tenth postoperative day. Fibroblasts that had grown into the sponges were separated, and polymerase chain reaction analysis was used to quantify the expression of messenger RNA for several extracellular matrix proteins.Results The expression of mRNA for some extracellular matrix proteins (elastase, hyaluronidase, and procollagen) was downregulated in the mitomycin test groups. The effect was more pronounced in the topical mitomycin test group compared with the injection test group. The wounds in the topical group were prone to dehiscence, and the wounds in the injection group demonstrated poor healing when compared with controls.Conclusions Mitomycin may inhibit wound healing by downregulating the gene expression for extracellular matrix proteins. This effect may be selective and may be more pronounced on inducible genes. Such findings prompt further studies regarding possible “best time” windows and selective gene suppression. The use of mitomycin may be limited in situations where wound integrity is necessary.