bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air Caloric Computer System Application in Monitoring Vestibular Function Changes after Cochlear Implantation
Authors: Szirmai Ágnes , Ribári Otto , Répássy Gábor 
Published: February 2003

INTRODUCTIONThe computer‐based ENG system's analytical routine refinements are available only in research laboratories. The computer‐based system contains a stimulator for saccadic eye‐movement and an air caloric stimulator interconnected to the registration program and analysis software. Several authors have reported the preoperative and postoperative vestibular functions in cochlear implant patients. The safe examination of the operated ear and comparison of the preoperative and postoperative average slow phase velocities of the caloric nystagmus is possible using the air caloric computer system.METHODSThe authors have used a computer‐based ENG system with caloric air stimulation, which is very useful for examination of the operated ear. The vestibular system of patients with total deafness was examined before and after the cochlear implantation. The results of 60 vestibular examinations of 64 patients are reported.RESULTSThe vestibular function in the operated ear was found unchanged in 20 patients. In 14 patients the vestibular function was worse. In 16 patients the postoperative vestibular responsiveness improved. The detailed data analysis of 10 patients in whom preoperative and postoperative vestibular examination was similar was performed by the authors. The preoperative and postoperative average slow phase velocity values and the relative canal paresis was observed. The values demonstrated that the caloric responsiveness of the operated ear improved in few cases.CONCLUSIONSThe computer‐based air caloric system is a useful and safe method in evaluation of the vestibular system changes after ear surgery. The reason of the improvement of vestibular responsiveness is not clear. The results need further investigation to solve the problem of vestibular responsiveness improvement after cochlear implantation.
The Cytoscan Model E‐II in Intraoperative Parathyroid Gland Identification in a Rabbit Model
Authors: Sofola Ifeolumipo O. , Pazos George A. , Buttolph Thomas B. , Casler John D. , Leonard David W. 
Published: February 2003

BACKGROUNDIntraoperative parathyroid gland identification and preservation is often a challenge even in the hands of experienced surgeons as they could be indistinguishable from fat or thyroid tissue.OBJECTIVEThe goal of this study was to demonstrate the use of the Cytoscan Model E‐II, which uses orthogonal polarization spectral (OPS) imaging technology, as an intravital microscope in identifying parathyroid glands intraoperatively and differentiating the parathyroid glands from fat and thyroid tissue in a rabbit model.METHODSThe necks of 4 New England white rabbits were explored with the animals under a general anesthesia. The Cytoscan was used to obtain images of the vasculature of tissue suspected to be parathyroid, fat, and thyroid tissue. These were confirmed by histologic evaluation.RESULTSAll tissues were correctly identified by the Cytoscan and confirmed by histologic analysis. There was an obvious difference in the images obtained of fatty tissue as compared with parathyroid tissues. There was also an appreciable difference between parathyroid and thyroid tissue based on the difference in vascularity.CONCLUSIONSOPS imaging technology can be used in identifying parathyroid glands based on the difference in vascularity from fat and the pattern and density of vessels when compared with thyroid tissue in a rabbit model.SIGNIFICANCEThe Cytoscan may play a future role in real time intraoperative identification of human parathyroid glands. Future investigation is warranted.
Biomechanical Properties of Tissue‐Engineered Cartilage from Human and Rabbit Chondrocytes
Authors: Park Stephen S. , Chi David H. , Lee Arnold S. , Taylor S. Ray , Iezzoni Julia C. 
Published: February 2003

OBJECTIVETo describe tissue‐engineered cartilage from rabbit and human chondrocytes.STUDY DESIGN AND SETTINGChondrocytes from rabbit and human ears were seeded onto a tem‐plate and implanted for 8 or 16 weeks of in vivo incubation.RESULTSFor the 8‐week and 16‐week groups, the UTS for cartilage was 3.8 MPa and 3.7 MPa, stiffness was 62.4 MPa and 51.8 MPa, and resilience was 181.8 J/m3 and 109.1 J/m3, respectively. Experimental cartilage was significantly different from controls. From 5 human specimens, the UTS was 5.4 MPa, stiffness was 6.6 MPa, and resilience was 2.0 J/m3. The control had UTS of 8.8 MPa, stiffness of 12.2 MPa, and resilience of 2.9 J/m3. Histology showed mature cartilage but with a fibrovascular infiltrate and increased cellularity.CONCLUSIONSMechanical properties of tissue‐engineered cartilage can be quantified and are less than that of controls.
Psychometric and Clinimetric Validity of the 20‐Item Sino‐Nasal Outcome Test (Snot‐20)
Authors: Piccirillo Jay F. , Merritt Michael G. , Richards Michele L. 
Published: February 2003

A valid measure of rhinosinusitis health status and quality of life is required for the complete assessment of treatment effectiveness. The purpose of this study was to analyze the psychometric and clinimetric validity of the 20‐Item Sino‐Nasal Outcome Test (SNOT‐20), a disease‐specific, health‐related quality‐of‐life measure for rhinosinusitis. The SNOT‐20 is a modification of the 31‐Item Rhinosinusitis Outcome Measure, and it contains 20 nose, sinus, and general items. To complete the instrument, patients indicate how much they are affected in each area and identify the 5 most important items. The SNOT‐20 was completed by 102, 72, and 46 patients at the initial visit and at 6 months and 1 year after treatment commencement, respectively. Cronbach's α was 0.9; test‐retest scores were highly correlated (r = 0.9). Patients who were more affected had greater SNOT‐20 scores (P < 0.002), and patients who had improved had greater change scores (P < 0.04). Items identified as important had greater scores (P < 0.0001) and showed greater change scores (P < 0.0002). The SNOT‐20 is a valid outcome measure for patients with rhinosinusitis; it describes the health burden and is sensitive to clinical change.
Eustachian Tube Dysfunction after Tobacco Smoke Exposure
Authors: Dubin Marc G. , Pollock Hoke W. , Ebert Charles S. , Berg Eric , Buenting John E. , Prazma Jiri P. 
Published: February 2003

OBJECTIVETo examine the effects of tobacco smoke exposure on eustachian tube (ET) function.STUDY DESIGNET pressures of Sprague Dawley Rats (n = 16) were measured after 1, 7, and 15 exposures and in control animals. Passive opening pressure, passive closing pressure, active clearance of positive pressure, and active clearance of negative pressure were measured. Mucociliary clearance times were also quantified (n = 32).RESULTSPassive opening and passive closing pressures of smoke‐exposed animals were greater than controls (P < 0.05). Passive opening pressure in smoke‐exposed animals increased with increasing exposure (P < 0.001). Animals with 1 exposure had an active clearance of positive pressure higher than controls (P = 0.005) and those with 7 and 15 exposures had more negative active clearance of negative pressure than controls (P = 0.002, 0.03) Mucociliary clearance time was significantly elevated in experimental animals with 7 exposures (P = 0.006).CONCLUSIONSAlterations in ET function exist in animals exposed to tobacco smoke.SIGNIFICANCEET dysfunction after tobacco smoke exposure may predispose children to the development of otitis media.
Does the Addition of Hyperbaric Oxygen Therapy to the Conventional Treatment Modalities Influence the Outcome of Sudden Deafness?
Authors: Aslan Ismet , Oysu Cagatay , Veyseller Bayram , Baserer Nermin 
Published: February 2003

OBJECTIVETo investigate the therapeutic effects of the addition of hyperbaric oxygen (HBO) therapy to the conventional therapies in sudden deafness (SD) and to investigate the influence of patient age on the effectiveness of HBO therapy.STUDY DESIGN AND SETTINGWe undertook a retrospective review of 50 cases of SD treated at a tertiary university hospital. Twenty‐five patients (group 1) were treated with betahistine hydrochloride, prednisone, and daily stellate ganglion block. A second group (group 2) of 25 patients received the same basic treatment with the addition of HBO therapy.RESULTSThe mean hearing gain was 20.0 dB in group 1 and 37.9 dB in group 2 (P < 0.05). In group 2 patients, the mean gains were 51.4 and 23.3 dB for those younger and older than 50 years (P < 0.05) and 48.9 and 14.5 dB for those younger and older than 60 years (P < 0.001), respectively. In patients older than 60 years, the mean gains were 14.5 and 14.4 dB in group 2 and group 1, respectively (P > 0.05).CONCLUSIONSThe addition of HBO therapy to the conventional treatment significantly improves the outcome of SD, especially in patients younger than 50 years. Additional HBO therapy provides limited benefit in patients older than 50 years and no benefit in patients older than 60 years.
Phase III Clinical Trial Results with the Vibrant Soundbridge Implantable Middle Ear Hearing Device: A Prospective Controlled Multicenter Study
Authors: Luetje Charles M. , Brackman Derald , Balkany Thomas J. , Maw Jennifer , Baker R. Stanley , Kelsall David , Backous Douglas , Miyamoto Richard , Parisier Simon , Arts Alexander 
Published: February 2003

OBJECTIVESThe goal of the study was to evaluate the performance of a semi‐implantable middle ear hearing device (Vibrant Soundbridge System [VSB]; Symphonix Devices, Inc).STUDY DESIGNA prospective, single‐subject, repeated‐measures multicenter study was conducted to determine the safety and efficacy of the VSB using analog and digital external processors. Measures included residual hearing, functional gain, speech recognition, acoustic feedback, occlusion, and patient self‐assessment to determine satisfaction, perceived performance, and device preference compared with an appropriately fit acoustic hearing aid. Fifty‐three adult subjects with moderate to severe sensorineural hearing loss were evaluated at 4 or more intervals after implantation.RESULTSImprovements in satisfaction, performance, and preference were statistically significant with the VSB, as was functional gain across all test frequencies (P < 0.001). Occlusion and feedback were virtually eliminated. Aided speech recognition was comparable between VSB and the hearing aid. Residual hearing was unchanged.CONCLUSIONThe VSB is a safe and effective treatment option for adults with moderate to severe sensorineural hearing loss.
Distortion‐Product Otoacoustic Emissions in Nonacoustic Tumors of the Cerebellopontine Angle
Authors: Mobley Steven Ross , Odabasi Onur , Ahsan Syed , Martin Glen , Stagner Bart , Telischi Fred F. 
Published: February 2003

OBJECTIVESThe goal of the present study was to compare the frequencies of cochlear and noncochlear patterns of distortion‐product otoacoustic emissions (DPOAEs) in patients with nonacoustic (non‐AN) tumors of the cerebellopontine angle (CPA)/internal auditory canal with those in patients with acoustic neuroma (AN).STUDY DESIGN AND SETTINGWe conducted a prospective study of patients with non‐AN internal auditory canal/CPA tumors treated between 1992 and 1999 in a tertiary care setting. We collected data on behavioral pure tone average, speech discrimination score, acoustic immittance tests, DPOAEs, and tumor size. DPOAEs were divided into those with a cochlear or a noncochlear pattern. Comparisons were made with a control group of patients with AN of the CPA.RESULTSTwenty‐four patients were included in the study: 12 patients in the non‐AN group and 12 patients in the AN group. In the non‐AN group, 5 (42%) patients had a cochlear pattern and 7 (58%) had a noncochlear pattern. In the AN group, 7 (58%) patients had a cochlear pattern and 5 (42%) had a noncochlear pattern. The differences between the non‐AN and AN groups were statistically significant. In the non‐AN group, patients with a cochlear‐pattern DPOAE had significantly smaller tumors (P = 0.03) and a trend (P = 0.07) toward higher speech discrimination score. Age and pure tone average were not significantly different in the non‐AN tumor patients. In the AN group, none of the study parameters were significantly related to the pattern of DPOAE.CONCLUSIONSANs appear to differ from other tumors of the CPA in their propensity to cause sensory versus neural hearing loss. A larger series of patients would be useful to confirm these preliminary findings.
Airway Complications of Infant Botulism: Ten‐Year Experience with 60 Cases
Authors: Anderson Timothy D. , Shah Udayan K. , Schreiner Mark S. , Jacobs Ian N. 
Published: February 2003

OBJECTIVEThe study goal was to understand the incidence, etiology, and management of airway complications in infant botulism.METHODSWe conducted a retrospective review of the period from January 1, 1987, to December 31, 1997.SETTINGUrban tertiary care children's hospital.RESULTSOf 60 children with infant botulism, 37 (61.7%) required endotracheal intubation for a mean of 21 days. No patient required a tracheostomy. Airway complications (stridor, subglottic stenosis, granuloma formation) occurred in 5 (13.5%) of 37 patients, with 3 requiring surgical bronchoscopy. Of the 37 children, 14 (37.8%), including 4 with airway complications, had endotracheal tube leak pressures recorded. In 3 (50%) of 6 patients with measured leak pressures of greater than 40 cm H2O, airway complications developed. Complications did not develop in patients with leak pressures of less than 20 cm H2O. No correlation between length of intubation and complications could be established.CONCLUSIONAirway complications in infant botulism may be accompanied by high leak pressures and can be managed with endoscopic techniques. The study data suggest that leak pressures should be measured on a regular basis and maintained at less than 20 to 25 cm H2O. A prospective trial to study this issue is warranted. Tracheotomy is not routinely necessary. A high index of suspicion, early diagnosis, and prompt intervention are required for the optimal management of airway complications in infant botulism.
Argon Beam Coagulation for Post‐Tonsillectomy Hemostasis
Authors: Bowling David M. 
Published: February 2003

OBJECTIVEThe study goal was to evaluate the effectiveness of argon beam coagulation (ABC) in the prevention of post‐tonsillectomy hemorrhage. ABC provides monopolar coagulation by arcing ionized argon gas to the target tissue; it is not a laser.METHODSTwo consecutive studies were performed as follows. In the first, a retrospective analysis of post‐tonsillectomy bleeding in 344 patients was conducted. Final tonsil fossa hemostasis was achieved with ABC (257 patients) or with electrocoagulation (EC) (87 patients). In the second, a prospective, randomized, patient‐blind study of post‐tonsillectomy bleeding was conducted in 88 patients. Final hemostasis was achieved using ABC in one fossa and EC in the other fossa, with the sides chosen at random.RESULTS: Post‐tonsillectomy hemorrhage was defined as the expectoration of fresh blood, as opposed to blood‐streaked saliva. The rates of bleeding for the 2 studies were as follows. In study 1 for EC, 20% for adults, 6.5% for children, and 10.3% for total; for ABC, 4.7% for adults, 0.6% for children, and 1.9% for total. In study 2 for EC, 19.2% for adults, 1.6% for children, and 6.8% for total; for ABC, 7.7% for adults, 0.0% for children, and 1.1% for total. The rates of hospital admission for observation or reoperation to treat the bleeding in study 1 for EC were 8% for adults, 6.5% for children, and 6.9% for total; for ABC, 1.2% for adults, 0.6% for children, and 0.7% for total. Corresponding rates for study 2 for EC were 15.4% for adults, 1.6% for children, and 5.7% for total; for ABC, 3.8% for adults, 0.0% for children, and 1.1% for total.CONCLUSIONABC is more effective than EC for hemostasis after tonsillectomy. The costs of ABC use vs the savings achieved from reduced bleeding are discussed.
Duplicate Publication in the Field of Otolaryngology‐Head and Neck Surgery
Authors: Bailey Byron J. 
Published: February 2003

OBJECTIVEThis study establishes the approximate prevalence and patterns of duplicate publication in the medical literature in the specialty of otolaryngology‐head and neck surgery.STUDY DESIGN AND SETTINGAll of the authors and articles published in the American Medical Association Archives of Otolaryngology‐Head and Neck Surgery were identified and listed for an 8‐year period. During this time, 1965 authors published 1082 articles in the Archives, and this same set of authors published a total of almost 50,000 articles during the 12‐year period between January 1977 and December 1988. Of the same set of 1965 authors, we picked 1000 at random and found that they had published a total of 24,353 articles. The titles of these articles were then screened for similar titles, and when similarities were noted, the complete articles were obtained when possible and compared for the degree and pattern of duplicate publication.RESULTSOf the 1000 authors studied, we found that 228 authors had published 938 articles with similar titles. We were able to obtain the full copy of 886 (94%) of the 938 articles in question, which were written by 226 (99%) of the 228 authors. We found that in the case of 25 authors, there was no duplication despite the similar titles, but in the case of 201 (20% of the 1000) authors, 644 articles were published with some degree of duplication (1.8% duplication rate).CONCLUSIONSThe most common duplicate publication involves sequential publication of very similar data and conclusions. Duplicate publications failed to reference prior articles by the same author 32% of the time or referenced the prior articles only partially (11% of the time). Artificial segmentation of a single study into multiple arbitrary segments composed 20% of the duplicate publication. Duplicate publication across different specialties was noted to account for 4% of the instances. Most of the authors duplicated only once or twice, and most duplicators do reference their prior publications.SIGNIFICANCE: Duplicate publication is an example of inappropriate academic conduct. Because it tarnishes the reputation of the duplicating author and represents an unfair practice in terms of displacing the work of others, efforts should continue to educate authors, particularly young academicians, to avoid the practice of duplicate publication.
Sleepy Driving: Accidents and Injury
Authors: Powell Nelson B. , Schechtman Kenneth B. , Riley Robert W. , Li Kasey , Guilleminault Christian 
Published: February 2003

OBJECTIVEThe study goals were to evaluate the associated risks of driving and to assess predictors of accidents and injury due to sleepiness.STUDY DESIGNA cross‐sectional Internet‐linked survey was designed to elicit data on driving habits, sleepiness, accidents, and injuries during the preceding 3 years. Statistical analysis included logistic models with covariate‐adjusted P values of <0.01 (odds ratios and 95% confidence intervals or limits). Independent accident predictors were sought.RESULTSResponses from 10,870 drivers were evaluated. The mean ± SD age was 36.9 ± 13 years; 61% were women and 85% were white. The Epworth Sleepiness Scale overall baseline score was 7.4 ± 4.2 (for drivers with no accidents) and ranged to 12.7 ± 7.2 (for drivers with ≥ 4 accidents) (P = < 0.0001). Twenty‐three percent of all respondents experienced ≥ 1 accident. Among respondents who reported ≥ 4 accidents, a strong association existed for the most recent accident to include injury (P < 0.0001). Sleep disorders were reported by 22.5% of all respondents, with a significantly higher prevalence (35%, P = 0.002) for drivers who had been involved in ≥ 3 accidents.CONCLUSIONFactors of sleepiness were strongly associated with a greater risk of automobile accidents. Predictors were identified that may contribute to accidents and injury when associated with sleepiness and driving.
Octogenarian Free Flap Reconstruction: Complications and Cost of Therapy
Authors: Blackwell Keith E. , Azizzadeh Babak , Ayala Carlos , Rawnsley Jeffrey D. 
Published: February 2003

OBJECTIVEThe study goal was to document the reliability, incidence of complications, and cost of therapy for patients older than 80 years who undergo microvascular head and neck reconstruction.PATIENTS AND METHODSThirteen octogenarians underwent free flap reconstruction of defects resulting from the treatment of head and neck cancer at an academic tertiary care medical center. The incidence of medical and reconstructive complications and the cost of hospitalization were compared with those for 99 younger patients who were treated during the same time period.RESULTSThere were no cases of free flap failure or significant reconstructive complications in the octogenarians. The incidence of medical complications was 62% in the octogenarians and 15% in the younger patients. The average cost of therapy was $54,702 per octogenarian patient compared with $30,397 per younger patient. The increased incidence of medical complications and increased cost arose primarily from an increased severity of preoperative systemic illness in the octogenarians. However, controlling for comorbidity did not eliminate the discrepancy in medical complications between the octogenarians and the younger patients.CONCLUSIONSAlthough microvascular head and neck reconstruction in the elderly is very reliable, the incidence of medical complications and the cost of therapy are significantly increased in octogenarians.
Can patient satisfaction with decisions predict compliance with surgery?
Authors: Parhiscar Afshin , Rosenfeld Richard M. 
Published: February 2003

BACKGROUNDPatient satisfaction with treatment decisions is a discrete and measurable component of the satisfaction paradigm, distinct from satisfaction with health care services.OBJECTIVEThe study goal was to determine if the Satisfaction With Decision (SWD) scale, a valid and reliable 6‐item survey, can predict patient compliance with surgery proposed by their otolaryngologist.DESIGNProspective study using the SWD scale plus measures of office visit satisfaction, provider satisfaction, and disease‐specific quality of life.SETTINGMetropolitan, private nonprofit hospital.PATIENTSThe study population consisted of 151 patients scheduled for surgery, with a median age of 5.8 years and an age range of 0.6 to 65.3 years.INTERVENTIONSAt the time surgery was scheduled, the decision‐maker completed a 12‐item questionnaire about satisfaction and quality of life that included the SWD scale. Noncompliant patients were contacted, and the specific reason for cancellation was ascertained.RESULTSThe strongest predictor of surgical cancellation was the SWD survey score, with a median value of 4.8 for patients completing surgery compared with 3.8 for those who cancelled (P < 0.001). Patients with scores <4.0 had a 57% cancellation rate, whereas those with scores >4.0 had a 98% completion rate. Patients were also more likely to cancel if it was their first visit with the surgeon (P = 0.004) or if they were responsible for their own decisions (P = 0.007). Cancellations were not associated with office visit satisfaction, patient quality of life, or demographic characteristics of the decision‐maker.CONCLUSIONSPatients who are satisfied with their initial decision to undergo surgery are most likely to comply with planned therapy. Conversely, patients who score <4.0 on the SWD scale may benefit from additional preoperative counseling to increase the likelihood of compliance.