bluuebunny/crossref_metadata_2025_split huggingface dataset:
Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): A 12‐year experience in more than 900 patients
Authors: Blitzer Andrew , Brin Mitchell F. , Stewart Celia F. 
Published: November 2003

AbstractObjectives: This paper reviews a 12‐year experience in more than 900 patients with spasmodic dysphonia who have been treated with botulinum toxin. Study Design: This is a retrospective analysis of patients with adductor spasmodic dysphonia (strainstrangled voice), abductor spasmodic dysphonia (whispering voice), and adductor breathing dystonia (paradoxical vocal fold motion), all of whom have been treated with botulinum toxin injections for relief of symptom. Methods: All of the patients were studied with a complete head and neck and neurologic examination; fiberoptic laryngostroboscopy; acoustic and aerodynamic measures; and a speech evaluation including the Universal spasmodic dysphonia rating scale. Some were given electromyography. All patients received botulinum toxin injections into the affected muscles under electromyographic guidance. Results: The adductor patients had an average benefit of 90% of normal function lasting an average of 15.1 weeks. The abductor patients had an average benefit of 66.7% of normal function lasting an average of 10.5 weeks. Adverse effects included mild breathiness and coughing on fluids in the adductor patients, and mild stridor in a few of the abductor patients. Conclusion: Botulinum toxin A injection of the laryngeal hyperfunctional muscles has been found over the past 12 years to be the treatment of choice to control the dystonic symptoms in most patients with spasmodic dysphonia. Laryngoscope, 108:1435–1441, 1998
Expression of glycoconjugates in human eustachian tubes with otitis media
Authors: Sone Michihiko , Paparella Michael M. , Schachern Patricia A. , Morizono Noriko , Le Chap T. , Lin Jizhen 
Published: November 2003

AbstractObjectives: To characterize glycoconjugate expression in normal human eustachian tubes and study the alterations in glycoconjugate expression found in eustachian tubes with otitis media. Study Design: Using lectin histochemistry, alterations in glycoconjugates were studied in three normal temporal bones, in four temporal bones with mucoid otitis media (MOM), and in five with serous otitis media (SOM). Methods: Sections of previously processed temporal bones were decelloidinized, and then incubated with seven biotinylated lectins‐WGA, SNA, MAA, BPA, PNA, UEA‐I, and LcH–that reflect seven carbohydrate residues of glycoconjugates, respectively: GlcNAc/NeuNAc, Ne‐uNAcα(2–6)GalNAc, NeuNAcα(2–3)GalNAc, Galβ(1–3) GalNAc, l‐fucose, and α‐mannose residues. Control sections were incubated with inhibitory carbohydrates or without biotinylated lectins. Results: In the normal temporal bones, five carbohydrate residues in goblet cells and cilia of the eustachian tube demonstrated moderate to strong activity—NeuNAcα(2–6)GalNAc, NeuNAcα(2–3)GalNAc, GalNAc, Galβ(1–3)GalNAc, and l‐fucose. Two residues demonstrated weak activity—GlcNAc/NeuNAc and α‐mannose. Temporal bones with MOM revealed increases in sialic acid and α‐mannose, and a decrease in l‐fucose. Residues of carbohydrates in the cilia of bones with SOM were notably decreased, especially for GalNAc, Galβ(1–3)GalNAc, and Neu‐NAcα(2–6)GalNAc. Conclusions: Glycoconjugates in the normal human eustachian tube are rich in GalNAc, Galβ(1–3)GalNAc, l‐fucose, and NeuNAcα(2–3/2–6) GalNAc, but low in α‐mannose and sialic acid. Eustachian tubes from cases with SOM or MOM demonstrated alterations in glycoconjugate expression in cilia and goblet cells, which may reflect disorder of the carbohydrate metabolism during otitis media, especially in SOM. Laryngoscope, 108:1474–1479, 1998
A new mutation in the POU3F4 gene in a japanese family with x‐linked mixed deafness (DFN3)
Authors: Hagiwara Hideo , Tamagawa Yuya , Kitamura Ken , Kodera Kazuoki 
Published: November 2003

AbstractObjective: The molecular defect in patients with X‐linked mixed deafness showing a perilymphatic gusher at stapedectomy (DFN3) has been attributed to mutations in the POU3F4 gene. This study aimed to clarify an allelic variant of this gene. Study Design: This was a genetic study of a single Japanese family with DFN3. Methods: Products of a polymerase chain reaction (PCR) were subjected to single‐strand conformation polymorphism (SSCP) analysis. Direct sequencing of PCR products from patients and carriers showing SSCP variants was performed using the fluorescent dideoxy termination method and a sequencer. Results: Sequencing of the PCR product revealed a 6‐base deletion (TTCAAA) at nucleotides 601 to 606, resulting in a two‐amino‐acid deletion in the POU3F4 protein, (phenylalanine and lysine at amino acid residues 201 and 202). The deletion was adjacent to the site of a nonsense mutation previously described. Conclusion: Microdeletions at a previously undescribed location account for some clinically important POU3F4 mutations. Laryngoscope, 108:1544–1547, 1998
Occult tonsillar carcinoma in the unknown primary
Authors: Mcquone Shelly J. , Eisele David W. , Lee Ding‐Jen , Westra William H. , Koch Wayne M. 
Published: November 2003

AbstractObjectives: Evaluate effectiveness of routine tonsillectomy in the assessment of patients with squamous cell carcinoma of the neck of unknown primary, and evaluate outcomes of this group compared with patients without a primary identified initially. Study Design: A retrospective review of the medical records of 37 patients presenting with an unknown primary tumor over a 10‐year period. Methods: Charts were reviewed for age and sex of patients, methods of evaluation and diagnosis, sites of tissues obtained on biopsy, N stage of disease, and presence of extracapsular spread. Recurrence and survival data were collected over a mean follow‐up period of 34 months. Results: All primary lesions discovered through pathologic evaluation arose from the tonsil (9/9), and all were detected in patients undergoing tonsillectomy in conjunction with direct laryngoscopy. None of the patients (0/9) with occult tonsillar carcinoma have had recurrence, in contrast to 60% (15/25) of remaining patients. Patients with tonsillar primary lesions demonstrated less extracapsular spread of disease (25%) than patients without tonsillar primaries (67%), despite similar N staging within the two groups. Conclusions: Occult tonsillar carcinoma accounts for the unknown primary more frequently than was previously recognized. Bilateral tonsillectomy is recommended to increase the detection yield and to capture the rare case of bilateral disease. A lower incidence of extracapsular spread and reduced recurrence rates in patients with unknown primary tumors presenting as occult tonsillar carcinoma may contribute to the improved prognosis observed in this group. Laryngoscope, 108:1605–1610, 1998
An orthotopic floor‐of‐mouth cancer model allows quantification of tumor invasion
Authors: Simon Christian , Nemechiek Andrew J. , Boyd Douglas , O'Malley Bert W. , Goepfert Helmuth , Flaitz Catherine M. , Hicks M. John 
Published: November 2003

AbstractObjectives: To establish an orthotopic murine floor‐of‐mouth cancer model for the analysis of the role of proteases such as urokinase‐type plasminogen activator (u‐PA) and the matrix metalloprotease MMP‐9 (MMP‐9) in in vivo invasion. Study Design: Randomized, prospective animal study. Methods: Two human squamous cell carcinoma cell lines, UM‐SCC‐1 and 022, were assayed via zymography for their in vitro secretion levels of u‐PA and MMP‐9. Both cell lines (5 × 106 cells) were injected into the cervical subcutaneous tissues of female athymic nude (nu/nu) mice superficial to the mylohyoid muscle. Mice were sacrificed after 30 days, and tumor invasion characteristics were histologically compared. Additional mice were then inoculated with invasive UM‐SCC‐1 cells and sacrificed 10, 30, and 40 days after inoculation to identify distinct stages of invasion. Results: In vitro secretion levels of MMP‐9 and activity of u‐PA were higher in UM‐SCC‐1 cells than in 022 cells. In the in vivo studies, tumors formed from 022 cells were found to be noninvasive, whereas tumors derived from UM‐SCC‐1 cells progressed through distinct and readily identifiable histologic stages of invasion. These stages included invasion of adjacent muscle layers (mylohyoid, geniohyoid, and genioglossus muscles) and of associated structures (blood vessels, bone, nerve, and regional lymph nodes). A staging system was devised accordingly. Conclusion: We developed an in vivo quantitative cancer invasion model that allows determination of the effect of the expression and activity levels of the proteases MMP‐9 and u‐PA. Tumor invasion occurred in an orderly and stepwise fashion involving muscles and related vascular, nervous, and bony structures of the floor of the mouth and tongue. This orderly invasion allowed the development of a staging system. We anticipate that this model will have wide applicability in the study of in vivo tumor response to a variety of novel therapeutic approaches. Laryngoscope, 108:1686–1691, 1998
A biomechanical study of the human cricoarytenoid joint
Authors: Kasperbauer Jan L. 
Published: November 2003

AbstractObjectives/Hypothesis: To develop a model to investigate the biomechanics of the cricoarytenoid joint and establish stiffness, laxity, and range of motion of the cricoarytenoid joint in adult human larynges. Study Design: Laboratory investigation of freshly frozen larynges from adult humans, measuring the stiffness, laxity, and range of motion in intact and injured cricoarytenoid joints. Methods: Eight normal‐appearing frozen cadaver larynges from adult humans were studied. The cricoid cartilage was fixed to a load cell sensitive to forces in three dimensions. A probe was rigidly fixed to the arytenoid cartilage and attached to a frame to allow active rotation, rocking, and gliding of the arytenoid. A computer program simultaneously recorded forces generated by these motions and tracked the motion of the arytenoid in three dimensions. The joint was studied before and after injury to the posterior cricoarytenoid ligament, and the joint surfaces were digitized after completion of these studies. Results: A successful method of evaluating the biomechanical properties of the cricoarytenoid joint was developed. Comparing intact and injured joints confirmed that laxity and range of motion increased during rocking, gliding, and rotational motion when the cricoarytenoid ligament had been divided. Stiffness measurements for rocking, rotation, and gliding also were documented. Conclusions: The model of study introduced in this report provides a significant and unique method of investigating the biomechanics of the cricoarytenoid joint, allowing insight into the basic joint characteristics and alteration in joint biomechanics related to injuries and surgical procedures. Dividing the cricoarytenoid ligament increases laxity and range of motion in sagittal rocking, gliding, and axial rotation. Secondary constraints on the joint provide significant stiffness of greater degrees of displacement. Further studies should provide insight into the significant secondary elements supporting the joint and into the mechanisms of cricoarytenoid injuries, as well as the effect of surgical procedures on the cricoarytenoid joint. Laryngoscope, 108:1704–1711, 1998
Ossiculoplasty with an intact stapes: Superstructure versus footplate prosthesis placement
Authors: Moretz William H. 
Published: November 2003

AbstractObjectives/Hypothesis: Many techniques and prostheses are used for ossiculoplasty in the various situations of ossicular chain status that the surgeon may encounter in tympanoplasty procedures. The current study seeks to determine whether any particular technique or prosthesis used by the author demonstrates superior hearing results with fewer failures. Study Design: Retrospective review. Methods: This study retrospectively reviews a consecutive series of cases with intact stapes superstructures, with an intact malleus handle (Austin‐Kartush group A) and without (Austin‐Kartush group C). The ossiculoplasties were performed with either partial prosthesis techniques from the stapes superstructure to the drum, malleus, or malleus/drum (as is traditionally reported by most authors) or with less frequently advocated total prosthesis techniques from the stapes footplate to the drum, malleus, or malleus/drum. Results/Conclusions: Of cases for which 1‐year postoperative air and bone hearing results were available, group A cases had significantly smaller air‐bone gaps than group C cases. There was no difference in mean air‐bone gaps between partial and total reconstruction within either group A or C. A few partial and total prosthesis types had low failure rates, good mean air‐bone gap hearing results, and tight spread of results to recommend them in group A cases. Total reconstruction had a lower prosthesis failure rate than partial reconstruction in group C cases, although mean air‐bone gap hearing results were the same.
Vocal mechanics as the basis for phonosurgery
Authors: Isshiki Nobuhiko 
Published: November 2003

AbstractObjective: A number of modifications in laryngoplastic phonosurgery have recently been proposed. This report is intended to clarify the concept on which the surgery should be based, vocal mechanics, for further rational development of the surgery. Study Design: The results of various previous surgeries were compared. In an attempt to elucidate what makes the difference in the results, simulation of voice production was conducted with the use of excised larynges. Methods: Excised larynges were mounted on a tube so as to be blown from below. Experimental variables in the model included the glottal area initially set, stiffness of the vocal folds, and subglottal pressure. The conditions under which the voice became hoarse were examined. Results: The voice became hoarse under the following major conditions: 1) the initial glottal area exceeded a certain value, 2) stiffness was too high, and 3) the glottis was too tightly closed. Clinical representation for each condition was made, particularly for excessively tight glottal closure such as in spasmodic dysphonia. A new type of surgical treatment for spasmodic dysphonia, lateralization thyroplasty, was briefly reported, which restored the voice to normal without recurrence for 1 year at the time of this writing. Conclusions: A potential new type of laryngoplastic phonosurgery should be conformed to the mechanics of voice production. In treating dysphonia, it is often necessary to switch from etiologic or radical treatment, if infertile, to symptomatic treatment instead, at the level of mechanics.
Endoscope‐assisted vestibular neurectomy
Authors: Wackym Phillip A. , King Wesley A. , Barker Fred G. , Poe Dennis S. 
Published: November 2003

AbstractObjective/Hypothesis: In some instances endoscopes offer better visualization than the microscope and frequently allow less invasive surgery. This study was undertaken to determine whether endoscopy is safe and effective during neurectomy of the vestibular nerve. Method: Ten patients with intractable unilateral Meniere's disease underwent a retrosigmoid craniotomy for neurectomy of the vestibular nerve. Endoscopy with a Hopkins telescope was used during each procedure to study posterior fossa anatomic relationships and to assist the neurectomy. Preoperative and postoperative audiometric evaluation was performed in all patients undergoing vestibular neurectomy. Nine of these patients had preoperative electronystagmography, and four patients completed postoperative electronystagmography. The 1995 American Academy of Otolaryngology—Head and Neck Surgery's Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease were used. Results: Complete neurectomy was achieved in all 10 patients. Endoscopy allowed improved identification of the nervus intermedius and the facial, cochlear, and vestibular nerves and adjacent neurovascular relationships without the need for significant retraction of the cerebellum or brainstem. In addition, endoscopic identification of the cleavage plane between the cochlear and vestibular nerves medial to or within the internal auditory canal (n = 3) was not made with the 0‐degree endoscope; however, identification was made with the 30‐ or 70‐degree endoscope in all cases. In all patients with Meniere's disease, elimination of the recurrent episodes of vertigo (n = 10) or otolithic crisis of Tumarkin (n = 1) was achieved. Conclusions: Posterior fossa endoscopy can be performed safely. Endoscope‐assisted neurectomy of the vestibular nerve may offer some advantages over standard microsurgery including increased visualization, more complete neurectomy, minimal cerebellar retraction, and a lowered risk of cerebrospinal fluid leakage.
A review of 308 cases of revision stapedectomy
Authors: Hammerschlag Paul E. , Fishman Andrew , Scheer Allan Austin 
Published: November 2003

AbstractObjective/Hypothesis: Identify causes of primary and revision stapedectomy failure in 308 patients, assess whether these are different based on source of initial surgery, and evaluate hearing results in revision stapedectomy to improve outcome. Study Design: Retrospective, nonrandomized chart review of patients undergoing revision stapedectomy in a referral otology practice in a large metropolitan region. Materials and Methods: Intraoperative findings, preoperative and postoperative revision stapedectomy air and bone conduction pure‐tone averages, speech discrimination scores, postoperative air‐bone gaps, complications, and repeated revisions were noted in 308 patients. Results: Leading causes of primary stapedectomy failure included dislocated prosthesis (24.4%), inadequate prosthesis length (14%), long process resorption (14%), and fibrous adhesions (13.6%). Revision stapedectomy air‐bone gaps were less than 10 dB in 80% and greater than 30 dB in 6.8% of cases. Increased sensorineural hearing loss occurred in 0.8% of revision stapedectomy cases. Five of seven cases of vertigo associated with primary stapedectomy resolved after revision surgery. Conclusion: Revision stapedectomy by experienced surgeons is highly effective in attaining successful air‐bone gap closure in 80% and improved closure in 84.8% of operative cases. Risk of vertigo and/or sensorineural hearing loss was not any higher in this patient population when compared with reports of primary stapedectomy.
Argon Plasma Coagulation for the Treatment of Hereditary Hemorrhagic Telangiectasia
Authors: Bergler Wolfgang , Riedel Frank , Baker‐Schreyer Antonio , Juncker Cathrin , Hörmann Karl 
Published: November 2003

AbstractObjectives: Patients with (HHT) often suffer from recurrent epistaxis, which poses considerable therapeutic problems. Theoretical considerations render argon plasma coagulation (APC) a promising new therapeutic approach. Study Design: In a prospective study 12 patients (aged 8–68 y) who presented with a long history of treatment for epistaxis were treated with telangiectasia in the nasal mucosa. After 2 weeks and again after 4 months the treatment results were evaluated by questionnaire. Methods: APC is based on high‐frequency electric energy transmitted through ionized argon gas to the tissue in a noncontact mode. Coagulation and desiccation of tissue are limited to 1 to 2 mm of penetration and therefore risk of tissue damage is low. Coagulative effects are best in tissue with high electrical conductivity, especially blood vessels. Results: All patients were satisfied with the postoperative results. Frequency and intensity of bleeding were significantly reduced. All patients reported better postoperative results than with any other treatment they had received previously. Conclusion: First clinical experience shows that APC is a useful alternative for the treatment of telangiectasia in the nasal mucosa and should be a therapeutic option for this disease.
Surgical Causes of Failure in Endoscopic Sinus Surgery
Authors: Ramadan Hassan H. 
Published: November 2003

AbstractObjectives: Evaluate causes of surgical failure at time of revision endoscopic sinus surgery. Study Design: Prospective review of 682 cases that had endoscopic sinus surgery performed between 1991 and 1995. Methods: In all cases, variables of age, sex, asthma, allergy, computed tomography stage, associated procedures, complications, and operative findings were collected. Those cases that had a failure after a previous endoscopic sinus procedure and not an intranasal procedure or an external procedure were evaluated. Results: Fifty‐two patients (7.6%) were identified. The age range was 24 to 70 years. The most common cause of failure was residual air cells and adhesions in the ethmoid area (30.7%), followed by maxillary sinus ostium stenosis in 27%, frontal sinus ostium stenosis in 25%, and a separate maxillary sinus ostium stenosis in 15% of the cases. Conclusion: Review of surgical causes of failure in endoscopic sinus surgery patients revealed that residual air cells and stenotic maxillary or frontal sinus ostium were the most common causes of failures.
Prognosis in Bilateral Vestibular Hypofunction
Authors: Gillespie M. Boyd , Minor Lloyd B. 
Published: November 2003

AbstractObjectives/Hypotheses: The outcomes of patients with bilateral vestibular hypofunction vary widely. Some resume relatively normal activity within months, whereas others have a more debilitated course. This study sought to identify factors that may affect outcome. Study Design: A retrospective review of patients treated for bilateral vestibular hypofunction over a 2‐year period at a neurotology clinic. Methods: Patients' medical charts, electronystagmography data, rotatory chair testing, and posturography results were reviewed. Subjective and objective measures were used to evaluate outcome. Results: Bilateral vestibular hypofunction was diagnosed in 35 patients. Improvement after vestibular rehabilitation therapy was noted in 18 patients (51%), whereas 12 (34%) showed little or no change and 5 (15%) were not available for follow‐up. The patients without improvement were more likely to have a chronic disorder as a cause of the vestibulopathy and had more medical comorbidities, on average, when compared with those who improved. Lower gains and time constants on rotatory chair testing were also seen in the group that did not improve. Conclusions: Poor rehabilitation results may be attributable to increased severity of vestibular insult, progressive peripheral or central vestibular dysfunction, and multiple medical problems.