bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicoepidemiologic Features of Sudden Deafness Diagnosed and Treated at University Hospitals in Japan
Authors: Nakashima Tsutomu , Itoh Akihide , Misawa Hayato , Ohno Yoshiyuki 
Published: February 2003

Nationwide epidemiologic surveys were done 3 times by the Research Committee of the Ministry of Health and Welfare in Japan to investigate the number of patients and clinical manifestations of idiopathic sudden sensorineural hearing loss (sudden deafness). The first, second, and third surveys were carried out during the 1970s, 1980s, and 1990s, respectively. For each patient, we have compiled data regarding age, sex, onset day, presence or absence of vertigo, and hearing ability, including initial and final audiograms, in a computer in the Nagoya University Computer Center. Regarding patients who visited university hospitals, complete data were collected for 421 subjects (age: 40.2 ± 15.4 years, female: 203, male: 218) between July 1973 and June 1974, for 813 subjects (age: 45.1 ± 15.4 years, female: 407, male: 406) in 1987, and for 1112 subjects (age: 49.1 ± 16.0 years, female: 591, male: 521) in 1993. The number of patients with sudden deafness treated in university hospitals in Japan has increased, especially in the elderly population. This increase is associated with population increase and age‐adjusted incidence rates per 100,000 in the elderly population. The initial and final hearing levels in the first survey were worse than those in the second and third surveys; there was no significant difference in hearing between the second and third surveys. The hearing levels were worse in children and elderly patients than in the other age groups.
Cochlear Implant Performance in Senior Citizens
Authors: Labadie Robert F. , Carrasco Vincent N. , Gilmer Carol H. , Pillsbury Harold C. 
Published: February 2003

Cochlear implants are indicated for elderly patients with severe‐to‐profound hearing loss (sensorineural hearing loss ≥ 70 dB). Their use has been limited, possibly by the misconception that elderly patients will perform poorly. To document the performance of older adults (≥65 years old), we undertook a retrospective analysis of our postlingually deafened adult patients who underwent implantation with the CLARION Multi‐Strategy Cochlear Implant and underwent formal audiologic analysis (sentence recognition [Central Institute for the Deaf, CID] and monosyllabic word recognition [consonant‐noun‐consonant, CNC]). Both younger (n = 20; mean age = 46.9 years) and older (n = 16; mean age = 71.5 years) adults showed statistically significant increases in CID and CNC scores after cochlear implantation. No statistically significant difference could be detected in operative time, anesthesia time, length of hospitalization, or CID or CNC scores between the two age groups. We conclude that age should not be a criterion for deciding who should receive cochlear implants. (Otolaryngol Head Neck Surg 2000;123:419‐24.)
Obstructive Sleep Apnea Surgery: Patient Perspective and Polysomnographic Results
Authors: Li Kasey K. , Riley Robert W. , Powell Nelson B. , Gervacio Lindsay , Troell Robert J. , Guilleminault Christian 
Published: February 2003

OBJECTIVEThe goal of this study was to assess the outcomes of obstructive sleep apnea (OSA) surgery based on the patient perspective and polysomnographic data.STUDY DESIGNFifty‐six patients with severe OSA completed the 2‐phase reconstructive protocol. A minimum of 6 months after the phase II surgery and after the postoperative polysomnography, questionnaires with visual analog scales (VAS 0‐10) were mailed to the patients to assess their perceptions of treatment results.RESULTSForty‐two (75%) questionnaires were returned. The mean patient age was 46.3 years. The mean respiratory disturbance index improved from 58.7 to 10.0. The mean lowest oxygen saturation improved from 76.3 to 87.3%. All 42 patients reported improved sleep (VAS 8.7). Although 10 patients reported changes in speech, the changes were insignificant, with 9 of the patients scoring 0 on the VAS (VAS 0.08 ± 0.3). Five patients reported changes in swallowing, and their VAS scores were 0.5, 0.9, 1.0, 2.7, and 6.9 (mean VAS 2.4 ± 2.7). Forty patients (95%) were satisfied with their results and would undergo the reconstruction again.CONCLUSIONSurgical airway reconstruction for severe OSA is a highly effective treatment option base on the objective as well as the subjective assessment.
Complications of Foreign Bodies in the Esophagus
Authors: Seng Loh Kwok , Siang Tan Luke Kim , Smith James D. , Hian Yeoh Kian , Dong Fang 
Published: February 2003

Major complications of foreign bodies in the esophagus carry significant morbidity and mortality risks. A retrospective case control study was performed to assess the factors associated with major complications. In total, 273 patients seen within a 7‐year period were divided into 2 groups; 253 had no or minor complications, and 20 had major complications. Age, sex, duration of the foreign body, total white cell count (TWC), and nature and site of the foreign body were analyzed in the 2 groups. The major complication rate was 7.3%. Duration of the foreign body and TWC were the only statistically significant factors associated with major complications. Six patients required open neck exploration, 1 had an open thoracotomy, and 13 were treated by endoscopic removal. There were 2 deaths. Given the significant morbidity and mortality risks, we conclude that patients with a prolonged history of a foreign body in the esophagus and a raised TWC should be treated urgently.
Head and Neck Squamous Cell Carcinoma: Measurement of Plasma Parathyroid Hormone‐Related Protein and Serum and Urine Calcium Concentrations
Authors: Sellers Rani S. , Schuller David E. , Sharma Pramod K. , Tannehill‐Gregg Sarah H. , Capen Charles C. , Rosol Thomas J. 
Published: February 2003

OBJECTIVESParathyroid hormone‐related protein (PTHrP) is expressed by squamous cell carcinomas. Our first objective was to examine the stability of PTHrP in normal human plasma. Our second objective was to determine whether plasma PTHrP could be used in patients with head and neck squamous cell carcinoma (HNSCC) as an indicator of tumor burden or relapse.STUDY DESIGN AND SETTINGBlood and urine samples from 55 HNSCC patients undergoing tumor resection at The Ohio State University were measured for plasma PTHrP (1‐86) concentration, serum ionized calcium concentration, and urine calcium/creatinine ratio.RESULTSTwo of 55 HNSCC patients had detectable levels of plasma PTHrP. Serum ionized calcium concentrations and urinary calcium/creatinine ratios were within normal limits in all patients.CONCLUSIONSPlasma PTHrP was not a valuable indicator of tumor presence or recurrence in our patient population.SIGNIFICANCEPlasma PTHrP is not a useful marker of tumor presence or recurrence in patients with stage II to IV or recurrent HNSCC.
Do Adenoids Regrow After Excision?
Authors: Buchinsky Farrel J. , Lowry Morgan A. , Isaacson Glenn 
Published: February 2003

OBJECTIVEThe goal was to determine the incidence of symptomatic adenoidal regrowth after adenoidectomy.STUDY DESIGNA cross‐sectional follow‐up study was done in a randomly selected group of 175 children who had undergone adenoidectomy 2 to 5 years earlier. Nasopharyngoscopy was performed in those children who still had symptoms of nasal obstruction.SETTINGAll surgery was performed at an academic hospital‐based practice in the northeastern United States by a single surgeon using a consistent operative technique.RESULTSForty‐six (26%) patients had nasal airway obstruction symptoms at follow‐up. Of the 35 who agreed to undergo nasopharyngoscopy, not a single one had adenoids occupying more than 40% of the nasopharynx, and most (71%) were found to have either no or only trace amounts of adenoidal tissue (usually in the pharyngeal recess).CONCLUSIONAdenoids rarely, if ever, regrow enough to cause symptoms of nasal obstruction after adenoidectomy that includes visualization and electrocautery of the adenoid bed.
Complications associated with labyrinthine fistula in surgery for chronic otitis media
Authors: Manolidis Spiros 
Published: February 2003

OBJECTIVE:Labyrinthine fistula (LF) is encountered during surgery for chronic otitis media (COM) with an average frequency of 7.5%. This study was undertaken to investigate the prevalence of coexisting complications with LF in surgery for COM.STUDY DESIGN AND SETTING:A retrospective review of 111 consecutive cases of COM surgery performed by the same surgeon in a large metropolitan teaching public hospital in the United States serving the inner city population.RESULTS:There were 23 (21%) LFs in 111 patients. The majority of cases were revision surgery with an average of 2.6 operations per patient. Other complications were encountered in 18 (78%) of the 23 patients with an LF: 5 (22%) encephaloceles, 9 (39%) dehiscences of the tegmen, 12 (52%) patients with facial nerve involvement by cholesteatoma, and 2 (8.7%) patients with facial nerve paralysis. These patients required extensive surgery for correction of their concurrent complications.CONCLUSION:Compared with those cases in which a fistula was not found, the ratio of the above complications were as follows: encephalocele, 1:9; facial nerve involvement by cholesteatoma, 1:11.3; facial nerve paralysis, 1:3.8.SIGNIFICANCE:Patients with neglected COM have an incidence of an LF twice that reported in the literature. The prevalence of associated complications with LF requiring extensive surgery is significantly higher than that observed in noncomplicated COM cases.
Improvement in bone conduction threshold after tympanoplasty
Authors: Tüz Mustafa , Doğru Harun , Uygur Kemal , Gedjklj Orhan 
Published: February 2003

OBJECTIVE:To investigate the causes of bone conduction threshold impairment associated with middle ear pathoses and the factors influencing improvement in bone conduction threshold after tympanoplasty.STUDY DESIGN AND SETTING:The records of 98 consecutive patients with unilateral chronic otitis media who underwent tympanoplasty were reviewed. Pre‐operatively, 15 dB or more depression of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was considered to be significant. Similarly in the postoperative period, 15 dB or more improvement of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was regarded as significant.RESULTS:Twelve (12.5%) of 98 cases were found to have depressed bone conduction threshold; 6 of 12 cases had improved bone conduction threshold after tympanoplasty.CONCLUSION:In cases with cholesteatoma and extensive middle ear disease, successful results could be achieved after tympanoplasty disregarding the air‐bone gap and deteriorated bone conduction threshold.SIGNIFICANCE:Bone conduction threshold may improve after tympanoplasty.
Cochlear implantation in patients with compromised healing
Authors: Odabasi Onur , Mobley Steven Ross , Bolanos Rodrigo A. , Hodges Annelle , Balkany Thomas 
Published: February 2003

BACKGROUND:The indications for cochlear implantation (CI) are continually evolving and, as experience accumulates, the relative contraindications for CI continue to decrease. However, there is little information regarding CI in patients who may be considered to be at risk for poor wound healing due to immunosuppression or intercurrent disease.OBJECTIVE:To assess and report the complication rates, postoperative course, postimplant rehabilitation, and long‐term performance of patients considered at risk due to presumably impaired healing capability. We hypothesized that these patients had outcomes similar to other implanted patients.METHODS:This is a retrospective chart review of 277 patients who have received CI at the University of Miami Ear Institute between 1990 and 1999. The clinical courses of 6 patients on immunosuppressive medications and 7 patients with diseases believed to be associated with poor healing are reported.RESULTS:Long‐term follow‐up (mean, 33 months) showed postoperative complication rates, performance, and rehabilitation compliance that were similar to published reports of noncompromised patients.CONCLUSION:CI of selected patients with potentially reduced healing capabilities is safe and effective.
Use of Plain Radiography and Computed Tomography to Identify Fish Bone Foreign Bodies
Authors: Lue Allen J. , Fang W. Daniel , Manolidis Spiros 
Published: February 2003

INTRODUCTIONFish bones are the most common aerodigestive foreign bodies in adults. Radiographic studies, often ordered for diagnosis, have questionable utility.METHODSWith a laryngoscope, bones from 10 fish species were placed in a variety of positions in a human head and neck cadaver specimen. Plain films and CT scans were obtained and evaluated by blinded readers.RESULTSPlain radiography exhibited a sensitivity and specificity of 39% and 72%. Cooking did not grossly change radio‐opacity. The species of fish affected visibility in soft tissue, without correlation to the characteristic optical density of each species. Bones placed orthogonal to the film in the vallecula were most readily identified. CT scanning correctly identified 9 of 10 bones.CONCLUSIONSPlain radiography poorly visualizes fish bone foreign bodies in soft tissue; visibility varied with fish species, location, and orientation. CT is the test of choice to radiographically diagnose fish bone impactions.
Identification of Internal Acoustic Canal in the Middle Cranial Fossa Approach: A Safe Technique
Authors: Cokkeser Yasar , Aristegui Miguel , Naguib Maged B. , Saleh Essam , Taibah Abdel K. , Sanna Mario 
Published: February 2003

BACKGROUNDThe middle cranial fossa approach (MCFA) is a very valuable functional approach in the armamentarium of the neuro‐otologic surgeon. Identification of the internal acoustic canal (IAC) in MCFA is one of the most tedious steps. Many techniques have been described to locate the IAC safely when using the MCFA.OBJECTIVEWe sought to describe a safe technique for identification of the IAC and to demonstrate its feasibility in temporal bone dissections, as well as to discuss our clinical experience with this technique.METHODSThe surgical anatomy of the 20 temporal bones were evaluated and measured, especially by defining the medial and lateral ends of the IAC and relations to the nearby located structures. Measurements were obtained at 3 levels: the width of the IAC at the level of the fundus, the width of the IAC at the level of the porus, and the safe distance around the IAC at the meatal level. The medial and lateral IAC end widths were compared with each other and with the safe area at the meatal level.RESULTSThe smallest, the largest, and the mean values were recorded. The mean width of the IAC at the level of the porus was found to be more than 3‐fold that of the width of the IAC at the level of the Bill's bar, and the ratio between the width of the medial safe area around the IAC and the lateral end of the IAC was found to be more than 7‐fold as wide.CONCLUSIONThis technique offers direct quick exposure of the IAC, without handling the facial nerve and the inner ear structures. Forty‐five cases of operations with the same technique showed excellent ease and safety of identifying the IAC medially in the MCFA. (Otolaryngol Head Neck Surg 2001;124:94‐8.)
Creating a Stable Tympanic Membrane Perforation Using Mitomycin C
Authors: O'Reilly Robert C. , Goldman Steven A. , Widner Sheri A. , Cass Stephen P. 
Published: February 2003

OBJECTIVETo determine the ability of topically applied mitomycin C to create a stable tympanic membrane perforation.STUDY DESIGN AND SETTINGTwenty‐four rats underwent subtotal removal of the tympanic membranes bilaterally. Forty ears received 0.2 mg/ml of mitomycin C. The remaining 8 received phosphatebuffered saline solution (control). Photographs taken every 3 to 5 days for 44 days were digitally scanned and computer analyzed to calculate the percentage of residual perforation. Application of solutions, photography, and data analysis were performed in a blinded fashion.RESULTSThe mitomycin C treated ears had delayed closure time and healing rate (from day 0 to 25) compared to the control group. All controls healed by day 14. By day 44, 92.5% of the mitomycin C treated ears healed.CONCLUSIONMitomycin C prolongs the closure and healing rate of myringotomies in rat tympanic membranes.SIGNIFICANCEMyringotomy with concurrent mitomycin C application may be useful for creating an animal model for chronic tympanic membrane perforation and should be tested in human beings as a method to maintain myringotomy patency for long‐term ventilation. (Otolaryngol Head Neck Surg 2001;124:40‐5)
Continuous Intratympanic Infusion of Gentamicin Via a Microcatheter in Menière's Disease
Authors: Schoendorf Jakob , Neugebauer Peter , Michel Olaf 
Published: February 2003

Between 1995 and 1998, 11 patients with disabling Menière's disease were treated at our institution with a continuous gentamicin infusion into the middle ear via a microcatheter. The patients had frequent attacks of vertigo and vomiting (functional levels 3‐5). Hearing threshold on the affected side was significantly worse than on the healthy side (stage 4+5). Gentamicin was applied by a high‐precision insulin pump with a flow rate of 40 mg per day directly in front of the round window. Application was stopped as soon as signs of vestibular affection appeared. A good overall control of vertiginous spells was achieved in 8 patients. Eight patients experienced complete hearing loss on the affected side, 1 experienced a slight worsening, and 1 had no hearing change. There was no correlation between the cumulative gentamicin dosage and the hearing loss. Our findings show that in terms of hearing loss and hospitalization time the continuous gentamicin application is inferior to other applications presented in the literature.
Altered MUC1 and MUC2 Glycoprotein Expression in Laryngeal Cancer
Authors: Jeannon Jean‐Pierre , Stafford Frank W. , Soames James V. , Wilson Janet A. 
Published: February 2003

The purpose of this study was to determine whether mucin expression is altered in laryngeal cancer. MUC1 and MUC2 mucin expression was examined in biopsy specimens from 80 patients that comprised 23 laryngeal dysplasias, 36 laryngeal carcinomas, and 21 normal larynx control specimens. High MUC1 expression was found in all 3 groups (P = 0.689, Fisher exact test). However, significantly higher levels of MUC2 expression were detected in carcinomas compared with dysplasias and control specimens (P = 0.009, Fisher exact test). Altered MUC2 expression may be an important step in carcinogenesis in laryngeal cancer.
Salivary Flow Dynamics after Parotid Surgery: A Preliminary Report
Authors: Chaushu Gavriel , Dori Shay , Sela Ben‐Ami , Taicher Shlomo , Kronenberg Jona , Talmi Yoav P. 
Published: February 2003

BACKGROUNDTumors in the parotid gland may affect salivary flow. The effects of tumor on glandular function and postoperative changes in both resected gland and contralateral gland were not formerly reported. We prospectively evaluated salivary flow rates and composition in patients undergoing parotidectomy preoperatively and postoperatively.METHODStimulated parotid saliva from 17 patients undergoing parotidectomy was collected bilaterally preoperatively and postoperatively by using a parotid cup. Subjective complaints were recorded. Salivary flow rates, sodium, potassium, and amylase levels were evaluated.RESULTSNone of the patients complained of “dry mouth” before or after surgery. Analysis of the individual results revealed 3 patterns of preoperative and postoperative response, compatible with either a preoperative or postoperative compensatory mechanism in the contralateral gland. The postoperative decrease in flow rate corresponds with the amount of gland removed. Salivary electrolyte composition was unchanged.CONCLUSIONThis study is the first to demonstrate the effects of parotid tumors and their surgery on salivary flow and a compensatory response and its different patterns in human parotid glands after their excision.
MUC4 (Sialomucin Complex) Expression in Salivary Gland Tumors and Squamous Cell Carcinoma of the Upper Aerodigestive Tract
Authors: Weed Donald T. , Gomez‐Fernandez Carmen , Bonfante Esteban , Lee Thomas D. , Pacheco Jeffrey , Carvajal Maria E. , Goodwin W. Jarrard , Carraway Kermit L. 
Published: February 2003

OBJECTIVESThis study investigates MUC4 expression in normal squamous epithelia and squamous cell carcinoma (SCC) of the upper aerodigestive tract (UADT), and in salivary gland neoplasms.STUDY DESIGNMUC4 antigens in tumor and adjacent normal tissue are localized by immunocytochemical studies. Fresh frozen tissues from surgical resection specimens are further analyzed by Western blot.RESULTSMUC4 is identified by immunocytochemical staining throughout the normal UADT mucosa, in 34 of 40 primary UADT SCC, and in 11 of 12 metastatic cervical lymph nodes. A trend toward decreased MUC4 staining in moderately and poorly differentiated tumors is noted. Immunoblots show MUC4 in 4 of 5 SCC analyzed. Immunocytochemical staining of MUC4 in 13 major and minor salivary gland neoplasms reveal variable staining of normal and neoplastic tissue. MUC4 is demonstrated in immunoblots of normal parotid tissue and in the single parotid malignancy analyzed, but is not demonstrated in one minor salivary gland malignancy. These findings characterize normal UADT mucosal and salivary MUC4 expression, and MUC4 expression in SCC of the UADT and in salivary gland tumors.SIGNIFICANCECorrelation of MUC4 expression with clinical outcomes may establish MUC4 as a potential molecular prognostic marker for these tumors.
Computed Tomography Imaging of the Maxillary and Ethmoid Sinuses in Children with Short‐duration Purulent Rhinorrhea
Authors: Schwartz Richard H. , Pitkaranta A. , Winther Birgit 
Published: February 2003

INTRODUCTIONAdults with a common cold often have paranasal sinus effusions detected by computed tomographic (CT) scans. There are no comparable data for children. The purpose of this study was to document the sinus CT findings in children with short‐duration purulent rhinorrhea.DESIGNThirty Children, 3 to 12 years of age (median age, 7 years), with purulent rhinorrhea for a mean duration of 5 days (and always less than 9 days) were enrolled in the study. The children were otherwise well. Institutional Review Board (IRB)‐approval was obtained before enrollment of the first patient. Informed written consent was obtained from each child's parent. CT imaging of the maxillary and ethmoid sinuses was obtained on the day of the initial visit (occasionally, the following day). Follow‐up CT scans were obtained from cooperative children/parents, 3 to 4 weeks later.RESULTSOpacification or an air/fluid level in the maxillary sinuses was seen in 27 (90%) of 30 study children at study entry. Ethmoid sinuses were not opacified without opacification of a maxillary sinus. Three weeks later, 24 of 27 study children, who had positive CT scans on study entry, improved clinically. Of 17 follow‐up CT scans, 10 (58%) normalized, 4 had improvement of bilateral disease, and 3 improved with unilateral disease. None appeared worse than baseline.CONCLUSIONSPansinus opacification (ethmoid and maxillary sinuses), on CT scans in children with short‐duration purulent nasal drainage was seen in 70% of children. An additional 20% had isolated maxillary sinus effusions (10% had no effusion). Three‐week follow‐up CT scans on 17 children were normal in 60% and improved (partial clearance) in 40%. In this patient population, the decision to treat with antibiotics should be made on clinical grounds alone.