bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preservation of Function and Histologic Appearance in the Injured Glottis With Topical Mitomycin‐C
Authors: Spector Jared E. , Werkhaven Jay A. , Spector Nicole C. , Huang Shan , Page Robert N. , Baranowski Bryan , Luther Matthew , McGehee Bartley , Reinisch Lou 
Published: November 2003

AbstractObjective: To evaluate the functional and histological effects of a single application of topical mitomycin‐C after laser injury in the posterior canine glottis. Study Design: A prospective, randomized study of 16 canines. Methods: A supersaturated (1%) solution of topical mitomycin‐C was applied to a unilateral, laser‐induced injury near the cricoarytenoid joint in eight dogs. The mitomycin‐soaked pledget was placed immediately after induction of the injury and was left in contact with exposed cartilage for 3 minutes. The opposite side was not injured to provide an internal control. In eight additional dogs, the same laser injury was allowed to heal untreated. After 6 weeks, the animals were sacrificed and their larynges harvested. Arytenoid adduction sutures were placed bilaterally, and the force required to bring the vocal folds to midline was measured for each side using tensiometry. Gross and microscopic histological analysis was performed. Statistical analysis was accomplished using a two‐tailed Student t test of unpaired samples, and the Wilcoxon Signed Rank Test where appropriate. Results: The mitomycin‐C treated larynges demonstrated improved cricoarytenoid joint mobility (P = .007), decreased granulation tissue development (P = .03), and complete prevention of secondary “vocal granuloma” formation (P = .0004) when compared with eight dogs with identical laser injuries allowed to heal untreated. No complications were noted. Conclusions: This study demonstrates functional preservation and improved histological appearance of the injured glottis after a single treatment with topical mitomycin‐C. Potential applications of these findings include prophylactic use of topical mitomycin‐C on glottic insults that commonly progress from granulation tissue formation to scarring and decreased vocal fold function.
Hyaluronic Acid (With Fibronectin) As a Bioimplant for the Vocal Fold Mucosa
Authors: Chan Roger W. , Titze Ingo R. 
Published: November 2003

AbstractObjectives: To measure the viscoelastic shear properties of hyaluronic acid, with and without fibronectin, and to compare them with those of the human vocal fold mucosa and other phonosurgical biomaterials. Methods: Viscoelastic shear properties of various implantable biomaterials (Teflon, gelatin, collagen, fat, hyaluronic acid, and hyaluronic acid with fibronectin) were measured with a parallel‐plate rotational rheometer. Elastic and viscous shear properties were quantified as a function of oscillation frequency (0.01–15 Hz) at 37°C. Results: The shear properties of hyaluronic acid were relatively close to those of human vocal fold mucosal tissues reported previously. Hyaluronic acid at specific concentrations (0.5%–1%), with or without fibronectin, was found to exhibit viscous shear properties (viscous shear modulus and dynamic viscosity) similar to those of the average male and female vocal fold mucosa. Conclusions: According to a theory that establishes the effects of tissue shear properties on vocal fold oscillation, phonation threshold pressure (a measure of the ease of phonation) is directly related to the viscous shear modulus of the vibrating vocal fold mucosa. Therefore, our findings suggest that hyaluronic acid, either by itself or mixed with fibronectin, may be a potentially optimal bioimplant for the surgical management of vocal fold mucosal defects and lamina propria deficiencies (e.g., scarring) from a biomechanical standpoint.
Relationship of the Facial Nerve to the Tympanic Annulus: A Direct Anatomic Examination
Authors: Adad Basil , Rasgon Barry M. , Ackerson Lynn 
Published: November 2003

AbstractObjective: To examine the relation of the facial nerve to the only identifiable surgical landmark in the external auditory canal.Institution: Communitybased teaching hospital.Study Design: Examination of formalin‐fixed human temporal bones.Background: The transcanal approach is often used in tympanoplasty, canaloplasty, hypotympanotomy, and removal of tumors of the external auditory canal (EAC), such as exostoses and osteomas. Surgery of the EAC places the facial nerve at risk for injury as the nerve courses vertically in the posterior canal wall. Few articles have described the relation of the facial nerve's course to the tympanic annulus, the only identifiable landmark in the EAC. This study is the first to document the relationship of the course of the facial nerve with respect to the tympanic annulus by direct anatomic measurement of the temporal bone.Methods: Thirty‐seven formalin‐fixed cadaver temporal bones were studied after skeletonization of the facial nerve and tympanic annulus.Results: The facial nerve coursed lateral to the plane of the annulus in 70% of specimens, always in the posteroinferior quadrant. The nerve also coursed anterior to a plane through the most posterior point of the annulus in 73.1% of specimens, also exclusively in the posteroinferior quadrant. The course of the nerve was quite variable with respect to the annulus.Conclusions: The facial nerve is most vulnerable to injury in the posteroinferior quadrant in transcanal surgery. The annulus is not a reliable landmark for the facial nerve. Anecdotal evidence is cited and recommendations are offered.
Modified Neck Dissection for Metastatic Nonseminomatous Testicular Carcinoma
Authors: Weisberger Edward C. , McBride Lawrence C. 
Published: November 2003

AbstractObjective: To examine the role of neck dissection in the treatment of metastatic stage 3 nonseminomatous germ‐cell tumors (NSGCTs) of testicular origin.Method: A retrospective review was made of 45 patients with metastatic NSGCT who underwent 48 unilateral and 3 bilateral neck dissections. Only level III‐VI nodes were dissected, often with concomitant or staged mediastinal dissection, thoracotomy, and/or retroperitoneal node dissection. Occasionally, resection of the clavicle, jugular vein, or subclavian artery, or a combination of these, was required to eradicate the disease.Results: There were only four instances of recurrence in dissected necks. There was one case of dedifferentiation of mature teratoma to adenocarcinoma. Patients who were followed for a mean period of 32 months had a disease‐free survival of 72%. Prognosis for patients with stage 3 disease but negative preoperative tumor markers (α‐fetoprotein and human chorionic gonadotropin) was excellent, with 97% of these patients having no evidence of disease at follow‐up. Factors having a negative impact on survival included positive tumor markers, elements of germ‐cell cancer in excised nodes, and a neck mass that represents late relapse of disease.Conclusion: Modified neck dissection has a demonstrated role in the treatment of metastatic NSGCT. It prevents reversion of mature teratoma to malignant germ cell tumor with minimal morbidity. Aggressive resection of disease is indicated, often in conjunction with thoracic surgery, to eradicate disease extending into the chest. There is an excellent prognosis in patients with negative preoperative serologic tumor markers.
Fosfomycin Does Not Inhibit the Tumoricidal Efficacy of Cisplatinum
Authors: Jordan Jennifer A. , Schwade Nathan D. , Truelson John M. 
Published: November 2003

AbstractObjectives: This study investigates the effect of fosfomycin on the tumoricidal efficacy of cisplatinum.Study Design: Prospective study utilizing the FaDu squamous cell carcinoma cell line and a nude mouse tumor xenograft model.Methods: Tumor cell growth was assessed in vitro in the presence of cisplatinum and/or fosfomycin utilizing the MTT assay. An optimal cisplatinum dose and dosing schedule was established in a nude mouse tumor xenograft model of squamous cell carcinoma. Using this model, fosfomycin was tested at three dosages and tumor growth monitored over 4 weeks.Results: Mice treated with cisplatinum and fosfomycin had smaller tumors than those treated with cisplatinum alone (P < .01).Conclusions: This study is the first demonstration that fosfomycin does not inhibit the tumoricidal efficacy of cisplatinum in vivo. This suggests that fosfomycin may be useful in preventing cisplatinum‐induced ototoxicity and nephrotoxicity in humans without altering the tumor response rate.
Treatment of Parkinson Hypophonia With Percutaneous Collagen Augmentation
Authors: Berke Gerald S. , Gerratt Bruce , Kreiman Jody , Jackson Katherine 
Published: November 2003

AbstractObjectives: It has been estimated that more than 70% of patients with Parkinson disease experience voice and speech disorders characterized by weak and breathy phonation, and dysarthria. This study reports on the efficacy of treating Parkinson patients who have glottal insufficiency.Study Design and Methods: Thirty‐five patients underwent collagen augmentation of the vocal folds for hypophonia associated with Parkinson disease, using a new technique of percutaneous injection with fiberoptic guidance. Patient response to the collagen augmentation was determined by telephone survey.Results and Conclusions: The procedure required minimal patient participation and was safely performed on all the patients who were studied. Results of the survey indicated that 75% of patient responses demonstrated satisfaction with the technique, compared with 16% of patient ratings reflecting dissatisfaction. These results were moderately correlated with the duration of improvement of the dysphonia. Results of this preliminary evaluation demonstrate that voice deficits in Parkinson disease are amenable to vocal fold augmentation. Because this procedure requires minimal patient participation and can be safely performed in an office setting, it may also be useful in other severely debilitating neuromotor diseases that result in glottal insufficiency and hypophonia.
Histologic and Physiologic Effects of Electrocautery, CO2 Laser, and Radiofrequency Injury in the Porcine Soft Palate
Authors: Courey Mark S. , Fomin Denilson , Smith Timothy , Huang Shan , Sanders David , Reinisch Lou 
Published: November 2003

AbstractObjectives: This study was undertaken to compare the effects of electrosurgery, CO2 laser, and radiofrequency on the histological structure and physiological properties of the soft palate. These surgical techniques are used for stiffening and reducing the soft palate in the treatment of snoring and mild sleep apnea.Study Design: Fifteen pigs were divided into five groups.Methods: Group 1 underwent electrosurgery incision of the lateral soft palate and excision of the uvula. Group 2 underwent the same procedure with the CO2 laser. Group 3 underwent CO2 laser ablation of the midline soft palate mucosa. Group 4 underwent radiofrequency volumetric reduction. Group 5 served as control. After 5 weeks the animals were sacrificed. Soft palate mucosa and muscle were subjected to tensiometric and histological analysis. Statistical analysis of tensiometric measurements was done with an ANOVA using a Bonferroni‐Dunn correction.Results: Tensiometric measurements of the mucosa were increased over normal controls when the surgical technique resulted in mucosal disruption. When the surgical technique resulted in primarily muscle disruption (radiofrequency) tensiometric measurements of the muscle were increased over controls. Histological analysis demonstrated normal remucosalization in all specimens, with fibrosis increased at the site of the primary injury.Conclusions: The type of injury produced resulted in identifiable patterns of physiological and histological change. Understanding of the effects of available surgical techniques is important in guiding our choice of surgical approach and allows us to better counsel our patients on their surgical options.
Prognostic Significance of p27 Expression in Carcinoma of the Oral Cavity and Oropharynx
Authors: Venkatesan T. K. , Kuropkat Christiane , Caldarelli David D. , Panje William R. , Hutchinson James C. , Chen Shande , Coon John S. 
Published: November 2003

AbstractObjective: To study the role of p27, a cyclin‐dependent kinase inhibitor, as a prognostic indicator in squamous cell carcinoma of the oral cavity and oropharynx.Study Design: Retrospective review of 35 patients with squamous cell carcinoma of the oral cavity and oropharynx who presented to Rush‐Presbyterian‐St. Luke's Medical Center, Chicago, Illinois, between 1986 and 1995.Methods: Inclusion criteria were the availability of clinical information, archival pretreatment biopsy material, and a minimum follow‐up of 24 months. p27 staining was scored for frequency and intensity of tumor cell expression following immunoperoxidase staining using standard techniques. Samples of squamous epithelium from the uvula of 15 nonsmoking patients without past or present squamous cell carcinoma were used as normal controls.Results: The association of p27 staining and other factors with response to treatment was evaluated by Fisher's Exact Test and with overall and disease‐free survival by the Kaplan‐Meier method with multivariate Cox regression. Low levels of p27 expression correlated significantly with unfavorable treatment response (P < .0001), shorter overall survival (P = .0001), and shorter disease‐free survival (P = .003). Tumor site (alveolus) was also associated with shorter disease‐free (though not overall) survival, but the association with p27 was independent of stage and site in multivariate analysis.
Hearing and Otopathology in Crouzon Syndrome
Authors: Orvidas Laura J. , Fabry Lee B. , Diacova Svetlana , McDonald Thomas J. 
Published: November 2003

AbstractObjectives: To better establish the incidence and types of otologic and auditory abnormalities in patients with Crouzon syndrome.Study Design: Retrospective chart review of the otologic and auditory findings of patients diagnosed with Crouzon syndrome who were seen at our institution between 1978 and 1994.Methods: Charts were reviewed and data recorded on patient sex, family history, appearance, auricular abnormalities, auditory findings, history of otologic disease, and follow‐up.Results: Nineteen patients were identified with the diagnosis of Crouzon syndrome: 12 males and 7 females. Twelve cases represented spontaneous mutations. Eight patients had abnormalities involving the external ear: from malalignment of the pinna (6 patients) to external auditory canal atresia (1 patient). Ten patients had documented hearing loss: 4 with conductive hearing loss, 2 with a mixed hearing loss, and 4 with a sensorineural hearing loss, the etiologies of which ranged from ossicular fixation and serous otitis media to unknown sensorineural deficits.Conclusions: Patients with Crouzon syndrome can exhibit various pathological features of the ear. Although external malformations are unusual, middle ear disease and hearing loss are common. We advocate close otologic and audiologic follow‐up in these patients and note a higher frequency of sensorineural hearing loss than previously reported. Recent genetic advances may allow more accurate and earlier diagnosis of this syndrome.
Straight Midline Mandibulotomy Revisited
Authors: Amin Milan R. , Deschler Daniel G. , Hayden Richard E. 
Published: November 2003

AbstractObjective: Describe recent experience with a simplified modification of the traditional mandibulotomy approach.Study Design: Retrospective chart review.Methods: Charts were reviewed retrospectively for 17 consecutive patients who underwent this approach over a 3‐year period as a part of treatment for oral and oropharyngeal malignancies.Results: No cases of bony nonunion, plate exposure, or other complications related to the mandibulotomy occurred in the postoperative phase.Conclusions: The modified straight midline mandibulotomy approach is simple and provides safe access for the treatment of oral and oropharyngeal tumors while minimizing postoperative morbidity.
A Novel, Biodegradable Polymer Conduit Delivers Neurotrophins and Promotes Nerve Regeneration
Authors: Hadlock Tessa , Sundback Cathryn , Koka Rahul , Hunter Daniel , Cheney Mack , Vacanti Joseph 
Published: November 2003

AbstractObjective/Hypothesis: A wide variety of substances have been shown to promote neuritic extension after nerve injury. An obstacle to achieving the maximal benefit from these substances has been the difficulty in effectively delivering the substances over a protracted time course that promotes maximal, directed growth. In this study the delivery of a growth‐promoting substance through a biodegradable conduit, using materials originally designed for drug delivery applications, was hypothesized to promote more robust neural regeneration than through conduits lacking the substance. The objectives of this study were to create a growth factor‐loaded biodegradable nerve guidance conduit, and to assess in vivo nerve regeneration through the conduit compared with that through conduits lacking the substance.Materials/Methods: Inosine, a purine analogue thought to promote axonal extension following neural injury, was loaded into cylindrical polymer foams composed of a polylactide‐co‐glycolide copolymer. First, in vitro extravasation of inosine was measured over a several week period using spectrophotometry. Second, the foams were fashioned into single‐channel cylindrical nerve guidance conduits via a novel, low‐pressure injection molding technique. The conduits were then used to bridge 7‐mm defects in the rat sciatic nerve (n=8). Control conduits lacking inosine were implanted into another set of animals as controls (n=12).Results: In vitro spectrophotometric measurements indicated appreciable leaching of inosine from the loaded foams over a period of at least 9 weeks. In the in vivo model, after 10 weeks, a higher percentage cross sectional area composed of neural tissue existed through the inosine‐loaded conduits compared with controls (mean 44%, SD 7.5% vs. 36%, SD 8.6%, respectively). A difference was also found in mean fiber diameter between the two groups, with the inosine‐loaded tubes showing a statistically significantly larger diameter than controls (P < .05).Conclusions: A nerve regeneration conduit was successfully created that delivers growth promoting substances over a protracted time course. In an in vivo model, the presence of inosine, a purine analogue, yielded neural regeneration whose histological features suggest possible superior long‐term motor function.
Early Polysomnographic Findings and Long‐Term Subjective Results in Sleep Apnea Patients Treated With Laser‐Assisted Uvulopalatoplasty
Authors: Walker Regina Paloyan , Garrity Thomas , Gopalsami Chellam 
Published: November 2003

AbstractObjectives/Hypothesis: To examine the long‐term results of laser‐assisted uvulopalatoplasty (LAUP) for the treatment of patients with obstructive sleep apnea syndrome (OSAS).Study Design: One hundred eighty‐two OSAS patients treated with LAUP were followed for an average of 4 years. Of these patients, 131 have completed treatment. Complete polysomnographic data are available on 48 patients. Five patients were eliminated owing to nasal surgery performed during the period between the preoperative and postoperative sleep studies, thus 43 patients were included who had only LAUP treatment. Another three patients were eliminated because their postoperative polysomnograms were performed less than 6 weeks after the last procedure. Complete long‐term subjective data are available on 31 patients.Methods: Between July 1993 and July 1998, 1038 patients were evaluated for LAUP treatment for snoring and OSAS. Of the 1038 patients, 409 were treated with LAUP and the remaining 629 were treated with other surgical procedures, devices, or behavior modification. The 40 patients who underwent only LAUP treatment for OSAS and have complete polysomnographic data are the focus of this study.Results: The significant objective polysomnographic findings include a decrease in the respiratory disturbance index (RDI) from 25.0 ± 2.8 to 15.3 ± 2.9 (P = < .0001), and a decrease in the apnea index (AI) from 14.6 ± 2.6 to 9.0 ± 2.4 (P = .00248). In addition, the percentage of time spent in rapid eye movement (REM) sleep significantly increased after LAUP, from 13.3% ± 1.0 to 17.6% ± 1.4 (P = .0149). The long‐term subjective results indicate that the presenting complaints were improved after LAUP in 74.9% ± 4.1 with a mean follow‐up of 4.04 years ± 72 days (median, 4.63 y).Conclusions: LAUP remains a safe and effective treatment for carefully selected patients suffering from OSAS. Five years after LAUP was introduced in the United States, objective polysomnographic data demonstrate reduction in the RDI and increased time spent in REM sleep after treatment. In addition, the long‐term subjective results show that the presenting symptoms were no longer present in 75% of patients treated with LAUP.
Effects of Middle Turbinate Medialization on Olfaction
Authors: Friedman Michael , Tanyeri Hasan , Landsberg Roy , Caldarelli David 
Published: November 2003

AbstractObjective/Hypothesis: Turbinate medialization techniques have gained popularity in an attempt to prevent turbinate lateralization. Theoretically, adhesions between the septum and middle turbinate will prevent lateralization but may compromise airflow to the olfactory neuroepithelium and affect the sense of smell. No studies have addressed this issue. The objective of this study is to evaluate effects of middle turbinate medialization on olfaction.Study Design: A prospective controlled study of olfaction before and after middle turbinate medialization using the University of Pennsylvania Smell Identification Test (UPSIT) and patient questionnaires.Methods: Fifty patients underwent endoscopic sinus surgery (ESS) with middle turbinate medialization and preservation. The caudal end of the middle turbinate and the opposing septal mucosa were abraded with a microdebrider for iatrogenic synechia formation in an attempt to avoid lateralization of the middle turbinate. Each of the patients underwent preoperative assessment with a questionnaire and UPSIT. All patients were reevaluated approximately 5 weeks after surgery by endoscopic examination, questionnaire, and the UPSIT. The preoperative and postoperative questionnaire responses were compared for subjective analysis. Objectively, The preoperative and postoperative UPSIT scores were compared using the Student t test.Results: The questionnaires showed that the study population's subjective sense of smell either did not change or improved compared with the preoperative state. Objectively, there was a mean increase of UPSIT scores after surgery. This difference was not statistically significant (P = .4).Conclusion: Middle turbinate medialization has no detectable adverse effect on olfaction.