bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Quality of Life of Patients With Head and Neck Cancer
Authors: de Graeff Alexander , de Leeuw J. Rob J. , Ros Wynand J.G. , Hordijk Gert‐Jan , Blijham Geert H. , Winnubst Jacques A.M. 
Published: November 2003

AbstractObjectives: To describe prospectively the long‐term changes of quality of life and mood in patients with squamous cell carcinoma of the head and neck treated with surgery and/or radiotherapy.Patients and Methods: One hundred seven patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core Questionnaire, the EORTC Head and Neck Cancer Module, and the Center for Epidemiological Studies Depression Scale before treatment, and 6, 12, 24, and 36 months later.Results: There was limited deterioration of physical and role functioning and of many head and neck symptoms at 6 months, with improvement thereafter. After 36 months only physical functioning, taste/smell, dry mouth, and sticky saliva were significantly worse, compared with baseline. Female sex, higher cancer stage, and combination treatment were associated with more symptoms and worse functioning. Despite physical deterioration, there was a gradual improvement of depressive symptomatology and global quality of life.Conclusion: Treatment for head and neck cancer results in short‐term morbidity, most of which resolves within 1 year. Despite an initially high level of depressive symptomatology, there is gradual improvement of psychological functioning and global quality of life over the course of 3 years. In this prospective study, the impact of the disease and its treatment in long‐term survivors seems to be less severe than it is often assumed to be.
The Comet Assay of Nasal Epithelia: Measurement of DNA Damage for the Assessment of Genotoxic Air Pollution
Authors: Glück Ulrich , Gebbers Jan‐Olaf 
Published: November 2003

AbstractObjectives: The alkaline single cell gel electrophoresis or “comet” assay allows measurement of DNA damage in single cells with a high degree of sensitivity, e.g., for investigations of the effect of environmental agents with DNA‐damaging potential. This study aimed to adapt this test to respiratory cells of the human nasal mucosa to examine the genotoxic effect of air pollution (cigarette smoke).Study Design: In a prospective study, nasal epithelia of 16 cigarette smokers were examined by the adapted comet assay and the results were correlated with the results of the Papanicolaou‐stained nasal cytology, carried out in a blinded fashion. The control group comprised 20 non‐smoking men. All subjects under investigation were healthy office workers.Methods: Nasal epithelia were harvested from the maxilloturbinates. One part of cells was Papanicolaou stained and evaluated by cytopathologists. The comet assay was performed on the other part of the cells. The examiners were blinded to the study and control groups.Results: Among cigarette smokers, a significant correlation between cytopathological cell nucleus changes (metaplasia and dysplasia) and the DNA migration (tail lengths) in the comet assay was found as a sign of DNA damage. This was not found in nonsmoking control persons.Conclusions: These results confirm the sensitivity of the comet assay and the hypothesis that cell nucleus changes in conventional nasal cytology are associated with DNA damage.
Airway Complication After Thyroid Surgery: Minimally Invasive Management of Bilateral Recurrent Nerve Injury
Authors: Rovó László , Jóri József , Brzózka Marek , Czigner Jenô 
Published: November 2003

AbstractObjectives: After bilateral vocal cord paralysis, the consequent paramedian position usually necessitates tracheostomy for at least 6 months, when the paralysis is potentially reversible. In the present study a reversible endoscopic vocal cord laterofixation procedure was used instead of tracheotomy.Study Design: Prospective study of 15 consecutive patients aged 33 to 73 years who suffered bilateral recurrent laryngeal nerve paralysis after thyroid surgery.Methods: The operation was performed endoscopically with a special endo‐extralaryngeal needle carrier instrument. Two ends of a monofilament nonresorbable thread were passed above and under the posterior third of the vocal cord and knotted on the prelaryngeal muscles, permitting the creation of an abducted vocal cord position. If movement of one or both vocal cords recovered, the suture was removed. Regular spirometric measurements and radiological aspiration tests were conducted on the patients.Results: During the follow‐up period of 3 to 40 months, airway stability was demonstrated in all but one patient. After the repeated lateralization procedure, this patient's breathing improved. Partial or complete vocal cord recovery was observed in eight patients. In six patients further voice improvement was achieved when the threads were removed after vocal cord medialization or recovery. Mild postoperative aspirations ceased in the first postoperative days.Conclusions: This management approach offers an alternative to tracheostomy in the early period of paralysis, avoids terminal loss of voice quality, and provides a “one‐stage” solution for permanent bilateral recurrent nerve injuries.
Prevalence of Herpes Simplex Virus in Malignant Laryngeal Lesions
Authors: Pou Anna M. , Vrabec Jeffrey T. , Jordan Jeanne , Wilson Deborah , Wang Su , Payne Deborah 
Published: November 2003

AbstractObjective: To determine the prevalence of herpes simplex virus (HSV) in malignant laryngeal lesions.Study Design: Retrospective review.Materials and Methods: Paraffin‐embedded, histologically confirmed specimens containing benign laryngeal lesions, squamous cell carcinoma of the larynx, and squamous cell carcinoma of the oral cavity were identified from archived surgical specimens. Biopsies of normal‐appearing oral cavity tissue were also obtained from fresh‐frozen cadavers. These tissues were analyzed for the presence of HSV DNA using polymerase chain reaction techniques. Patient charts were reviewed for patient demographics, risk factors, stage, clinical course, treatment, and outcome.Results: HSV was detected in nine laryngeal squamous cell carcinomas (75%) and in none of the benign laryngeal lesions (P = .0001). HSV was also found in three oral cavity squamous cell carcinomas (25%) and in none of the controls (P = .049).Conclusion: HSV is more prevalent in squamous cell carcinoma of the larynx and oral cavity than in their respective control groups, suggesting a role for carcinogenesis. HSV is more prevalent in squamous cell carcinoma of the larynx than of the oral cavity. Further studies to determine the role of HSV as a cocarcinogen and its interrelationship with other environmental factors in laryngeal cancer are warranted.
Extradural Extranasal Combined Transmaxillary Transsphenoidal Approach to the Cavernous Sinus: A Minimally Invasive Microsurgical Model
Authors: Sabit Ibrahim , Schaefer Steven D. , Couldwell William T. 
Published: November 2003

AbstractThe authors have previously described an extradural transmaxillary approach to the anterior compartment of the cavernous sinus. In an effort to expand the surgical access to that area without necessitating a craniotomy or wide transfacial dissection, they present a modification of the transmaxillary approach to the sellar region and cavernous sinus.Methods:The approach was developed on 12 fresh and 12 embalmed cadaveric specimen, and 2 dry skulls. The initial sublabial incision is followed by a maxillotomy to expose the course of the infraorbital nerve (terminal branch of maxillary branch of the trigeminal nerve) on the roof of the maxillary sinus. The route of the infraorbital nerve is traced to the pterygopalatine fossa as a guide to the foramen rotundum. Superomedial drilling of the foramen rotundum is then performed to reveal the contents of the superior orbital fissure. After the nerves are safely identified in the superior orbital fissure, medial enlargement of the window into the cavernous sinus is made possible by drilling the lateral and posterior wall and septum of the sphenoid sinus.Results:The combined transmaxillary transsphenoidal approach offers an excellent exposure of the sellar and infrasellar region. The approach offers clear visualization of the ipsilateral loop of the carotid artery, the pituitary fossa, and the cranial nerves of the ipsilateral cavernous sinus. Mean operative reach is 38 mm from the posterior wall of the maxillary sinus to the ipsilateral carotid loop and 56 mm to the contralateral loop. The width of the operative window is 26 mm at the base within the cavernous sinus.Conclusion:The model offers a minimally invasive approach that avoids the need for craniotomy or violating the nasal cavity. It may be safely employed to access vascular as well as invasive lesions of the sellar and infrasellar region. The approach offers excellent visualization of the ipsilateral intracavernous carotid artery with both proximal and distal control, as well as cranial nerves III, IV, VI, V2, the hypophyseal region, and the medial aspect of the contralateral cavernous sinus.
Predictive Factors for Complications in Children With Laryngeal Damage at Extubation
Authors: Watier‐Launey Cécile , Buronfosse Anne , Saliba Elie , Bertrand Philippe , Ployet Marie‐Josèphe 
Published: November 2003

AbstractObjectives: To determine which factors contribute to early complications when intubated children show macroscopic lesions at extubation.Study Design: Retrospective review of 96 consecutive medical records of children aged 1 day to 15 years. Patients were divided into three groups depending on the extent of the subsequent treatment required: medical, reintubation, and surgical.Methods: Age, sex, clinical history, and macroscopic features of the lesions were collected and data were compared in each group.Results: Underlying noninfectious respiratory diseases and young age were found to be risk factors for higher incidence of complications, but not prolonged or multiple intubations. Edema, especially in the glottic area, was a risk factor for surgical treatment. Multiple lesions were risk factors for reintubation.Conclusions: History of intubation, its cause, and lesions discovered at extubation can provide the basis for definition of an “at risk” profile for intubated children.
Corticosteroid Treatment for Idiopathic Facial Nerve Paralysis: A Meta‐analysis
Authors: Ramsey Mitchell Jay , DerSimonian Rebecca , Holtel Michael R. , Burgess Lawrence P. A. 
Published: November 2003

AbstractObjective A meta‐analysis was designed to evaluate facial recovery in patients with complete idiopathic facial nerve paralysis (IFNP) by comparing outcomes of those treated with corticosteroid therapy with outcomes of those treated with placebo or no treatment.Study Design Meta‐analysis of prospective trials evaluating corticosteroid therapy for idiopathic facial nerve paralysis.Methods A protocol was followed outlining methods for trial selection, data extraction, and statistical analysis. A MEDLINE search of the English language literature was performed to identify clinical trials evaluating steroid treatment of IFNP. Three independent observers used an eight‐point analysis to determine inclusion criteria. Data analysis was limited to individuals with clinically complete IFNP. The endpoints measured were clinically complete or incomplete facial motor recovery. Effect magnitude and significance were evaluated by calculating the rate difference and Fisher's Exact Test P value. Pooled analysis was performed with a random effects model.Results Forty‐seven trials were identified. Of those, 27 were prospective and 20 retrospective. Three prospective trials met the inclusion criteria. Tests of heterogeneity indicate the trial with the smallest sample size (RD = −0.19; 95% CI, −0.58–0.20), to be an outlier. It was excluded from the final analysis. Analyses of data from the remaining two studies indicate corticosteroid treatment improves complete facial motor recovery for individuals with complete IFNP. Rate difference demonstrates a 17% (99% CI, 0.01–0.32) improvement in clinically complete recovery for the treatment group based on the random effects model.Conclusions Corticosteroid treatment provides a clinically and statistically significant improvement in recovery of function in complete IFNP.
Adenoidectomy With Laser or Incisional Myringotomy for Otitis Media With Effusion
Authors: Szeremeta Wasyl , Parameswaran Mahesh S. , Isaacson Glenn 
Published: November 2003

AbstractObjectiveTo compare the effectiveness of CO2laser myringotomy to incisional myringotomy at the time of adenoidectomy for refractory otitis media with effusion (OME).Study DesignControlled retrospective consecutive case series.MethodsAll children undergoing myringotomy and adenoidectomy for OME in the spring of 1999 had 1.7‐mm‐diameter perforations created in their tympanic membranes using a CO2laser and conventional microslad. Their ears were evaluated at first postoperative visit (mean, 16.65 days after surgery) by a validated otoscopist to determine the presence or absence of perforations and middle ear effusions. These patients were compared with historical controls comprising all children undergoing incisional myringotomy and adenoidectomy in 1998. A χ2analysis was performed to compare the results of these two myringotomy techniques.ResultsTwenty‐three children (39 ears) underwent laser myringotomy and adenoidectomy in 1999, compared with 26 children (48 ears) who underwent incisional myringotomy and adenoidectomy in 1998. In the laser myringotomy group, 8 of the 39 ears had a persistent opening at first follow‐up; 4 of the 39 ears showed evidence of effusion. In the incisional myringotomy group, all 48 ears had healed; 7 of these ears showed evidence of effusion.ConclusionMyringotomies created using the CO2laser are more likely to be patent at first postoperative visit than those made with incisional technique (P< .01). However, this prolonged middle ear ventilation does not significantly decrease the prevalence of effusion (P> .1).
Otolaryngological Manifestations of Velocardiofacial Syndrome: A Retrospective Review of 35 Patients
Authors: Ford Lloyd C. , Sulprizio Sandra L. , Rasgon Barry M. 
Published: November 2003

AbstractObjective Because many patients with velocardiofacial syndrome (VCFS) are first examined by otolaryngologists for ear or speech problems before being diagnosed with VCFS, we describe a series of patients with this genetic disorder, which is associated with multiple anomalies, including velopharyngeal insufficiency, cardiac defects, characteristic facial features, and learning disabilities.Study Design We retrospectively analyzed the medical charts and available nasoendoscopic observations for 35 patients who were diagnosed with VCFS and who had a microscopic deletion in chromosome 22q11 as shown by DNA probe and fluorescence in situ hybridization.Results For most patients, the medical chart documented cardiac anomalies, velopharyngeal insufficiency with hypernasal speech, and characteristic facial features including nasal, auricular, craniofacial, and ocular abnormalities. Incidence of middle ear infection with associated conductive hearing loss was also high and necessitated early placement of pressure equalization tubes. Some patients were treated with adenoidectomy for chronic otitis media; consequently, velopharyngeal insufficiency and hypernasal speech worsened. Nasoendoscopic examination as documented in the medical chart showed occult cleft palate, a small adenoid pad, and pulsation in the muscular wall.Conclusion Otolaryngologists have an important role in diagnosis and treatment of persons with VCFS and therefore should familiarize themselves with the typical history and most frequent head and neck manifestations of this syndrome.
Identification of Genes Overexpressed in Head and Neck Squamous Cell Carcinoma Using a Combination of Complementary DNA Subtraction and Microarray Analysis
Authors: Villaret Douglas B. , Wang Tongtong , Dillon Davin , Xu Jiangchun , Sivam Dhileep , Cheever Martin A. , Reed Steven G. 
Published: November 2003

AbstractObjectives/Hypothesis To discover unique genes specific for squamous cell carcinoma of the head and neck for eventual development as tumor markers and vaccine candidates.Study Design Molecular biological analysis of fresh‐frozen head and neck squamous cell cancer (HNSCC).Methods A subtractive library was made from two HNSCC and six normal tissues using a polymerase chain reaction (PCR)–based approach. Genes from this library were PCR amplified and placed on a microarray glass slide. RNA was prepared or obtained from 16 fresh‐frozen HNSCC and 22 normal tissue sources. Fluorescent probes were made from the polyA+ RNA derived from the tumor and normal tissues. The probes were hybridized to the glass slides and excited by a tuneable laser. One hundred seven of the genes showing the highest differential fluorescence value between tumor and normal tissue were identified by sequence analysis.Results Thirteen independent genes were found to be overexpressed in tumor tissues. Of these, nine were previously known: keratins K6 and K16, laminin‐5, plakophilin‐1, matrix metalloproteinase‐2 (MMP), vascular endothelial growth factor, connexin 26, 14–3‐3 sigma, and CaN19. The level of polyA+ RNA of these genes in the tumors was significantly different from the levels in normal tissue (P < .05). Four previously unidentified genes were also discovered to have increased expression in tumor tissue. Comparing the total tumor group (n = 16) to the normal group (n = 22), only one of these genes showed significant overexpression.Conclusion We report the identification of nine known genes that are significantly overexpressed in HNSCC as compared to normal tissue using subtractive and microarray technology. In addition, we present four previously unidentified genes that are overexpressed in a subset of tumors. These genes will be developed as tumor markers and vaccine candidates.
Assessment of Carotid Artery Invasion in Patients With Head and Neck Cancer
Authors: Yoo George H. , Hocwald Eitan , Korkmaz Hakan , Du Wei , Logani Sanjay , Kelly John K. , Sakr Wael , Jacobs John R. 
Published: November 2003

AbstractPurpose Define radiological and histological features in which patients with head and neck cancer would benefit from a carotid artery resection. Resection of the carotid artery has been advocated for local control of advanced squamous cell carcinoma of the head and neck. To provide appropriate preoperative counseling and optimize the utilization of resources, the criteria for patient selection has to be defined.Methods Thirty‐four patients underwent carotid artery resection based on the clinical impression of tumor fixation. Eighteen and 28 patients were evaluated using computed tomography (CT) and histological analysis, respectively. The distance between the tumor cells and external elastic lamina was measured. CT scans were examined to determine the circumference of tumor attachment around the carotid artery.Results Clinical assessment predicted tumor within 1.8 mm of the carotid artery in 68% of cases. The overall survival for patients with tumor greater than 1.8 mm (N = 9) was better than that of patients with less (N = 19) than 1.8 mm (33.3% vs. 5.3%; median 24 versus 9 mo, P = .0899). Three of six patients (50%) with less than 180° circumference tumor attachment had tumor within 1.8 mm from the external elastic lamina. Eight of twelve patients (67%) with tumors encompassing more than 180° of the artery wall had tumor within 1.8 mm from the external elastic lamina. The overall survival rates for patients with tumor attachment greater and less than 180° were 8.3% and 33%, respectively.Discussion Tumor invasion into the carotid artery was the strongest predictor of outcome. Clinical assessment was as predictive as CT for tumor invasion. If tumor involvement of the carotid artery is less than 180°, peeling the tumor is an alternative to carotid artery resection.
Anterior Distribution of Human Olfactory Epithelium
Authors: Leopold Donald A. , Hummel Thomas , Schwob James E. , Hong Seok Chen , Knecht Michael , Kobal Gerd 
Published: November 2003

AbstractObjectives/Hypothesis To functionally investigate the distribution of the olfactory epithelium in humans by means of the electro‐olfactogram (EOG) and anatomically located biopsy specimens.Study Design Prospective, nonrandomized, investigational.Methods Supra‐threshold EOG recordings were made on 12 healthy, trained volunteers (6 women, 6 men; age range, 21–48 y). Vanillin was used as the stimulus, since it exclusively excites olfactory receptor neurons. The EOG was recorded with tubular electrodes that were placed using thin‐fiber endoscopic guidance. Biopsy specimens were obtained of anterosuperior nasal cavity mucosa in the same regions as the positive EOGs in 15 smell‐tested patients (7 women, 8 men; age range, 22–60 y) during routine nasal and sinus surgery. This biopsied tissue was histologically processed and stained for olfactory and neural proteins.Results Viable responses to EOG testing were obtained in 7 of 12 subjects. In these seven subjects it was possible to identify nine sites above or below the anterior middle turbinate insertion where EOGs were obtained. The biopsy results showed mature olfactory receptor neurons in this same area.Conclusions Human olfactory epithelium appears to be distributed more anteriorly than previously assumed.
Objective and Subjective Outcomes in Surgery for Chronic Sinusitis
Authors: Kennedy David W. , Wright Erin D. , Goldberg Andrew N. 
Published: November 2003

AbstractEndoscopic and radiological findings in patients with chronic sinusitis do not always correlate with symptoms. Studies suggest that postoperative endoscopic examination of the sinonasal cavity provides prognostic information regarding the potential for future episodes of sinusitis and the need for revision surgery. It is recommended that findings on nasal endoscopy be included in future outcomes studies on sinusitis.