bluuebunny/crossref_metadata_2025_split huggingface dataset:
Auditory Manifestations of Keratitis‐Ichthyosis‐Deafness (KID) Syndrome
Authors: Szymko‐Bennett Yvonne M. , Russell Laura J. , Bale Sherri J. , Griffith Andrew J. 
Published: November 2003

AbstractObjective Evaluation of the auditory manifestations of Keratitis‐Ichthyosis‐Deafness (KID) syndrome, a rare genodermatosis characterized by follicular hyperkeratosis, vascularizing keratitis, and congenital hearing loss.Study Design Five individuals with sporadic KID syndrome were evaluated in the outpatient audiology clinic at the Warren Grant Magnuson Clinical Center of the National Institutes of Health.Methods Audiologic examinations included pure‐tone audiometry, speech audiometry, and middle ear immittance testing. Auditory brainstem responses and otoacoustic emissions were analyzed in 2 subjects.Results Four subjects had prelingual, bilateral, profound sensorineural hearing loss, whereas the fifth subject had significant residual hearing that exhibited no progression on serial audiograms. All 5 subjects had a history of non‐erosive keratosis obturans and cutaneous cysts in the external ear canals that prevented continuous use of ear molds.Conclusions The sensorineural hearing loss in KID syndrome is generally prelingual and profound. This combination of auditory and cutaneous phenotypes is similar to those previously reported for KID syndrome. KID syndrome presents a difficult challenge for communication rehabilitation because keratitis may impair the perception of sign and spoken language, and the cutaneous manifestations routinely curtail use of external amplification devices.
Phenotype of DFNA11: A Nonsyndromic Hearing Loss Caused by a Myosin VIIA Mutation
Authors: Tamagawa Yuya , Ishikawa Kazuhiro , Ishikawa Kotaro , Ishida Takashi , Kitamura Ken , Makino Shinji , Tsuru Tadahiko , Ichimura Keiichi 
Published: November 2003

AbstractObjectives/Hypothesis To characterize the audiovestibular phenotype of DFNA11, an autosomal dominant nonsyndromic hearing impairment caused by a mutation in the myosin VIIA gene (MYO7A), including whether DFNA11‐affected subjects have retinal degeneration as is characteristic of Usher syndrome type 1B, caused by different MYO7A mutations.Study Design Retrospective study of audiovestibular and ophthalmological data in a Japanese family linked to DFNA11.Methods Otoscopic examination and pure‐tone audiometry were performed in all participants in the family. Selected subjects underwent additional examinations including speech discrimination scoring, acoustic reflex measurements, Békésy audiometry, evoked and distortion‐product otoacoustic emissions, auditory brainstem responses, and bithermal caloric testing; visual acuity, ocular tonometry, slit‐lamp examination, ophthalmoscopy, and electroretinography; and computed tomography of the temporal bone.Results Most affected individuals had moderate cochlear hearing loss beginning in the second decade and progressing at all frequencies. Variable degrees of asymptomatic vestibular dysfunction were present. Computed tomography showed normal inner and middle ear structures. No evidence suggested retinitis pigmentosa.Conclusions The phenotype of DFNA11 is postlingual, nonsyndromic sensorineural hearing loss with gradual progression. Showing moderate hearing loss with asymptomatic variable vestibular dysfunction and no retinal degeneration, the DFNA11 phenotype is mildest among phenotypes caused by MYO7A mutations.
Validity of the Western Blot Immunoassay for Heat Shock Protein‐70 in Associated and Isolated Immunorelated Inner Ear Disease
Authors: García Berrocal José Ramón , Ramírez‐Camacho Rafael , Arellano Beatriz , Vargas Juan Antonio 
Published: November 2003

AbstractObjective To assess the validity of the Western blot immunoassay for heat shock protein‐70 (hsp‐70) for diagnosis of autoimmune inner ear disease.Study Design Retrospective study of 53 patients affected by sudden deafness (n = 19), idiopathic progressive sensorineural hearing loss (n = 24), and Meniere's disease (n = 10) who were treated from 1995 to 1999. The clinical course and response to corticosteroid were evaluated.Methods A purified hsp‐70 antigen from bovine kidney cell line was used for the Western blot immunoassay.Results Only five patients (9.4%) showed anti–hsp‐70 antibodies: Two presented a sudden sensorineural hearing loss (sudden deafness group), two showed an idiopathic progressive sensorineural hearing loss (idiopathic progressive sensorineural hearing loss group), and one was affected by fluctuating hearing loss (Meniere's disease group). A systemic autoimmune condition was observed in 29.1% of patients with idiopathic progressive sensorineural hearing loss.Conclusions The low sensitivity of Western blot immunoassay for patients affected by idiopathic progressive sensorineural hearing loss and Meniere's disease may result from either the long time elapsed from the hearing loss and vertigo to the initial examination or from the increased percentage of cases of systemic autoimmune disease present in patients with idiopathic progressive sensorineural hearing loss. More studies to detect the immune‐mediated inner ear disease in Western blot immunoassay–negative patients are required.
The Effect of Neuromuscular Stimulation of the Genioglossus on the Hypopharyngeal Airway
Authors: Mann Eric A. , Burnett Theresa , Cornell Sonia , Ludlow Christy L. 
Published: November 2003

AbstractObjectives To determine the effects of neuromuscular stimulation (NS) of the genioglossus muscle on hypopharyngeal airway size.Study Design Fourteen consecutively recruited healthy volunteers underwent percutaneous electrical NS of the genioglossus muscle.Methods Bipolar hooked wires were inserted percutaneously into the genioglossus muscle and used for NS. The anterior–posterior diameter of the hypopharynx was measured at the level of the superior edge of the epiglottis at baseline and during NS from recorded video endoscopic examinations.Results NS of the genioglossus muscle resulted in a significant increase in the diameter of the hypopharyngeal airway (P = .002) compared with baseline, ranging from a 33% to 284% increase in airway diameter. Three of the 14 patients demonstrated modest decreases in airway diameter, likely the result of faulty electrode placement in surrounding tongue retrusive muscles.Conclusions NS of the genioglossus muscle was effective in increasing the hypopharyngeal airway and may provide a useful alternative to direct stimulation of the hypoglossal nerve with a nerve cuff electrode in the development of neuroprosthetic treatments for obstructive sleep apnea.
The Mechanical Stability Under Load of Tracheal Anastomoses After Various Phases In Vivo
Authors: Behrend Matthias , Kluge Eva , Schüttler Wolfgang , Klempnauer Jürgen 
Published: November 2003

AbstractObjective The objective of our study was to postoperatively examine the mechanical stability under load of tracheal anastomoses over different periods in time and to compare these with native tracheae.Study Design A randomized experimental study on animals.Method We performed tracheal anastomoses on sheep with three different suturing techniques and different resection lengths (3, 6, and 9 cm): These anastomoses were subjected to a breaking test at different intervals in vivo (1, 2, 4, 8, and 24 wk) and compared with the tracheae of healthy sheep.Results After 1 week in vivo, the anastomosis itself tore off from the remaining trachea under tension, regardless of the suturing technique used and the length of resection. With all animals that survived for a longer period, the trachea broke a greater distance away from the anastomosis. The necessary breaking forces were only minimally lower than those required for breaking healthy tracheae and the difference is statistically insignificant. When all operated tracheae are combined and the forces compared with native tracheae, this reveals that the operated tracheae are significantly more stable (P = .015) and present a lower longitudinal elasticity (P = .004).Conclusion During the first postoperative days, the stability under load of tracheal anastomoses is slightly lower than that of healthy trachea. This difference is, however, far from those values that can be measured intraoperatively on tracheal anastomoses. Thus, supplementary measures for the mechanical protection against suture line separation do not seem necessary.
FDG PET for Mucosal Malignant Melanoma of the Head and Neck
Authors: Goerres Gerhard W. , Stoeckli Sandro J. , von Schulthess Gustav K. , Steinert Hans C. 
Published: November 2003

AbstractObjectives/Hypothesis To evaluate imaging findings using positron emission tomography (PET) and 18F‐fluorodeoxyglucose (FDG) in mucosal malignant melanoma (MMM) of the head and neck.Study Design Retrospective evaluation.Methods Eighteen PET examinations were performed for initial staging and/or follow‐up in 10 patients with MMM. Medical records of 6 male and 4 female patients (age range, 43–81 y; mean, 67 y) were reviewed retrospectively with regard to the patients' history, symptoms, and clinical course. Primary melanoma elsewhere in the body was excluded at the time of diagnosis.Results All MMM were visible in staging PET examinations, but FDG uptake depended on lesion size and anatomic site. Big lesions with a nodular growth, as seen in pathologic specimens, were better visible compared with lesions with a more superficial spread within the mucous membranes. Lesions in the anterior part of the nasal cavity were more difficult to detect than those in the posterior sinonasal complex because of possible interference with nonspecific uptake in muscles of the mouth and pronounced appearance of the skin when imaging was performed using filtered back projection without attenuation correction.Conclusion We found that MMM of the head and neck can be visualized using FDG PET. Furthermore, locoregional and distant metastases can be evaluated much like those of cutaneous malignant melanoma. Therefore, PET may be suitable for the staging and/or restaging of these patients. Further studies have to elucidate the potential role of FDG PET in patient management.
Autofluorescence Endoscopy in the Diagnosis of Early Laryngeal Cancer and Its Precursor Lesions
Authors: Malzahn Karin , Dreyer Thomas , Glanz Hiltrud , Arens Christoph 
Published: November 2003

AbstractObjectives Because early detection and preoperative assessment of laryngeal cancer and its precursor lesions are essential for curative and function‐preserving surgical treatment, autofluorescence endoscopy has been developed to gain more information about the biologic character of these lesions. The aim of the present study is to investigate a high, representative number of patients and to evaluate the diagnostic potential and the limitations of this method.Methods In a prospective study, 127 patients were investigated during microlaryngoscopy. A total of 111 patients were suspected of having precancerous or cancerous lesions, 12 had benign lesions, and 4 patients had normal epithelium. Autofluorescence was induced by filtered blue light (380–460 nm) of a xenon short arc lamp and processed by a CCD camera system (D‐light‐AF system; Storz, Tuttlingen, Germany). Autofluorescence endoscopic images were immediately assessed for diagnosis, correlated to the dysplasia grading system and compared with the histopathologic findings.Results Normal laryngeal mucosa displayed a typical green fluorescence signal. Moderate and high epithelial dysplasia, carcinoma in situ, and invasive carcinoma showed a diminished green fluorescence. False‐negative results (n = 2) were the result of extreme hyperkeratosis. False positive cases (n = 8) either showed mild dysplasia with inflammatory reactions or scarring of the vocal folds. In 105 of 111 cases (94.6%), we found concordant results (sensitivity, 97.3%; specificity, 83.8%).Conclusion Autofluorescence endoscopy facilitates the detection and delineation of precancerous lesions, carcinoma in situ, and microinvasive cancer of the larynx more accurately than clinical observation alone. Scarring, marked hyperkeratosis, and inflammation can limit the predictive value of the method.
Swallowing Disorders in the Elderly
Authors: Schindler Joshua S. , Kelly James H. 
Published: November 2003

AbstractChanges that occur as a natural part of senescence in the complex action of deglutition predispose us to dysphagia and aspiration. As the “baby‐boomers” begin to age, the onset of swallowing difficulties will begin to manifest in a greater number of our population. Recent advances in the evaluation of normal and abnormal swallowing make possible more precise anatomical and physiological diagnoses. Coupled with an understanding of swallowing physiology, such detailed evaluation allows greater opportunity to safely manage dysphagia with directed therapy and appropriate surgical intervention. The current study is a discussion of the changes that occur in deglutition with normal aging, contemporary evaluation of swallowing function, and some of the common causes of dysphagia in elderly patients.
Secondary Tracheoesophageal Puncture With Local Anesthesia
Authors: Eerenstein Simone E. J. , Schouwenburg Paul F. 
Published: November 2003

AbstractObjectives To present a new technique for secondary tracheoesophageal puncture (TEP) in laryngectomized patients. The technique is performed on an outpatient basis under local anesthesia.Study Design Laryngectomized patients waiting for secondary TEP procedures were given the choice between the new technique under local anesthesia on an outpatient basis and the traditional technique under general anesthesia requiring hospitalization.Methods Using basic implements available in an outpatient clinic, the traditional TEP technique was modified with the oral introduction of an intubation tube with an illuminated, inflatable cuff at the puncture site. The illuminated, inflated cuff serves as a beacon during the procedure and the tube protects the posterior tracheal wall.Results Nine patients underwent the procedure under local anesthesia. In 8 of them the procedure went smoothly, but in 1 of them the inflatable cuff could not be satisfactorily placed as a result of the local anatomy and the procedure was canceled. All patients were pleased with the technique and said the procedure was painless.Conclusions With some modifications, the traditional TEP technique has been rendered suitable for selected outpatient use under local anesthesia, and the necessary hospitalization for secondary TEP can thus be avoided.
Intentional Ablation of Vestibular Function Using Commercially Available Topical Gentamicin‐Betamethasone Eardrops in Patients With Meniere's Disease: Further Evidence for Topical Eardrop Ototoxicity
Authors: Kaplan Daniel M. , Hehar Sukhminderjit S. , Bance Manohar L. , Rutka John A. 
Published: November 2003

AbstractObjective To determine whether the controversial findings of suspected ototoxicity from commercially available gentamicin sulfate and betamethasone sodium phosphate eardrops can be used in a therapeutic fashion to ablate (or attenuate) vestibular function in patients with unilateral Meniere's disease.Study Design Prospective case review.Methods At a tertiary care dizziness unit at the University Health Network, Toronto General Hospital, University of Toronto (Toronto, Ontario, Canada), adults with unilateral Meniere's disease undergoing intratympanic ablation therapy were studied. After insertion of a tympanostomy tube with the patient under local anesthesia, patients instilled gentamicin containing eardrops three times daily until they became vertiginous for longer than 24 hours and then for an additional 2 days longer or for 1 month, whichever came first. Electronystagmographic caloric test responses were measured before treatment using bithermal water caloric and after treatment using air caloric tests. Main outcome measures included clinical titration of drops to the onset of prolonged vertigo. As well, post‐treatment findings on electronystagmography and audiometry were compared with pretreatment testing.Results Twenty patients were available for review. Fifteen patients had a significant reduction in caloric test responses compared with pretreatment values; among them, 10 patients had absent air caloric test responses on the treated side. In 10 patients hearing worsened according to the 1995 American Academy of Otolaryngology—Head and Neck Surgery Committee on Hearing and Equilibrium Guidelines for reporting in Meniere's disease.Conclusions Topical gentamicin‐betamethasone eardrops can pass through a tube into the middle ear, where they may prove primarily vestibulo‐ototoxic patients with Meniere's disease. The study further confirms clinical observations that gentamicin‐containing eardrops might prove ototoxic, especially in noninflamed ears with a tympanic membrane defect.
Intralesional Cidofovir Therapy for Laryngeal Papilloma in an Adult Cohort
Authors: Bielamowicz Steven , Villagomez Vicente , Stager Sheila V. , Wilson William R. 
Published: November 2003

AbstractObjectives To confirm the safety and efficacy of intralesional cidofovir in the management of laryngeal papilloma and to identify variables that correlate with number of injections needed to achieve remission.Study Design An open‐trial prospective evaluation of the efficacy of intralesional cidofovir in subjects with laryngeal papilloma.Methods Fourteen adult subjects with biopsy‐proven laryngeal papilloma were enrolled in a treatment study of intralesional cidofovir. Preprotocol disease duration ranged from 1 to 30 years with a mean duration of 7 years. Subjects received monthly injections of cidofovir with a maximum dose of 37.5 mg per injection in 6 cc saline (6.25 mg/mL). Injections were repeated until no papilloma could be visually identified during an intraoperative evaluation. After disease remission was achieved, subjects received an additional injection. All injections occurred during suspension microlaryngoscopy.Results All subjects have achieved disease remission using an injection‐only treatment protocol. No additional laryngeal scarring or systemic toxicity was identified. On average, 6 injections were required to achieve remission. Preprotocol disease duration and anatomical staging correlated positively with the number of injections required for disease remission.Conclusions Intralesional injection of cidofovir is an excellent treatment option with limited local and systemic toxicities. The injection therapy regimen requires perseverance from both patient and surgeon. Remission of disease can be achieved in adults with laryngeal papilloma.
Human Papillomavirus in Larynx
Authors: Aaltonen Leena‐Maija , Rihkanen Heikki , Vaheri Antti 
Published: November 2003

AbstractObjectives The core of the present clinical and basic research knowledge of laryngeal human papillomavirus (HPV) infection is described.Study Design Review.Methods A computer‐aided search of MEDLINE database supplemented by hand searches of key journals was conducted.Results One of the tumor‐promoting factors in the larynx is the HPV found both in normal laryngeal epithelium and in laryngeal tumors. The most important manifestation of laryngeal HPV infection is laryngeal papillomatosis, a rare disease caused by HPV types 6 and 11. In laryngeal carcinogenesis, the role of HPV remains uncertain. The means of transmission of HPV are partly unknown, and the course of laryngeal HPV infection is unpredictable and variable. Treatment of laryngeal papillomatosis is based on surgery, especially on CO2 laser and shaver. Alpha‐interferon is the drug of choice in patients whose response to surgery is poor. However, neither interferon nor other antiviral drugs are able to eradicate the virus from laryngeal mucosa. Little is known about immunological mechanisms involved in laryngeal HPV infection, but in defense against HPV cellular immunity is considered a more important mechanism than humoral immunity. A good experimental model of HPV infection is lacking in which the entire viral life cycle can take place. Organotypic cell cultures (collagen rafts) are useful, but the rate‐limiting step in this method is the difficulties in culturing HPV‐positive epithelial cells.Conclusions Although laryngeal papillomatosis is clinically well defined, the mechanisms and treatment modalities of laryngeal HPV infection need further investigations.
Airway Assessment by Volumetric Computed Tomography in Snorers and Subjects With Obstructive Sleep Apnea in a Far‐East Asian Population (Chinese)
Authors: Chen Ning‐Hung , Li Kasey K. , Li Shia‐Yu , Wong Chao‐Reng , Chuang Ming‐Lung , Hwang Chung‐Chi , Wu Yao‐Kaung 
Published: November 2003

AbstractObjectives To evaluate the airway dimension of simple snorers and subjects with obstructive sleep apnea (OSA) in a Far‐East Asian population (Chinese).Study Design Prospective study of 117 near‐consecutive patients evaluated for snoring and possible OSA from January 1998 to December 1998 in a sleep laboratory. Overnight polysomnography (PSG) was performed on all patients and the sleep parameters, including respiratory disturbance index (RDI), snoring index, minimal oxygen saturation (min O2), percentage of slow wave sleep (SWS), and rapid eye movement (REM) were recorded. Three‐dimensional computerized tomography (CT) during awake periods was performed. The anteroposterior (AP) and the lateral distance of the retropalatal (RP) region in the oropharynx, the smallest area of RP, and retroglossal (RG) regions, and the total volume of the oropharynx were measured.Result Ninety‐eight patients were diagnosed with OSA (mean RDI, 41.48 ± 26.45 events per hour; min O2, 72.82 ± 12.86%), whereas 19 were simple snorers. The AP and the lateral distance of the RP region, as well as the smallest area of the RP region, are significantly smaller in subjects with OSA. However, no differences in the RG region and the total volume of the oropharynx were found between the two groups. Linear regression analysis demonstrated that the lateral dimension and the smallest RP area in overweight subjects inversely correlated with the RDI, but only the AP dimension of the RP area was found to have an inverse correlation with the RDI in the underweight subjects.Conclusion In Far‐East Asians (Chinese), the RP airway was found to be the primary site of narrowing in subjects with OSA, and the narrowest RP area was inversely correlated with RDI. Furthermore, weight may influence the pattern of RP narrowing by contributing to lateral collapse.
Dimensional Stability of the Free Fascia Grafts: An Animal Experiment
Authors: Indorewala Shabbir 
Published: November 2003

AbstractObjectives/Hypothesis It appears that autologous free fascia grafts (fascia lata and temporal fascia) change their dimensions during the vital first 5 days of healing. Poor dimensional stability of these grafts can be an important reason for failure of complete closure of tympanic membrane perforations in tympanoplasty operations. There has been no study regarding this dimensional instability.Study Design Prospectively dimensional instability of the free fascia grafts was studied in 14 mongrel dogs.Methods Fourteen healthy Mongrel dogs were operated on twice. During the first surgery, fascia lata and temporal fascia grafts of measured dimensions (length, breadth, and thickness) were implanted in the subcutaneous pockets on the thoracoabdominal wall of the same dog (autograft). Five dogs were operated on again after 2 days, and 7 dogs were operated on again after 5 days to harvest the implanted grafts. The dimensions of the harvested grafts were noted. Changes with respect to their implant dimensions after 2 days and after 5 days were calculated.Results It was found that free fascia lata exhibits significantly superior dimensional stability when compared with free temporal fascia during the early healing phase, before graft integration has occurred. Shrinking and thickening of temporal fascia are greater and are also most unpredictable.Conclusions Poor dimensional stability of temporal fascia may compromise a well‐sealed perforation at the time of surgery, and it may reopen by the 5th day. This must be one of the causes of failure of tympanoplasty, which needs to be studied further.