bluuebunny/crossref_metadata_2025_split huggingface dataset:
Small Doses of Propofol, Droperidol, and Metoclopramide for the Prevention of Postoperative Nausea and Vomiting After Thyroidectomy
Authors: Fujii Yoshitaka , Tanaka Hiroyoshi , Kobayashi Noriaki 
Published: February 2003

OBJECTIVETo evaluate the efficacy and safety of small doses of propofol, droperidol, and metoclopramide for the prevention of postoperative nausea and vomiting (PONV) after thyroidectomy.STUDY DESIGNProspective, randomized, double‐blinded study.SETTINGUniversity‐affiliated teaching hospital.METHODSIn a randomized, double‐blinded study, 90 patients (75 females) received propofol 0.5 mg/kg, droperidol 20 μg/kg, or metoclopramide 0.2 mg/kg intravenously (n = 30 in each group) at the end of surgery. A standardized general anesthetic technique was used.RESULTSThe incidence of PONV during the first 24 hours after anesthesia was recorded in 13%, 47%, and 50% of patients who had received propofol, droperidol, and metoclopramide, respectively (P < 0.05; overall Fisher exact probability test). No clinically important adverse events were observed in any of the groups.CONCLUSIONSmall dose (0.5 mg/kg) of propofol is more effective than droperidol or metoclopramide for the prevention of PONV after thyroidectomy.
Estrogen Metabolism as a Risk Factor for Head and Neck Cancer
Authors: Yoo Helen J. , Sepkovic Daniel W. , Bradlow H. Leon , Yu Guo Pei , Sirilian Henedia V. , Schantz Stimson P. 
Published: February 2003

OBJECTIVEEstrogen metabolites have been associated in the pathogenesis of breast and cervical cancer; 16α‐hydroxyestrone(16α‐OHE1) demonstrated proliferative effects whereas 2‐hydroxyestrone(2‐OHE1) had antiproliferative effects. Our study's objective is to demonstrate that head and neck (H&N) cancer patients metabolize estrogen differently than healthy controls, which may constitute a risk factor for H&N cancer development.STUDY DESIGNUrinary metabolite levels of 2‐OHE1 and 16α‐OHE1 from 50 H&N cancer patients and 50 age‐ and sex‐matched controls were measured using enzyme‐linked immunosorbent assay (ELISA). Absolute values and 2‐/16α‐OHE1 ratios were calculated. Conditional logistic regression for univariate and multivariate analysis with odds ratio (OR) and 95% confidence interval (Cl) were used.RESULTSThirty percent (15 of 50) from the case group had a low 2‐/16α‐OHE1 ratio compared with only 4% (2 of 50) in the control group (OR = 11.1; 1.4‐91.5, 95% Cl) (P < 0.05). When adjusted for tobacco, OR remained significant at 15.6 (1.1212.5, 95% Cl) (P < 0.05).CONCLUSIONH&N cancer patients are more likely to express abnormal estrogen metabolism than healthy controls; 2‐/16α‐OHE1 may serve as a potential biological marker of individuals at increased risk of H&N cancer.
Endoscopic Ligature of the Sphenopalatine Artery for Severe Posterior Epistaxis
Authors: Voegels Richard Louis , Thomé Daniela Curti , Iturralde Patsy Priscilla Vasquez , Butugan Ossamu 
Published: February 2003

OBJECTIVETo present our experience with endoscopic ligature of the sphenopalatine artery in the treatment of severe posterior epistaxis of patients who had previously undergone conservative procedures.METHODSEleven patients with severe posterior epistaxis were treated during a 25‐month period with an endoscopic ligature of the sphenopalatine artery. The basic principle of the surgical technique is to identify the branches of the sphenopalatine artery through an endoscopic endonasal approach and to apply a titanium clip under direct vision.RESULTSThe endoscopic ligature of the sphenopalatine artery was performed unilaterally in 10 patients and bilaterally in 1 patient, with a total of 12 ligatures. It was possible to identify the sphenopalatine artery in all cases with a successful outcome using this surgical technique alone.CONCLUSIONEndonasal endoscopic ligature of the sphenopalatine artery has been an effective surgical technique for treating severe posterior epistaxis.
Analysis of Vocal Fold Vibration by X‐Ray Stroboscopy With Multiple Markers
Authors: Kusuyama Toshiyuki , Fukuda Hiroyuki , Shiotani Akihiro , Nakagawa Hideki , Kanzaki Jin 
Published: February 2003

OBJECTIVETo derive a more precise description of vocal fold vibration, experimental phonation of excised canine larynxes was studied.STUDY DESIGN AND SETTINGMultiple X‐ray‐positive markers were inserted, and their vibratory movement was observed with x‐ray stroboscopy with change of pitch and intensity. A histologic study was also carried out.RESULTRegular waves were observed just above the lowest point of the lamina propria of the mucous membrane, which shifted upward at high pitch, but downward in high intensity.CONCLUSIONSThe starting point of the mucosal wave was confirmed on the lower surface of the vocal fold, histologically just above the lowest point of the lamina propria of the mucous membrane and shifted upward at high pitch, but downward in high intensity.SIGNIFICANCEThis is the first study investigating the starting point of mucosal wave in vocal fold vibration in a frontal plane using x‐ray stroboscopy, providing the evidence for the body‐cover theory.
Posterior petrous face meningiomas
Authors: Selesnick Samuel H. , Nguyen Teri D. , Gutin Philip H. , Lavyne Michael H. 
Published: February 2003

OBJECTIVETo define the clinical presentation, treatment options, and outcomes for a subset of meningiomas of the posterior fossa skull base that arise from the posterior petrous face between the region of the porus acousticus and the sigmoid sinus.STUDY DESIGN AND SETTINGA retrospective chart review from a large skull base surgery practice at a tertiary care institution.RESULTSThis cohort of patients presented with minimal symptoms, yet large tumors, averaging 3.8 cms and causing significant cerebellar compression. Retrosigmoid craniotomies afforded excellent exposure.CONCLUSION AND SIGNIFICANCEPatients with large tumors emanating from the posterior fossa aspect of the temporal bone should be evaluated on the basis of their site of origin. Patients with tumors emanating from the anterior or ventral portion of the temporal bone have greater symptoms and greater operative complications than those emanating from the posterior petrous face, between the porus acousticus and sigmoid sinus.
Acoustic Role of the Buttress and Posterior Incudal Ligament in Human Temporal Bones
Authors: Hato Naohito , Welsh Joseph T. , Goode Richard L. , Stenfelt Stefan 
Published: February 2003

OBJECTIVESIn middle ear surgery using intact ear canal wall techniques, the buttress, which is the bony bridge at the medial end of the posterior‐superior bony ear canal, is commonly retained during posterior tympanotomy. In some cases, the surgical exposure may be improved by resectioning the buttress, and this requires sectioning the posterior incudal ligament. To date, the acoustic effects of removing the buttress with sectioning of the attached ligament have not been studied.METHODUsing a laser Doppler vibrometer system, 15 human cadaver temporal bones were measured with 80 dB sound pressure level at the tympanic membrane over the 0.1 to 10 kHz frequency range.RESULTThe resection of the buttress and sectioning the posterior incudal ligament had no effect on stapes footplate velocity.CONCLUSIONThese results suggest that the posterior incudal ligament does not play a significant role in the acoustic function of the ossicles.
Action of histamine on eustachian tube function
Authors: Downs Brian W. , Butehorn Henry F. , Prazma Jiri , Rose Austin S. , Stamat Jocelyn C. , Pillsbury Harold C. 
Published: February 2003

INTRODUCTIONThe role of allergy in eustachian tube dysfunction is controversial. In this study, allergy was simulated by exposure to histamine, and eustachian tube function testing was performed in an experimental rat model.METHODSVentilatory function was assessed by measuring passive opening and closing pressures of the eustachian tube after challenge with either transtympanic or intranasal histamine. The mucociliary clearance time of the tubotympanum was assessed by observing dye transport from the middle ear to the nasopharynx after challenge with either transtympanic histamine or control solution.RESULTSThere was a statistically significant increase in passive opening and closing pressures with transtympanic histamine versus intranasal histamine. In addition, mucociliary clearance times of the tubotympanum after transtympanic histamine showed a statistically significant increase when compared with those after transtympanic control solution.CONCLUSIONSTranstympanic histamine exposure causes eustachian tube dysfunction in the rat by increasing passive opening and closing pressures of the eustachian tube and impairing mucociliary clearance time.
Cost and Cost‐effectiveness of Universal Screening for Hearing Loss in Newborns
Authors: Kezirian Eric J. , White Karl R. , Yueh Bevan , Sullivan Sean D. 
Published: February 2003

OBJECTIVETo estimate the cost and cost‐effectiveness of universal newborn hearing screening.STUDY DESIGN AND SETTINGDecision analysis model utilizing the hospital perspective. This model evaluated 4 distinct protocols for screening a fixed and defined hypothetical cohort of newborn infants.OUTCOME MEASURESCost of screening and the number of infants with hearing loss identified through universal screening.RESULTSOtoacoustic emissions testing at birth followed by repeat testing at follow up demonstrated the lowest cost ($13 per infant) and had the lowest cost‐effectiveness ratio ($5100 per infant with hearing loss identified). Screening auditory brainstem evoked response testing at birth with no screening test at follow‐up was the only protocol with greater effectiveness, but it also demonstrated the highest cost ($25 per infant) and highest cost‐effectiveness ratio ($9500 per infant with hearing loss identified). These findings were robust to sensitivity analysis, including best‐case and worst‐case estimation. The prevalence of hearing loss and the fraction of infants returned for follow‐up testing had a large impact on the absolute level, but not relative level of protocol cost and cost‐effectiveness.CONCLUSIONThe otoacoustic emissions testing protocol should be selected by screening programs concerned with cost and cost‐effectiveness, although there are certain caveats to consider.SIGNIFICANCEThe most significant barriers to implementation of universal newborn hearing screening programs have been financial, and this study compares the most common protocols currently in use. This study can assist program directors not only in the decision to initiate universal screening but also in their choice of screening protocol.
Expression of Nitric Oxide Synthase Type 3 in Reflux‐Induced Esophageal Lesions
Authors: Chandra Rakesh , Haines G. Kenneth , Bentz Brandon G. , Shah Pinky , Robinson Alan M. , Radosevich James A. 
Published: February 2003

BACKGROUNDThe expression of endothelial constitutive nitric oxide synthase (NOS3) by squamous dysplasia and carcinomas of the head and neck has previously been described. We sought to compare NOS3 expression in squamous mucosa, glandular metaplasia, and adenocarcinoma of the esophagus.METHODSForty paraffin‐embedded specimens from 20 patients with adenocarcinoma were stained with anti‐NOS3 monoclonal antibody. The percentage of cells stained and the intensity of staining were determined for squamous epithelium, metaplasia, and adenocarcinoma. Staining characteristics were statistically analyzed according to clinical variables.RESULTSNOS3 expression was significantly higher in adenocarcinoma and squamous epithelium compared with glandular metaplasia. Among the carcinomas, larger tumor size (T3/4), nodal positivity, and advanced TNM stage (III/IV) significantly correlated with increased NOS3 expression.CONCLUSIONSNOS3 is expressed in refluxinduced lesions of the esophagus. Glandular metaplasia shows basal levels of NOS3 that significantly increase with malignant transformation and tumor progression. The role of free radicals in carcinogenesis is being actively studied.
Safety and Efficacy of Topical Mitomycin C in Myringotomy Patency
Authors: Jassir David , Buchman Craig A. , Gomez‐Marin Orlando 
Published: February 2003

OBJECTIVETo develop an alternative method for prolonged middle ear ventilation using topical mitomycin C.STUDY DESIGN AND SETTINGTwenty guinea pigs with normal ears had bilateral myringotomies performed using the argon laser. After myringotomy, either mitomycin C (0.4 mg/mL) or saline pledgets were applied topically. Monitoring consisted of otomicroscopy and distortion‐product otoacoustic emissions.RESULTSBefore myringotomy, all tympanic membranes were intact, and distortion‐product otoacoustic emissions were measurable. After myringotomy, none (0%) of the saline‐treated myringotomies were patent at day 7 as compared with 100% of the mitomycin C‐treated myringotomies. At day 42, 10 (52.6%) of 19 mitomycin‐treated myringotomies remained patent and 4 (28.6%) of 14 were patent at 131 days. Five (13.1%) ears developed purulent otorrhea; 3 were mitomycin C‐treated and 2 were treated with saline solution. Distortion‐product otoacoustic emissions testing did not document any evidence of ototoxicity.CONCLUSIONTopical mitomycin C appears to be safe and effective at prolonging the duration of myringotomy patency in the guinea pig.SIGNIFICANCEMitomycin C may be useful as an adjunct for preventing myringotomy closure.
Occult Laryngeal Pathology in a Community‐Based Cohort
Authors: Reulbach Todd R. , Belafsky Peter C. , Blalock P. David , Koufman James A. , Postma Gregory N. 
Published: February 2003

BACKGROUNDLittle information is available regarding the prevalence of laryngeal pathology in adults.PURPOSETo estimate the prevalence of occult laryngeal pathology in a community‐based cohort of adults over 40 years of age.METHODSOne hundred consecutive volunteers over age 40 with no history of voice disorders were enrolled. All completed a self‐administered laryngeal symptom questionnaire and underwent a comprehensive head and neck examination including transnasal fiberoptic laryngoscopy.RESULTSThe mean age of the cohort was 61 years. Vocal fold bowing (presbylaryngis) was present in 72% of the patients, and findings of laryngopharyngeal reflux were present in 64% of the cohort. In addition, other laryngeal pathology were identified in 21%. Only 12% had a completely normal laryngeal examination.CONCLUSIONSOccult laryngeal pathology is very common in persons over 40. Findings suggestive of laryngopharyngeal reflux are present in 64%, and vocal fold bowing is present in 72% of persons over 40.
Dosage Regimens of Intranasal Aerosolized Surfactant on Otitis Media with Effusion in an Animal Model
Authors: Venkatayan Natarajan , Connelly Patricia E. , Mautone Alan J. , Troublefield Yolanda L. , Chandrasekhar Sujana S. 
Published: February 2003

OBJECTIVETo determine optimal dosage regimens of intranasal metered dose aerosolized surfactant with and without other medications in the treatment of otitis media with effusion (OME).STUDY DESIGNResolution of experimental OME in gerbils was determined based on otomicroscopy and tympanometry. Experimental intranasal drugs were: surfactant, surfactant with betamethasone, surfactant with phenylephrine, and a normal saline solution placebo. Medications were administered once or twice daily via a metered dose inhaler.RESULTSFor twice‐daily dosing, mean days to OME resolution were 8.5 for the aerosolized surfactant, 6.3 for the surfactant with betamethasone, 18.7 for the surfactant with phenylephrine, and 16 each for control and placebo. Resolution with the once‐daily dosage was longer for all conditions. Results were comparable using tympanometry.CONCLUSIONOME resolved faster than the natural course when treated with intranasal surfactant with and without steroids. Twice‐daily dosing was statistically superior.SIGNIFICANCEThis study reiterates the effectiveness of OME treatment with an aerosolized synthetic surfactant with and without steroids and establishes a superior twice‐daily dosage schedule.
Node Counts in Neck Dissection: Are they Useful in Outcomes Research?
Authors: Agrama Mark T. , Reiter David , Topham Allan K. , Keane William M. 
Published: February 2003

OBJECTIVESWe studied the unilateral nodal yields for procedures reported as standard or modified radical neck dissection (RND) to determine their applicability in outcomes research.METHODSWe analyzed the unilateral nodal yields for all procedures reported as RND for carcinoma of the oral cavity, pharynx, and larynx at our institution from 1985 to 1997 (n = 64, no prior treatment). These included both standard and modified techniques, encompassing levels I through V of the neck. Each side of a bilateral RND was treated as a separate case. This sample was compared with a similar population from the National Cancer Institute's Surveillance, Epidemiology, and End‐Results (SEER) registry. Nodal yield was obtained for RND alone and for unspecified neck dissection with primary excision for the same diseases and time period (n = 1499).RESULTSThe mean nodal yield from 64 RND was 30 vs 27 in the SEER data. The standard deviation was 14.7 compared with 17.2 in the SEER data. Values ranged from 7 to 66 nodes whereas the SEER range was from 1 to 97 nodes. Although the SEER data contain nodal yields from regional or selective neck dissection, we corroborate our findings of large variance in nodal yield from our RND sample.CONCLUSIONSLarge variance in nodal yields from RND may have undefined effects on quality of life, cure rate, and survival. Until correlation of nodal yields with outcomes is examined, we cannot know how to relate RND to outcomes.
Hemostatic Alterations in Patients with Acute, Unilateral Vestibular Paresis
Authors: Fattori Bruno , Nacci Andrea , Casani Augusto , Cristofani Renza , Sagripanti Andrea 
Published: February 2003

OBJECTIVESThe etiopathogenesis of acute unilateral peripheral vestibulopathy (APV) still remains a matter of debate; ischemic changes in the circulation of the labyrinth may play a role. We consequently looked for possible hemostasis alterations in a group of patients with APV of an unknown nature.METHODSWe evaluated blood parameters known to be involved in circulation disorders, including total and HDL cholesterol, tryglycerides, apolipoprotein A and B, lipoprotein(a), homocysteine, folate, prothrombin time, activated partial thromboplastin time, fibrinogen, D‐dimer, antithrombin III, protein C, protein S, activated protein C resistance, and anticardiolipin IgG and IgM antibodies. A series of 23 patients affected with APV were consecutively referred to our department, in the acute phase, before treatment, and in the follow‐up phase after 4 to 6 weeks of pharmacologic washout. The aforementioned blood parameters were also measured in a series of 15 patients with Menière's disease.RESULTSThe patients with APV in the acute phase compared with the patients with Menière's disease in the acute phase exhibited increased plasma levels of fibrinogen (mean, 338.3 ± 135.9 SD vs 271.3 ± 69.8 SD mg/dL, P = 0.05), increased plasma levels of D‐dimer (mean, 320 ± 207.8 SD vs 226.7 ± 138.7 SD NG/mL), enhanced plasma levels of lipoprotein(a) (41.4 ± 38.6 SD vs 16 ± 18.2 SD mg/dL, F = 5.67, P = 0.02), high leukocyte count (9.1 ± 2.7 SD vs 6.5 ± 1.3 SD x 103/μL; F = 8.42, P < 0.006), and low serum folate concentration (5.3 ± 1.8 SD vs 7.1 ± 2.7 NG/mg; F = 4.34, P = 0.04). During follow‐up the prothrombin time was prolonged (F = 4.34, P = 0.04) and leukocyte count decreased (F = 7.39, P < 0.019) in the APV patients, whereas fibrinogen, D‐dimer, lipoprotein(a), and folate were unchanged.CONCLUSIONOur results provide evidence suggesting an involvement of the hemostatic system in APV.
Revision Myringoplasty with Solvent‐Dehydrated Human Dura Mater (Tutoplast)
Authors: Sertaç Yetişer , Tosun Fuat , Bülent Satar 
Published: February 2003

OBJECTIVESSeveral grafting materials have been used in the reconstruction of the perforations of the tympanic membrane. The use of dehydrated dura homografts as a substitute for the tympanic membrane has not been fully documented. On the other hand, revision surgery is more critical in terms of patients' expectations. The aim of this study is to determine the tissue stiffness, the compliance, and the wound healing rate of dura homografts in revision surgery of perforations of the tympanic membrane.STUDY DESIGN AND SETTINGThe charts of 45 patients who have received dura grafts because of re‐perforation or failure of the myringoplasty have been reviewed retrospectively. The healing process of the myringoplasty, graft take rate, pure‐tone hearing level, and tympanogram were reviewed.RESULTS AND CONCLUSIONIt has been concluded that dura homografts, which have excellent tissue‐compability, stability, and an 86.7% graft success rate, are preferred in patients in whom their own temporalis fascia cannot be used because of previous operations. It has been demonstrated by tympanometric analysis that the compliance of the graft during various pressure applications is as good as the normal eardrum.
Free Radical Damage in Nasal Polyp Tissue
Authors: Doğru Harun , DeliBaş Namik , Döner Fehmi , Tüz Mustafa , Uygur Kemal 
Published: February 2003

OBJECTIVETo investigate whether the free radical injury in nasal polyp tissue exists or not.STUDY DESIGNA prospective study in patients with nasal polyps.METHODSPolyp specimens were obtained from 19 patients. Control specimens were acquired from 16 patients who underwent partial turbinectomy with concha bullosa free of rhinitis, sinusitis, and allergy, confirmed by endoscopic nasal examination, coronal paranasal sinus CT scan, and prick test. MDA levels of nasal polyps and control specimens were measured by using the method of Knudsen et al.RESULTSThe mean MDA levels of nasal polyps and control specimens were 38.2 ± 5.1 (33.3–52.2) and 33.9 ± 1.6 (32.6–37.4), respectively. MDA levels in NP were significantly higher compared with control specimens (P < 0.01).CONCLUSIONHigh level of MDA in nasal polyp tissue that represents FR increase supports the existence of cell injury in nasal polyp tissue. FRs should be considered in the development and life cycles of NP which is thought to have multifactorial pathogenesis.
Cerebrospinal Fluid Fistula after Transtemporal Skull Base Surgery
Authors: Leonetti John , Anderson Douglas , Marzo Sam , Moynihan George 
Published: February 2003

OBJECTIVESThe purpose of this article is to outline our methods for the prevention and management of cerebrospinal fluid (CSF) leak after transtemporal skull base surgery.METHODSA total of 589 patients underwent a variety of transtemporal surgical approaches for the extirpation of skull base tumors at our institution from July 1988 to October 1999. The medical records were retrospectively reviewed to identify the tumor histology, size, and location as well as the surgical approach, defect reconstruction technique, and the incidence of postoperative CSF leak.RESULTSThe risk of CSF fistulae was greatest in utilizing the restrosigmoid approach (8%) and least in those who underwent a translabyrinthine approach (4%). Tumor size had no bearing on the incidence of the CSF leak and the overall incidence of meningitis was 1.0%.CONCLUSIONThe proper surgical technique will minimize the risk of CSF leak after transtemporal skull base surgery. Immediate management of CSF fistulae helped prevent meningitis in the majority of these patients.