bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Rat Model of Otitis Media with Effusion Caused by Eustachian Tube Obstruction with and without Streptococcus Pneumoniae Infection: Methods and Disease Course
Authors: Piltcher Otavio B. , Swarts J. Douglas , Magnuson Karin , Alper Cuneyt M. , Doyle William J. , Hebda Patricia A. 
Published: February 2003

OBJECTIVETo describe the clinical and histopathologic progression of a rat model of otitis media with effusion caused by eustachian tube obstruction (ETO) with and without Streptococcus pneumoniae infection.METHODSIn 164 rats, the left, bony eustachian tube was approached via a ventral incision and obstructed with dental material. Then 108 rats were infected via an intrabullar injection with S pneumoniae. At 48 hours, the infected rats were treated for 5 days with ampicillin. All ears were evaluated by weekly otomicroscopy. On each of days 1, 2, 7, 21, 35, 56, and 112, four rats were killed for histologic study. All effusions were cultured for bacteria.RESULTSFourteen rats died of surgical complications; effusion resolved by 2 weeks in 9 rats. During the first few days, infected ears with ETO had bulging tympanic membranes, followed by tympanic membrane retraction, purulent effusion, and otorrhea (50%) over the next few weeks, whereas uninfected ears with ETO developed retraction and serous effusion during the same time frame. At later times, all ears with ETO presented with retraction and serous or serous‐mucoid effusion. S pneumoniae was recovered only from the infected ears with ETO (days 1 and 2), with some colonization by nonpathogenic microorganisms observed equally in both groups of ears. Histology showed a typical acute inflammatory reaction in the challenged ears with ETO through day 14 and then a chronic inflammation for all ears with ETO.CONCLUSIONThe experimental methods provoked reproducible pathologic signs similar to those for otitis media with effusion. Given the availability of rat‐specific reagents, this model is well suited for studies of cytokine elaboration during disease pathogenesis.
Rhinosinusitis Treatment Protocol: Changing Provider Habits in Primary Care
Authors: Kinney William C. 
Published: February 2003

OBJECTIVESinus infections are common and represent a high cost to the health care industry. Clinical protocols can be used to develop cost‐effective treatment strategies. Our objective was to show that a protocol for rhinosinusitis can change provider practice patterns in primary care.STUDY DESIGN AND SETTINGWe used a literature search, survey of primary caregivers, and chart review from an academic health center to define and document current patterns. A protocol was developed and evaluated using the Rhinosinusitis Disability Index.RESULTSSurvey and chart review identified that primary caregivers do not elicit a detailed history for rhinosinusitis. Protocol use increased this to 100%. First‐line antibiotic therapy was used for only 49.4% of the patients before protocol use and for 68.5% after protocol use. Patients felt better after treatment 84.1% of the time; the Rhinosinusitis Disability Index could not measure improvement.CONCLUSIONProvider practice patterns were positively influenced by use of the protocol.SIGNIFICANCEClinical protocols should be developed to direct provider treatment practices.
The Association between Laryngeal Pseudosulcus and Laryngopharyngeal Reflux
Authors: Belafsky Peter C. , Postma Gregory N. , Koufman James A. 
Published: February 2003

BACKGROUNDA pattern of edema on the ventral surface of the vocal fold, called pseudosulcus vocalis, was described in 1995. It refers to infraglottic edema extending from the anterior commissure to the posterior larynx. It can be differentiated from sulcus vergeture, which is caused by adhesion of the vocal fold epithelium to the vocal ligament. Although it has been related to laryngopharyngeal reflux (LPR), this has not been thoroughly investigated.PURPOSEOur goal was to evaluate the association between pseudosulcus and LPR.METHODSThirty patients with a clinical diagnosis of LPR confirmed by double‐probe pH monitoring and 30 controls without LPR were enrolled. The prevalence of pseudosulcus was determined with fiberoptic laryngoscopy.RESULTSSeventy percent (21 of 30) of patients with LPR and 30% (9 of 30) of controls had pseudosulcus. Patients with pseudosulcus were 2.3 times more likely to have pH‐documented LPR (95% confidence interval 1.3–4.2). The sensitivity and specificity of pseudosulcus in the diagnosis of LPR are 70% and 77%, respectively.CONCLUSIONSPseudosulcus is highly correlated with pH‐documented LPR (P < 0.001). The presence of pseudosulcus is suggestive of LPR.
Office‐Based Treatment of Laryngeal Papillomatosis with Percutaneous Injection of Cidofovir
Authors: Chhetri Dinesh K. , Blumin Joel H. , Shapiro Nina L. , Berke Gerald S. 
Published: February 2003

OBJECTIVEOur aim was to report our experience with office‐based treatment of severe laryngeal papillomatosis with percutaneous injection of cidofovir in a case series of 5 patients.STUDY DESIGN AND SETTINGWe conducted a retrospective review of a case series in a tertiary academic care voice disorders clinic. Adult patients with papillomas of the vocal cords and anterior commissure received percutaneous injection using a point‐touch technique. Clinical improvement or remission of the papillomatosis was noted.RESULTSBefore initiation of office treatments, patients required direct laryngoscopy and CO2 laser ablation of papillomas on average every 2.8 months. There were no complications related to the injection technique. During a treatment period of 7 to 16 months (mean 12 months), a significant reduction in the volume of papillomatosis was achieved in all patients. One patient received 2 treatments and another received 1 treatment in the operating room for final clearance of papillomas.CONCLUSIONOffice‐based treatment of adult patients with anterior laryngeal papillomatosis using percutaneous injection of cidofovir reduces the need for repeated direct laryngoscopy and laser ablation under general anesthesia.SIGNIFICANCEPercutaneous injection treatment with cidofovir is a useful adjunct to direct laryngoscopy and laser ablation in the treatment of laryngeal papillomatosis.
Skull Base Cerebrospinal Fluid Fistulas: A Comprehensive Diagnostic Algorithm
Authors: Zapalac Jeffrey S. , Marple Bradley F. , Schwade Nathan D. 
Published: February 2003

OBJECTIVEOur goal was to assess the efficacy of current diagnostic modalities in the management of skull base cerebrospinal fluid (CSF) fistulas.METHODSWe conducted a retrospective review of all patients presenting to our institution over the past 6 years with skull base CSF fistulas.RESULTSFifty‐two patients were included in the study. β2‐Transferrin analysis of collected specimen was the most efficacious means of confirming a CSF leak. High‐resolution computed tomography was the most informative radiographic study, yielding a sensitivity and an accuracy of 87%. Magnetic resonance cisternography, yielding a sensitivity and an accuracy of 78%, was instrumental in localizing the site of leak for a few cases but was most commonly corroborative. Using a graduated diagnostic approach, successful repair was attained in 88% of cases after 1 attempt and 98% after 1 or 2 attempts.CONCLUSIONFor patients with skull base CSF fistulas, a graduated diagnostic approach with emphasis on confirmation of leak by β2‐transferrin analysis and precise localization by high‐resolution computed tomography is both efficacious and cost effective.
Minimally Invasive Approaches to the Sphenoid Sinus
Authors: Gibbons Mark D. , Sillers Michael J. 
Published: February 2003

OBJECTIVEWe sought to develop an algorithm for surgical approaches to the sphenoid sinus.STUDY DESIGN AND SETTINGRetrospective review was conducted of all patients who underwent a sphenoid sinusotomy by the senior author between July 1994 and August 2001.RESULTSThe study population consisted of 141 patients, in whom 5 different surgical approaches were used: transseptal (47 (33.3%)), transnasal (19 (13.5%)), transethmoid (72 (51.1%)), transmaxillary (2 (1.42%)), and external (1 (0.7%)). Of the 47 transseptal approaches, 43 (91.5%) were for extirpation of a neoplasm. In contrast, 60 of 72 (83.3%) transethmoid procedures were for infectious/inflammatory disorders. An endoscopic approach was used for 7 of 8 (87.5%) skull base repairs. Four transsphenoid optic nerve decompressions were performed. The minor and major complication rates were 2.1% and 0.71%, respectively.CONCLUSIONSThe anatomic location of the pathologic process can guide the surgeon in selecting the most appropriate technique.SIGNIFICANCESurgical treatment of sphenoid pathology can be safely and successfully performed through a variety of approaches.
Hearing Status in Brucellosis
Authors: Bayazit Yildirim A. , Namiduru Mustafa , Bayazit Nurhayat , Özer Enver , Kanlikama Muzaffer 
Published: February 2003

BACKGROUNDAlthough brucellosis can lead to multisystem complications, involvement of the ear in brucellosis is rarely reported in the literature. The purpose of this study was to assess the hearing status of patients with brucellosis.STUDY DESIGNThirty‐two patients with brucellosis were included in the study. Pure tone and speech audiometry and tympanometry were performed in the patients.RESULTSThe mean pure tone averages of the patients were within normal limits and were similar in both ears (P > 0.05). The pure tone averages of the patients with or without anti‐Brucella treatment were not significantly different (P > 0.05) and were within the normal limits. When the hearing levels of these patients were compared at the frequencies of 250, 500, 1000, 2000, 4000, and 8000 Hz, there was no significant difference as well (P > 0.05).CONCLUSIONSPeripheral brucellosis does not appear to be associated with hearing loss.
Silver Nitrate Injury in the Rat Sciatic Nerve: A Model of Facial Nerve Injury
Authors: Wachter Bryan G. , Leonetti John P. , Lee John M. , Wurster Robert D. , Young M. Rita I. 
Published: February 2003

BACKGROUNDAn unpublished communication of a permanent facial paralysis secondary to silver nitrate application in a postoperative mastoid cavity with a dehiscent facial nerve raises concern regarding its neurotoxicity. This study was performed to examine functional neural injury and the morphology of nerve injury due to silver nitrate contact with a peripheral motor nerve.METHODSSprague‐Dawley male rats were assigned to a sham surgery group or to a group where silver nitrate was applied directly to a surgically exposed sciatic nerve for 1, 5, or 10 seconds. Individual walking track data were collected on postoperative days (POD) 1, 4, 7, and 14, and the Sciatic Functional Index (SFI) was calculated to assess neural function. On POD 14, the cauterized nerve was harvested, and the histologic axon loss of each specimen was graded.RESULTSIn all experimental groups, the most severe functional loss was noted on POD 1. At POD 14 the greatest neural recovery was observed in the 1‐second group, whereas the 5‐ and 10‐second cautery groups demonstrated a significantly worse deficit. A moderate or greater degree of axon loss was observed in 50% of animals injured for 1 second and nearly all animals injured for 5 or 10 seconds.CONCLUSIONFunctional and neuropathologic data demonstrate that silver nitrate causes significant injury to the rat sciatic nerve. A 5‐second cautery causes greater functional impairment and more severe axonal loss than a 1‐second injury.
Short Treatment Durations for Acute Bacterial Rhinosinusitis: Five Days of Gemifloxacin versus 7 Days of Gemifloxacin
Authors: Ferguson Berrylin J. , Anon Jack , Poole Michael D. , Hendrick Kim , Gilson Martyn , Seltzer Elyse G. ,   The Gemifloxacin 186 Study Group
Published: February 2003

OBJECTIVEThe primary objective of this study was to demonstrate the clinical and radiologic efficacy of 5 days compared with 7 days of gemifloxacin therapy in the treatment of acute bacterial rhinosinusitis (ABRS).STUDY DESIGNIn this prospective, double‐blind, multicenter, parallel‐group study, adult patients presenting with ABRS were randomized to receive gemifloxacin 320 mg once daily for either 5 days (n = 218) or 7 days (n = 203).RESULTSFor the primary efficacy end point, clinical response to therapy at follow‐up, 5 days of therapy with gemifloxacin was as effective as 7 days of therapy (per‐protocol population; treatment difference 0.44%; 95% confidence interval (CI), −6.54 to 7.41). Five and 7 days of treatment with gemifloxacin were well tolerated.CONCLUSION AND SIGNIFICANCEThe clinical efficacy of gemifloxacin 320 mg daily for 5 days is at least as good as the efficacy of gemifloxacin 320 mg daily for 7 days in the treatment of ABRS.
Retrograde Degeneration of the Facial Nerve after Acute Traction on Parotid Gland: An Experimental Investigation
Authors: Wang Zhengmin , Dai Chun‐Fu , Chi Fanglu 
Published: February 2003

The parotid gland of the cat underwent traction for 2 hours (group A) or until the facial nerve was broken (group B). The cats survived postoperatively for 1 day, 2 weeks, 1 month, and 3 months, respectively. Each cat underwent an electroneurography session before they were killed. The facial nerve was harvested and underwent histologic examination. The present study demonstrated that, in group A, the degree of facial nerve degeneration indicated with evoked electroneurography was 100% at 1 day and 2 weeks and 85% and 35%, respectively, at 1 and 3 months after damage. In group B, no electric response was recorded, epineurium of extratemporal segment was broken. This study also showed that the pronounced alteration of the facial nerve following acute traction on the parotid gland was retrograde degeneration; it involved up to its internal acoustic meatus segment. Furthermore, pronounced damage was noted in its stylomastoid foramen and extratemporal segment.
A New Absorbable Pressure‐Equalizing Tube
Authors: D'Eredità Riccardo , Marsh Roger R. , Lora Silvano , Kazahaya Ken 
Published: February 2003

OBJECTIVEWe investigated pressure‐equalizing (PE) tubes made of biodegradable, absorbable material in an animal model.METHODSPE tubes, made of poly‐bis(ethylanate)phosphazene (PBE) were inserted in 55 ears of 28 Hartley guinea pigs, with survival times of 10, 30, and 60 days after tube insertion. In vivo reactions between the PBE‐PE tube and the tympanic membrane (TM) were studied. Tubes, TMs, and middle ears were examined by scanning electron microscopy and light microscopy.RESULTSThere was neither infection nor an inflammatory reaction to the tube within the middle ear in any animal. At 30 days, 53% of the tubes had disintegrated. At 60 days, tubes were still functioning in the 25% of ears.CONCLUSIONMore research must be performed before these new PBE PE tubes can be considered for clinical use. Nonetheless, these tubes are promising. The disintegration rate can be controlled by varying the formulation of the polymer, so treatment can be adjusted to the needs of each patient.
Free Tissue Transfer versus Pedicled Flap Cost in Head and Neck Cancer
Authors: Funk Gerry F. , Karnell Lucy Hynds , Whitehead Stacey , Paulino Arnold , Ricks Joan , Smith Russell B. 
Published: February 2003

OBJECTIVEWe sought to compare the overall 1‐year management costs for patients receiving a free tissue transfer with those of patients receiving a pedicled flap reconstruction as a component of their primary head and neck cancer treatment.STUDY DESIGN AND SETTINGCase‐control, cost identification analysis of 21 matched pairs of patients and multivariate analysis of variables associated with treatment costs was conducted in a tertiary referral academic institution.RESULTSNo significant difference in total 1‐year charges between the pedicled and free tissue transfer groups was found. A structured measure of patient comorbidity was the only variable significantly associated with total 1‐year charges.CONCLUSIONSTotal 1‐year treatment costs of primary upper aerodigestive tract cancers are similar for patients reconstructed with free tissue transfer or a pedicled flap.SIGNIFICANCEWithin the context of overall 1‐year management costs, the primary determinants of health care expense for these patients are comorbidity and extent of disease, not reconstructive technique.
Influence of Lecithin on Mitochondrial DNA and Age‐Related Hearing Loss
Authors: Seidman Michael D. , Khan Mumtaz J. , Tang Wen Xue , Quirk Wayne S. 
Published: February 2003

;OBJECTIVESLecithin is a polyunsaturated phosphatidylcholine (PPC), which are high energy functional and structural elements of all biologic membranes. PPC play a rate‐limiting role in the activation of numerous membrane‐located enzymes, including superoxide dismutase and glutathione, which are important antioxidants protecting cell membranes from damage by reactive oxygen species (ROS). ROS‐induced damage to mitochondrial DNA may lead to reduced mitochondrial function in the cochlea and resultant hearing loss.STUDY DESIGN AND SETTINGThe effects of lecithin on aging and age‐associated hearing loss were studied in rats by measuring hearing sensitivities using auditory brainstem responses (ABR). In addition, mitochondrial function as a measure of aging was assessed by determining mitochondrial membrane potentials using flow cytometry and by amplifying mitochondrial DNA deletions associated with aging. Harlan‐Fischer rats aged 18 to 20 months (n = 14) were divided into 2 groups. The experimental group was supplemented orally for 6 months with lecithin, a purified extract of soybean phospholipid (Nutritional Therapeutics, Allendale, NJ).RESULTSThe data obtained were compared with the control group. ABRs were recorded at 2‐month intervals and showed significant preservation of hearing sensitivities in the treated subjects. Flow cytometry revealed significantly higher mitochondrial membrane potentials in the treated subjects, suggesting preserved mitochondrial function. Finally, the common aging mitochondrial DNA deletion (mtDNA4834) were amplified from brain and cochlear tissue including stria vascularis and auditory nerve. This specific deletion was found significantly less frequent in all tissues in the treated group compared with the controls.CONCLUSIONThese experiments support our hypothesis and provide evidence that lecithin may preserve cochlear mitochondrial function and protect hearing loss associated with aging.
Chondrocyte Repopulation of Allograft Cartilage: A Preliminary Investigation and Strategy for Developing Cartilage Matrices for Reconstruction
Authors: Kelley Timothy F. , Sutton Frank M. , Wallace Vincent P. , Wong Brian J. F. 
Published: February 2003

OBJECTIVETo evaluate the ability of devitalized cartilage to sustain repopulation by allogenic chondrocytes and to use 2‐photon microscopy to assess cultured chondrocyte viability.STUDY DESIGN AND SETTINGAt an academic medical center, we conducted experimental analysis of lagomorph nasal septa devitalized by subjecting them to either 1) chemical dehydration in ethanol, 2) lyophilization (freeze dry), or 3) repeated freeze‐thaw (12 cycles) in liquid nitrogen. The processed cartilages were seeded with chondrocytes isolated from the septa of either the same rabbit or another rabbit and cultured for 4 weeks. They were assessed with a variety of techniques.RESULTSThe seeded chondrocytes maintained viability on the devitalized cartilage throughout the study period. Two‐photon microscopy was effective in assessing the viability of cultured chondrocytes.CONCLUSIONIsolated lagomorph chondrocytes can be maintained in allogenic cartilage grafts devitalized using conventional physicochemical techniques.SIGNIFICANCEThis is the first experimental study to demonstrate that cultured chondrocytes can be maintained on devitalized cartilage.
Preliminary Findings from a Prospective, Randomized Trial of Two Palatal Operations for Sleep‐Disordered Breathing
Authors: Terris David J. , Coker Joan F. , Thomas Adrian J. , Chavoya Martha 
Published: February 2003

OBJECTIVESWe compared the efficacy of 2 palatal surgical procedures in the treatment of patients with mild sleep‐disordered breathing (SDB).STUDY DESIGN AND SETTINGWe conducted a prospective, randomized, crossover surgical trial at a university hospital.METHODSTwenty patients with mild SDB for whom conservative treatment failed were identified and consecutively enrolled into an institutional review board‐approved surgical protocol. They were randomly assigned to undergo either radiofrequency ablation of the palate (RFAP) for a planned 3‐stage treatment or laser‐assisted uvulopalatoplasty (LAUP), also for 3 stages of treatment, using a CO2 laser. Parameters assessed included severity of SDB (polysomnography), subjective and objective loudness of snoring (visual analog scale and SNAP recording), sleepiness (Epworth Sleepiness Scale), and anatomic changes (upper airway endoscopy), as well as demographic factors. Patients not achieving satisfactory improvement in their condition were crossed over to the alternative surgical therapy for attempted salvage.RESULTSSeventeen of the enrolled patients have completed the protocol. Ten of these were randomized to the RFAP group, and 7 to the LAUP group. Six of the RFAP patients (60%) achieved a satisfactory resolution of their snoring, and 4 failed and were salvaged with LAUP. Six of the LAUP patients (86%) achieved a satisfactory resolution of their snoring, and 1 patient failed and was salvaged with nasal surgery. One patient who was initially cured had a relapse after 9 months and was successfully salvaged with RFA.CONCLUSIONProspective, randomized trials of surgery for SDB are possible. Preliminary findings from the current protocol reveal a slight advantage of LAUP over RFAP but with a greater degree of discomfort postoperatively.
Endoscopic Treatment of Zenker's Diverticulum Using CO2 Laser
Authors: Krespi Y. , Kacker A. , Remacle M. 
Published: February 2003

OBJECTIVESThe objective of the present study was to review the technique of endoscopic laser‐assisted esophagodiverticulostomy (ELAED) for the treatment of Zenker's diverticulum.METHODSWe reviewed 83 cases of ELAED performed for the treatment of Zenker's diverticuli during the past decade.RESULTSELAED‐treated patients had a reduced hospital stay and were able to start an oral diet earlier than were patients who underwent other surgical procedures. Two (2.4%) of our patients developed small fistulas, which closed spontaneously. An additional 2 (2.4%) of our patients required conversion to an open approach due to inadequate endoscopic exposure, and 5 (6%) required a revision endoscopic procedure for persistent symptoms.CONCLUSIONSOur series of 83 patients treated at 2 large academic centers during the past decade with an average follow‐up of 4 years demonstrates that ELAED is a safe and effective procedure for the management of Zenker's diverticulum.