bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nucleus 22 Cochlear Implantation Results in Postmeningitic Deafness
Authors: Rauch Steven D. , Herrmann Barbara S. , Davis Lynne A. , Nadol Joseph B. 
Published: November 2003

AbstractCochlear implant surgery was performed on 13 patients with postmeningitic deafness (seven adults, six children). Two adults and two children (30.8%) had severe labyrinthitis ossificans requiring radical “drill‐out.” Five of 13 (38.5%) had some bone growth requiring partial drill‐out, and four of 13 (30.8%) had normal insertion with no drill‐out. Hearing results for patients with no bone growth were similar to nonmeningitic patients; three of four (75%) had open‐set speech recognition. Performance of patients with total drill‐out was poor; “auditory only” performance was limited to detection and pattern perception of speech, and no patients had open‐set speech recognition. Results for patients with partial drill‐out were similar to results in patients with no bone growth. Labyrinthitis ossificans not only presents surgical challenges to cochlear implantation but may also adversely affect hearing outcome.
Extended Canine Laryngeal Preservation for Transplantation
Authors: Kevorkian Kevin F. , Sercarz Joel A. , Ye Ming , Kim Young‐Mo , Hong Ki‐Hwan , Berke Gerald S. 
Published: November 2003

AbstractThe goal of successfully transplanting the larynx has motivated researchers since the 1960s. Early laryngeal transplant techniques limited the donor larynx to 45 minutes of ischemia. In this study, a method of prolonged laryngeal preservation is employed in three canines. In vivo cold laryngeal perfusion with University of Wisconsin Solution (UWS) was performed. The larynx was removed and placed into cold storage in 4°C UWS. After 24 hours of storage, the same canines underwent laryngeal reimplantation. The animals were sacrificed 7 days after reimplantation. No evidence of necrosis or vascular insufficiency was identified histologically. The results indicate that canine larynges can be successfully reimplanted after 24 hours of preservation. Future studies will assess the application of this technique to laryngeal transplantation.
Deep Neck Infections in Children: A New Approach to Diagnosis and Treatment
Authors: Nagy Mark , Pizzuto Michael , Backstrom James , Brodsky Linda 
Published: November 2003

AbstractForty‐seven children presented with the diagnosis of a deep neck infection‐either cellulitis or abscess‐between January 1991 and July 1996. Forty‐four (94%) had contrast‐enhanced computed tomography (CT) imaging consistent with this diagnosis. Three patients with no CT scan had confirmation of an abscess at surgical drainage. Parenteral antibiotics alone were effective in the treatment of 24 of 47 infections (51%): seven parapharyngeal, one retropharyngeal, and 16 combined. By CT scan these infections represented cellulitis in 17 of 24 (71%), an abscess in three of 24 (13%), and incomplete abscess in four of 24 (17%). The average duration of hospitalization for this group was 4.8 days, with symptomatic improvement usually seen within 24 hours. Surgical drainage was performed on 23 of 47 infections (49%): three parapharyngeal, 17 combined, and three of unknown specific location. In 22 of these 23 children (96%), transoral drainage of the abscess was used as the primary surgical approach. In 21 of these 22 (95%) there was complete resolution without complications or recurrence; one abscess required a subsequent external approach. CT scanning with contrast revealed that all deep neck infections were located medial (usually anteromedial) to the great vessels. Abscesses with volumes estimated to be greater than 2000 mm3 were more likely to undergo surgery, but these differences were not statistically significant. The use of contrast‐enhanced CT scanning provides information regarding abscess size, location, and relative position of the great vessels for safe and successful transoral drainage. Thus we recommend CT‐assisted transoral drainage for combined retropharyngeal/parapharyngeal abscesses and selected isolated parapharyngeal abscesses that do not respond to parenteral antibiotics.
Characterization of Smoking‐Induced Nasopharyngeal Lymphoid Hyperplasia
Authors: Finkelstein Yehuda , Malik Zvi , Kopolovic Juri , Bernheim Jöelle , Djaldetti Meir , Ophir Dov 
Published: November 2003

AbstractThe frequency of smoking‐induced nasopharyngeal lymphoid hyperplasia in heavy smokers and its potential clinical implications are still unknown. Precise criteria to differentiate this entity from other types of nasopharyngeal lymphoid hyperplasia are needed. A prospective clinicopathological study of smoking‐induced nasopharyngeal lymphoid hyperplasia was conducted in 17 heavy smokers. Ten nonsmoking patients, five of them with chronic sinusitis, three with adult‐onset adenoid hypertrophy, and two children with adenoidal hypertrophy served as a control group. Both in smokers and in nonsmokers, lymphocytic infiltration of the mucosa was characterized immunohisto‐chemically as T cells. In smokers, semithin (1 micron) sections revealed deformed and migrating cytotoxic lymphocytes in the nasopharyngeal mucosa. The lymphocytes were attached to epithelial, ciliated, and goblet cells, resulting in cell damage. Transmission electron microscopy of biopsies from smokers revealed emperipolesis, characterized by mucosal invasion and epithelial cell damage by an unusual population of migrating T lymphocytes that penetrate them. These findings confirm a direct effect of smoking on the nasopharyngeal lymphoid tissue, which forms part of the immune system. It is concluded that the diagnostic evaluation and therapeutic approach of heavy smokers with otological and airway symptoms should be based on thorough endoscopic examination of the nasopharynx. When the diagnosis is not clear‐cut, selective tele‐endoscopic biopsy and electron microscopic examination are recommended. This entity should be added to the list of known clinical manifestations of the smoking habit.
Overlay Versus Underlay Tympanoplasty. Part I: Historical Review of the Literature
Authors: Rizer Franklin M. 
Published: November 2003

AbstractThe history of otology is the history of the successful treatment of infections of the middle ear and the eardrum. Otologists have sought to restore hearing lost to infections of the eardrum since the 1600s. The development of instruments, techniques, and materials to treat infection is fascinating because of the serendipitous nature of the discoveries and the insight of the discoverers. This historical review describes the history of the treatment of infections of the ear and the development of modern techniques of ear surgery. Two contemporary methods of tympanic membrane repair are then described.
Practice of Otolaryngology via Telemedicine
Authors: Blakeslee Don B. , Grist William J. , Stachura Max E. , Blakeslee Betsey S. 
Published: November 2003

AbstractTeleotolaryngology is becoming a reality as a result of improvements in technology and telecommunications. This prospective, clinical trial was designed to demonstrate the utility of three telemedicine systems in an otolaryngology practice. Optel is a desktop system used in the office. Picasso is a mobile system used from various locations throughout the hospital. The Georgia Statewide Telemedicine Program (GSTP) is a large, sophisticated system used from a fixed site within a rural hospital. Patients with a wide variety of ear, nose, and throat problems were presented to consultants at two medical teaching centers in Georgia. Fifty‐four consults were completed over a 24‐month period. In addition, three teleconsultations demonstrated enhanced capabilities for continuing medical education (CME) and health care networks. Nine different specialty fields were accessed by the otolaryngologist. Five consults were completed via the Optel system; 13 via the Picasso system; and 36 via GSTP. Overall, teleotolaryngology provided quality audio and visual communication between the physicians that significantly improved diagnostic capabilities and treatment options for the patient.
Histologic Study of Oral Mucosa Wound Healing: A Comparison of a 6.0‐ to 6.8‐µm Pulsed Laser and a Carbon Dioxide Laser
Authors: Bryant Grady L. , Davidson Jeffrey M. , Ossoff Robert H. , Garrett C. Gaelyn , Reinisch Lou 
Published: November 2003

AbstractIncisional wound healing in the canine oral mucosa was histologically monitored at 3, 7, and 14 days after incision. Healing was compared from a scalpel, a carbon dioxide (CO2) laser at 10.6µm, and the Vanderbilt free‐electron laser tuned to 6.0, 6.45, and 6.8µm. A significant delay in wound healing was observed when incisions were made with the CO2 laser, probably attributable to the excess thermal damage caused by the continuous‐wave laser beam. When using the short pulsed, free‐electron laser, a much smaller delay comparable to the scalpel wound healing was observed. This smaller delay tended to decrease with increasing tissue absorption. The results emphasize the greater importance of laser pulse duration rather than wavelength in relation to the subsequent wound healing.
Vocal Fold Augmentation by Injection of Autologous Fascia
Authors: Rihkanen Heikki 
Published: November 2003

AbstractVocal fold augmentation by injection under direct visual control is a quick and simple operation. However, when autologous fat or bovine collagen is used, resorption creates a problem. The low metabolic requirements and the relatively stable histologic character of free fascial grafts make autologous fascia a fascinating material in vocal fold augmentation. This research project was carried out to establish a suitable method to transplant fascia into a vocal fold and to assess its impact on the voice. A piece of fascia lata was chopped with a scalpel. The material was injected in the lateral aspect of the thyroarytenoid muscle using a pressure syringe. Nine subjects with a paralyzed vocal fold were analyzed after the injection. The postoperative voice, rated by a panel of experienced listeners, was significantly better than the preoperative (
P
< 0.05). Five of nine voices were rated normal or near normal after the procedure. The mean maximal phonation time increased significantly (
P
< 0.01). All patients considered that their voice had improved, and eight of nine regarded it as good. No one reported deterioration of the result during the follow‐up (mean duration, 10 months; range, 3 to 18 months).
Postnatal Persistence of Epidermoid Rests in the Human Middle Ear
Authors: Levine Jonathan L. , Wright Charles G. , Pawlowski Karen S. , Meyerhoff William L. 
Published: November 2003

AbstractIt is widely believed that congenital cholesteatoma originates from epidermoid cell rests in the temporal bone. Congenital cholesteatomas of the anterior‐superior middle ear may arise from such a rest, known as the
epidermoid formation (EF), which has been described by Michaels and others. The EF is thought to disappear by 33 weeks' gestation in most cases; however, if it persists beyond fetal life, it may provide a nidus for cholesteatoma formation. The authors studied human temporal bones from individuals ranging from 20 weeks' gestation to 5 years of age to investigate pre‐ and postnatal occurrence of the EF. A total of 106 temporal bones were surveyed; 76 of these were fetal specimens and 30 were postnatal. EFs were present in 14 (18.4%) of the fetal specimens; they were identified in four(13.3%) of the postnatal temporal bones, with the oldest being 2 years, 7 months of age. Multiple EFs within a single temporal bone were also present in some cases. Although the EFs were composed of cells morphologically identical to those of the external ear canal epidermis, none of the specimens showed keratinization. These findings support the contention that EFs do occasionally persist into postnatal life and may be a source of cholesteatoma. However, a clear transition from epidermoid formation to unequivocal cholesteatoma has not yet been demonstrated.
Myringotomy: A Prerequisite for the Development of Myringosclerosis?
Authors: Mattsson Cecilia , Magnuson Karin , Hellström Sten 
Published: November 2003

AbstractStreptococcus pneumoniae
was inoculated into the left middle‐ear cavity in two groups of rats, resulting in purulent otitis media. After 3 days, one group of infected animals and a third group of noninfected animals were subjected to left‐sided myringotomy. The tympanic membranes were examined both otomicroscopically and histologically 1 and 3 months later. On otomicroscopic examination the noninfected myringotomized animals had developed extensive myringosclerotic lesions, whereas only minimal sclerotic deposits were noted in the myringotomized animals with acute otitis media (AOM). On histologic examination both the noninfected myringotomized animals and the myringotomized animals with AOM were similar in the frequency and extension of sclerotic lesions in the tympanic membrane. The nonmyringotomized rats with AOM were free of sclerotic lesions, except for minor changes found in one animal.
Use of Antibiotic Prophylaxis in Ear Surgery
Authors: Govaerts Paul J. , Raemaekers Jan , Verlinden Arnout , Kalai Moulud , Somers Thomas , Offeciers F. Erwin 
Published: November 2003

AbstractA prospective, double‐blind, randomized, placebo‐controlled study was performed to evaluate the effect of antibiotic prophylaxis in ear surgery. The present study reports on the results of 750 patients, half of whom received cefuroxime for 1 day, the other half, placebo. All postoperative infections occurring within 2 weeks after the intervention were recorded, together with several preoperative and perioperative parameters. It is concluded that exploratory tympanoplasties (including stapedotomy) and “dry perforation” tympanoplasties should be considered “clean” operations according to the American National Research Council and do not benefit from antibiotic prophylaxis. On the other hand, tympanoplasties performed on draining ears and on ears with cholesteatoma should be considered “dirty” operations for which antibiotic prophylaxis may decrease the postoperative infection rate by factor 3. All postoperative infections healed without sequels under proper treatment, except for three that resulted in graft necrosis‐one in the placebo group and two in the cefuroxime group. In consequence, prophylaxis may not be mandatory in the dirty group, although the authors advocate its use for the sake of patient and surgeon comfort.
Expression of Human Papillomavirus 6 in Inverted Papilloma Arising in a Renal Transplant Recipient
Authors: Harris Monte O. , Beck Jill C. , Terrell Jeffrey E. , McClatchey Kenneth D. , Carey Thomas E. , Bradford Carol R. 
Published: November 2003

AbstractA 36‐year‐old renal transplant recipient taking cyclosporin A presented with bilateral nasal polypoid lesions involving the nasal septum and lateral nasal walls. Pathologic findings from surgical excision demonstrated inverted papilloma (IP) with focal atypia and mild dysplasia. DNA extracted from the tissue was tested with the polymerase chain reaction (PCR) using human papillomavirus (HPV) E6 and L1 consensus primers. This revealed amplification of the expected size fragment consistent with the presence of HPV DNA. Hybridization of PCR products with HPV type‐specific oligonucleotide probes revealed a strong signal with only HPV 6. This result was confirmed by PCR amplification with HPV 6 type‐specific primers. RNA extracted from the tissue was subjected to reverse transcription PCR (RT‐PCR) with a primer pair specific for viral E6/E7 transcripts. The HPV early proteins, E6 and E7, are the transforming proteins implicated as critical for tumorigenesis. RT‐PCR experiments generated products representing the E1/E4 spliced transcript originating from the E6/E6 promoter and a smaller unclassified fragment. These results provide evidence for HPV 6 E6/E7 expression in IP, lending credence to the concept that HPV may play a role in the origin of this neoplasm. Histologically normal nasal tissue from the same patient contained HPV DNA and similar transcripts to those described in the IP specimen.
Long‐term Results of Functional Endoscopic Sinus Surgery
Authors: Senior Brent A. , Kennedy David W. , Tanabodee Jirayu , Kroger Hans , Hassab Mohammed , Lanza Donald 
Published: November 2003

AbstractAlthough much has been reported on the short‐term outcomes of functional endoscopic sinus surgery (FESS), little has been reported with regard to its long‐term impact on chronic sinusitis. The senior author (D.W.K.) previously reported detailed subjective and endoscopic follow‐up on 120 patients at a mean of 18 months following surgery. This current study represents a long‐term follow‐up (average, 7.8 years) of 72 patients (60%) from the same cohort. Of patients responding to a question about overall symptoms, 98.4% (n = 66) reported improvement compared with before surgery. There was a trend toward continued subjective improvement in symptom scores with longer follow‐up, but the changes did not reach statistical significance. Thirteen patients (18%) required subsequent surgical procedures. Preoperative stage, prior surgery, and other factors that might affect outcome were evaluated. The study demonstrates that excellent subjective results following FESS can be maintained in the long term with appropriate postoperative management. The study also validates the concept that patients in whom the cavity can be normalized following surgery are unlikely to require further surgery
Long‐term Compliance of Laryngectomized Patients With a Specialized Pulmonary Rehabilitation Device
Authors: Ackerstaff Annemieke H. , Hilgers Frans J.M. , Balm Alfons J.M. , Tan I. Bing 
Published: November 2003

AbstractPrevious studies have demonstrated the positive effect of a heat and moisture exchanger (HME) on the respiratory system in patients after laryngectomy. However, patient compliance with these devices was reduced by device‐related problems and troublesome combination with a voice prosthesis. Recently a more specialized device has become available. This is an HME combined with a valve for easy digital occlusion of the stoma (Provox Stomafilter; Hörby, Sweden). In the authors' initial study of this revised device, a clear improvement in short‐term compliance was demonstrated. To investigate long‐term compliance, 69 consecutive patients were interviewed by means of a structured questionnaire. The results show that all patients expressed their satisfaction with the valve used for digital occlusion of the stoma. Sixty‐three percent of the patients reported that voicing was facilitated. Subjective intelligibility improved in 55% of the patients. Previous problems with other devices(e.g., plaster adherence, skin irritation, and handling) were clearly diminished, increasing the long‐term compliance of the patients to 78%. This new HME can be considered as a beneficial pulmonary rehabilitation tool for laryngectomized patients.
Prognostic Value of Histopathologic Parameters and DNA Flow Cytometry in Squamous Cell Carcinoma of the Pyriform Sinus
Authors: Del Valle‐Zapico Adolfo , Fernández Fidel Fernández , Suárez Antonio Rubio , Angulo Carmelo Morales , Quintela Julio Rama 
Published: November 2003

AbstractA retrospective study of a group of 51 patients who underwent surgery for squamous cell carcinoma of the pyriform sinus was performed. Primary tumors and lymph nodes were reviewed histologically. The primary tumors were also examined by flow cytometry for DNA ploidy and cell cycle analysis. Sixteen (33%) of the cases were aneuploid and 64% had a moderate or high S‐phase fraction. The overall 3‐year survival rate was 49% (25/51). In the univariate analysis, tumor size, lymphatic invasion, inflammatory infiltrate, presence of lymph node metastases, clinical and histologic N status, size and number of lymph nodes involved, and presence of extracapsular extension all correlated with survival. When multivariate analysis was used, the only independent prognostic factors were tumor size, lymphatic invasion, and histologic N status. Ploidy and S‐phase fraction did not contribute further prognostic information.
Vestibular Stimulation by Multichannel Cochlear Implants
Authors: Bance Manohar L. , O'Driscoll Martin , Giles Ellen , Ramsden Richard T. 
Published: November 2003

AbstractThe recipient of a Nucleus 22 multichannel cochlear implant began to experience severe vestibular stimulation related to the implant. This patient's experience initiated a study with the objective of determining the frequency of implant‐related vestibulo‐ocular stimulation. Subjects consisted of 17 randomly selected patients who use cochlear implants. Included in the study were 14 Nucleus 22 and three Med‐El Combi 40‐devices. Stimulation of the implants was performed both by individual channel and with sound field broad‐band 80‐dB noise using the users' normal device settings. Eye movements were monitored with infrared videonystagmography. Only one subject, who used a Med‐El Combi 40, showed a consistent and strong ocular response to cochlear stimulation but had no subjective symptoms. The authors conclude that vestibulo‐ocular activation is possible with multichannel cochlear implants but is infrequent and may not be clinically significant.
Combined Epstein‐Barr Virus and Human Papillomavirus Infection in Nasopharyngeal Carcinoma
Authors: Rassekh Christopher H. , Rady Peter L. , Arany Istvan , Tyring Stephen K. , Knudsen Sharen , Calhoun Karen H. , Seikaly Hadi , Bailey Byron J. 
Published: November 2003

AbstractEpstein‐Barr virus (EBV) has been shown to be a likely etiologic agent in nasopharyngeal carcinogenesis. Human papillomaviruses (HPVs) have previously been identified in numerous upper aerodigestive tract carcinomas. This pilot study was undertaken to investigate the prevalence of combined EBV and HPV infection in 17 patients with nasopharyngeal carcinoma (NPCA) using polymerase chain reaction (PCR). The primary goal was to determine if the presence of HPV could be correlated with molecular, histologic, or clinical parameters. There were seven patients with undifferentiated NPCA (World Health Organization [WHO] type III) and 10 patients with squamous cell carcinoma (WHO type I). All 17 patients had stage IV disease at presentation. EBV was identified in 15 patients (88.2%), and HPV subtypes were identified in samples from nine patients (52.9%). All HPV‐positive cases were also EBV positive. Western blot analysis of six samples showed a high level of expression of c‐myc and cdc2 kinase and a low level of p53 protein in NPCAs that contained both HPV and EBV (n = 3). Increased expression of c‐myc and cdc2 kinase was seen in the cases that contained EBV only, but to a lesser extent (n = 2). These findings indicate an effect of the virus on cellular proliferation and differentiation. Similarly, an elevated level of Rb protein was found only in the HPV‐containing NPCAs. Moderate differentiation (keratinization) occurred in four of eight HPV‐negative and none of the nine HPV‐positive NPCAs. (All HPV‐positive cases were poorly differentiated or undifferentiated.) This difference is statistically significant for this sample size (P < 0.03). There was a trend for the group that was HPV positive to have WHO III histology and for the HPV‐negative group to have WHO I. The presence of HPV could not be correlated with any clinical parameters in this small group of patients with advanced disease; however, these data suggest that coexistence of EBV and HPV infection may be a factor in the pathogenesis of NPCA and may have an effect on regulation of cellular proliferation and differentiation.