bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lateral Dural Sinus Thrombosis in Childhood
Authors: Holzmann David , Huisman Thierry A.G.M. , Linder Thomas E. 
Published: November 2003

AbstractObjectives: To present etiology, diagnosis, and treatment of dural sinus thrombosis (DST) in children. To discuss the diagnostic role of contrast‐enhanced computed tomography (CECT) and to evaluate the controversial treatment modalities of anticoagulation, surgical drainage of the infected sinus, and ligation of the internal jugular vein (IJV).Study Design: Retrospective chart review and analysis of computed tomography (CT) scans and follow‐up visits to document the clinical outcome.Methods: Between 1986 and 1996, CT scans of 15 children revealed DST. These patients were further investigated.Results: The etiology could be divided in three groups: group A, infection (6); group B, trauma (6); and group C, coagulation disorders. There were neither symptoms nor clinical findings specifically related to DST but rather, these were related to the underlying disease or condition (otitis media, skull base fractures). Diagnosis was made by CECT in all cases. Fusobacterium necrophorum was found in 4 of 6 patients in group A. Early mastoidectomy with incision and drainage of the thrombosed sigmoid sinus was performed in patients in group A. Postoperative intravenous (IV) heparin was given; however, no ligation of the IJV became necessary. In all patients in group C, protein C or protein S deficiency, or both, was detected.Conclusions: CECT with adequate window‐level settings allows the diagnosis of a DST with high sensitivity. Treatment of choice for septic DST consists of administration of antibiotics and early surgical drainage. We recommend anticoagulation therapy in children with septic DST during their hospitalization.
Vocal function after vertical partial laryngectomy with glottic reconstruction by false vocal fold flap: Durational and frequency measures
Authors: Biacabe Bernard , Crevier‐Buchman Lise , Hans Stéphane , Laccourreye Ollivier , Brasnu Daniel 
Published: November 2003

AbstractObjective: Compare vocal function following vertical partial laryngectomy (VPL) with or without glottic reconstruction by false vocal fold (FVF) mucosal flap. Study Design: Twenty‐seven patients with T1a squamous cell carcinoma (SCC) of the glottis were included in a prospective randomized clinical study. All patients were treated by frontolateral partial laryngectomy (FLPL). Glottic reconstruction with FVF mucosal flap was performed in 14 patients at the time of the FLPL, whereas 13 patients had standard FLPL. Methods: Objective voice assessment was based on computerized acoustic recordings performed before and 1 year after surgery. When possible, additional recordings were performed at 3 months, 6 months, and 2 years postoperatively. Incidence of postoperative granuloma and anterior neoglottic web were noted. Repeated analysis of variance (ANOVA) was used to compare the durational (maximum phonation time, speech rate) and frequency measurements (average fundamental frequency [Fo], standard deviation of Fo, jitter, shimmer, noise‐to‐harmonics ratio, degree of voice breaks) between patients with or without glottic reconstruction, postoperative granuloma, and anterior neoglottic web. Linear regression was used to study the evolution over time of the durational and frequency measurements. Results: Frequency measurements improved with time and were significantly better in patients treated with glottic reconstruction. In addition, glottic reconstruction decreased incidence of postoperative granuloma and anterior neoglottic web. Conclusions: The FVF mucosal flap technique can improve vocal results in selected cases of T1a SCC of the glottis when FLPL is the adequate surgical treatment.
Anatomical and theoretical observations on otolith repositioning for benign paroxysmal positional vertigo
Authors: Buckingham Richard A. 
Published: November 2003

AbstractObjective: To determine if there is an anatomic basis for the assumption that loose, “rogue” otoliths presumed to arise from the utricular macula and theorized to cause benign paroxysmal positional vertigo (BPPV) by impinging on semicircular canal ampullae could be returned to their original site by a series of changes in the position of the head called particle repositioning maneuvers (PRMs). Further, if such otolith movement were possible, once they were replaced into the utricle, would they adhere to the utricular macula? Study Design: Kodachrome photographs of 2‐mm‐thick macrosections of human temporal bones were available for evaluation. The bones were sectioned in horizontal, coronal, and sagittal planes. Rice grains were placed on the photographs of the cross‐sections to demonstrate the possible paths taken by loose otoliths under the influence of gravity in different positions of the head. Results: A study of cross‐sections of the temporal bone shows that loose macular otoliths after PRMs would tend to fall into the lumen of the utricle. Once the patient assumes the erect position, however, repositioned otoliths would tend to fall into the near or utriculopetal side of the cupula of the posterior semicircular canal, which opens directly into the inferior portion of the utricle, and could cause labyrinth stimulation and BPPV by the same mechanism of misplaced otoliths on the opposite or far side of the cupula. Loose otoliths in the utricle could also stimulate the horizontal ampullae. Conclusions: PRMs do not remove or fix otoliths in any specific site in the labyrinth. Repositioning of loose otoliths onto the original site in the macula of the utricle, which lies superiorly in the vestibule, could not be accomplished by any of the repositioning maneuvers. If otoliths were to be repositioned on the utricular macula, there is no evidence that the otoliths would adhere to the macula when the patient assumes the erect position. The good results obtained by physiotherapeutic procedures suggest that some other mechanism than repositioning of otoliths is responsible for the relief of BPPV.
Bone modeling dynamics in acute otitis media
Authors: Cayé‐Thomasen Per , Hermansson Ann , Tos Mirko , Prellner Karin 
Published: November 2003

AbstractObjective: A number of middle ear diseases are associated with pathologic bone modeling, either formative or resorptive. As such, the pathogenesis of a sclerotic mastoid has been controversial for decades. Experimental studies on acute middle ear infection have shown varying degrees of both osteoresorption and osteoneogenesis. This study presents data on the dynamics of bone modeling in a rat model of acute pneumococcal otitis media, studied longitudinally from day 1 through 6 months after inoculation. Results: Qualitative, as well as quantitative histopathology revealed initial osteoresorption, followed by increasing apposition of new bone in the middle ear cavity, initiated at the outer periosteum. Measured bone thickness in four anatomically distinct locations peaked 3 months after inoculation, followed by some degree of normalization. However, bone thickness was still massively increased 6 months after the acute incident. Except in perilymphatic spaces of the otic capsule, resorptive and formative activity were found in all bone tissue structures surrounding the middle ear cavity, including the bony external auditory canal and the ossicles. Conclusion: These findings may support the existence of a perilymphatic barrier of specialized bone and suggest that even a single episode of acute infection may alter properties of ossicular chain conduction. The authors conclude that acute otitis media is accompanied by massive and progressing net osteoneogenesis, already evident at 3 days and peaking 3 months after inoculation, followed by some degree of normalization. This is conceivably in support of the environmental theory of mastoid pneumatization, claiming inflammatory disease as the cause of a sclerotic mastoid.
Prevalence of meniere disease in finland
Authors: Kotimäki Jouko , Sorri Martti , Aantaa Eero , Nuutinen Juhani 
Published: November 2003

AbstractObjectives: To assess the prevalence of Meniere disease in the population of 5 million in Finland according to the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology—Head and Neck Surgery (AAO‐HNS) recommendation. Study Design: Retrospective investigation based on patient records of 306 patients treated for Meniere disease and recognized as such according to the International Statistical Classification of Diseases and Related Health Problems (ICD‐9 or ICD‐10) in seven Finnish hospitals serving a population of 1.5 million people. Methods: Patients were selected from the computerized patient registers of outpatients and inpatients having received an appropriate diagnosis during the period from 1992 to 1996 and re‐evaluated. Definite cases according to AAO‐HNS guidelines were identified to calculate the prevalence of Meniere disease in Finland at the end of 1996. ReRults: A total of 131 definite cases of Meniere disease were identified. The prevalence of at least 43 per 100,000 and an average annual incidence of 4.3 per 100,000 were obtained. The prevalence turned out to be higher (P < .001) in Northern areas (49/100,000) than in the south (38/100,000). The prevalence did not differ in the areas of university hospitals (44/100,000) from those of central hospitals (42/100,000). Conclusions: The prevalence and incidence in Finland is lower than could be expected from previous international surveys, most of which provide inadequate data for forming a real picture of the epidemiology of Meniere disease. Uniform diagnostic criteria are indispensable for further research.
Association of vascular endothelial growth factor expression with angiogenesis and lymph node metastasis in nasopharyngeal carcinoma
Authors: Wakisaka Naohiro , Wen Qing‐Hua , Yoshizaki Tomokazu , Nishimura Toshiro , Furukawa Mitsuru , Kawahara Ei , Nakanishi Isao 
Published: November 2003

AbstractObjective: Recent experimental evidence indicates that angiogenesis affects tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is considered to be an important regulator of tumor angiogenesis. The present study was designed to examine the role of VEGF on angiogenesis and lymph node metastasis in primary nasopharyngeal carcinomas (NPCs). Study Design: Formalin‐fixed paraffin‐embedded biopsy specimens were obtained from 29 primary NPCs that consisted of 22 differentiated nonkeratinizing carcinomas and seven undifferentiated carcinomas. Methods: Microvessels were highlighted by staining endothelial cells with von Willebrand factor (VWF) using immunohistochemical techniques, and were counted (per × 400 field) in the most active area of angiogenesis on light microscopy. The expression of VEGF was also studied with immunohistochemistry. Positive ratio for VEGF was graded on a scale of 1 and 2. Scale 1 represents patients with less than the mean value of the positive ratio, and scale 2 represents patients with more than the corresponding value. Results: There was a significant correlation between increased microvessel count and the progression of regional lymph node involvement. The microvessel counts and the progression of N factor were significantly higher in scale 2 patients than in scale 1 patients. Conclusion: These results suggest that VEGF plays an important role in lymph node metastasis through induction of angiogenesis in NPCs.
Botulinum toxin: Adjunctive treatment for posterior glottic synechiae
Authors: Nathan Cherie‐Ann O. , Yin Shengguang , Stucker Fred J. 
Published: November 2003

AbstractIntroduction: Synechiae formation of the posterior glottis can result in tracheostomy dependence secondary to airway obstruction. Stenosis is caused by total or partial fixation of the vocal folds in adduction resulting from scar contracture. The treatment poses a management dilemma because of recurrent scar formation, made worse by mobility of the vocal folds. Although various treatment options from conservative endoscopic repair to open procedures have been proposed, the results are not satisfactory and patients often require multiple procedures. Methods: We present the trial of a conservative approach that includes microscopic CO2 laser resection of the scar with concomitant botulinum toxin injection of the interarytenoid and thyroarytenoid muscles of the more mobile cord. This results in a temporary paresis of the adductor muscles and hence prevents overadduction in the posterior commissure during the postoperative healing period. Study Design: We present the surgical technique and results in three patients who underwent the procedure. Results: Treatment in all three patients was successful. Conclusions: The appropriate use of botulinum toxin may help improve the treatment outcome of posterior synechiae of the larynx without sacrificing any laryngeal components. Key Words: Larynx, stenosis, botulinum toxin.
Zenker's diverticulum: Analysis of surgical complications from diverticulectomy and cricopharyngeal myotomy
Authors: Feeley Marc A. , Righi Paul D. , Weisberger Edward C. , Hamaker Ronald C. , Spahn Thomas J. , Radpour Shokri , Wynne Michael K. 
Published: November 2003

AbstractObjective: To identify risk factors for postoperative complications in patients undergoing diverticulectomy and cricopharyngeal (CP) myotomy for Zenker's diverticulum. Study Design: Retrospective. Materials and Methods: A chart review was conducted of all patients with a Zenker's diverticulum who were treated with diverticulectomy and cricopharyngeal myotomy at three tertiary care centers in central Indiana between 1988 and 1998. Results: Of the 24 patients identified, 9 developed postoperative complications (2 medical and 7 surgical). Statistical analysis of multiple potential risk factors revealed that only diverticulum size greater than 10 cm2 at surgery placed the patient at increased risk for postoperative surgical complications. To our knowledge, this is the first report that has specifically addressed diverticulum size as an independent risk factor for postoperative surgical complications following diverticulectomy and CP myotomy. Conclusions: Given our findings, we recommend considering diverticulopexy rather than diverticulectomy in a patient with a Zenker's diverticulum greater than 10 cm2 in size if a cervical approach is the selected treatment. Key Words: Zenker's diverticulum, cricopharyngeal myotomy, surgical complications, diverticulectomy.
Magnetic resonance navigation for head and neck lesions
Authors: Davis Shane P. , Anand Vinod K. , Dhillon Gurmeet 
Published: November 2003

AbstractObjective: Review applications of interventional magnetic resonance imaging and describe methods, procedures, and additional instrumentation for the magnetic resonance “operating theater.” Describe advantages of magnetic resonance navigation for biopsies of head and neck tumors. Study Design: Patients with palpable and nonpalpable head and neck and cranial base tumors were recruited into the study. Patients underwent magnetic resonance–guided biopsy. Retrospective analysis of 21 patients was conducted. Methods: 0.5 Tesla superconducting open magnetic resonance imaging was used for navigation of the biopsy needle. Patient records and magnetic resonance images were reviewed. The type, size, and location of the lesions were tabulated. Type of anesthesia and monitoring method were analyzed. The histopathologic correlation was conducted in patients who required further surgeries or open surgical biopsies. Results: Twenty‐two biopsies were carried out in the magnetic resonance suite. One patient required general anesthesia and the other biopsies were conducted under intravenous sedation. There was only one case of nonconcurrence in a patient with Wegener's granulomatosis of the posterior orbit. Overall, a 92% concurrence rate between image‐directed fine‐needle aspiration, open biopsy, and surgical therapy was encountered. No complications occurred. Conclusions: The use of interventional magnetic resonance imaging to assist with fine‐needle aspiration core biopsy has made the biopsy procedure safer and more accurate. Potentially morbid and disfiguring surgeries have been avoided in some patients. Deeper lesions have been more easily approached, as the needle for biopsy is under constant magnetic resonance guidance. Improved visualization for critical structures allows safer performance of biopsies. The primary difficulties of open magnetic resonance imaging relate to the need for nonferromagnetic instrumentation and equipment and their high costs. An inverse relationship exists between the imaging quality and the “dead time” required to acquire images. Key Words: Interventional magnetic resonance imaging, fine‐needle aspiration, head and neck tumors.
Effect of photodynamic therapy on the critical primary ischemic time of fasciocutaneous flaps
Authors: Belmont Michael J. , Marabelle Nicole , Mang Thomas S. , Wax Mark K. 
Published: November 2003

AbstractBackground: Photodynamic therapy (PDT) may be used as an adjuvant intraoperative therapy to improve locoregional control. PDT has been shown to delay wound healing. This raises concern about PDT's effect on survival of fasciocutaneous flaps. Objective: Evaluate the effect of 1) PDT on the critical ischemic time in a rat fasciocutaneous flap model and 2) photosensitizer activation by the surgical light source. Design: A fasciocutaneous flap, based on the left inferior epigastric vessels, was used. Ischemic times of 2, 4, 6, 8, 10, and 12 hours were induced by clamping the vascular pedicle. Animals were randomly divided into five groups: ischemia only, group I; light treatment to wound bed, group II; Photofrin before surgery with the flap elevated without a fiber optic head light, group III, or with a headlight, group IV; Photofrin prior to surgery with light treatment to the wound bed, group V. Flap survival was assessed on postoperative day 7. Results: The critical primary ischemic time of group V (PDT) was significantly less (P < .05) than groups I, II, III, and IV. There was no statistical difference in the critical primary ischemic time when a fiber optic headlight was used (group III vs. group IV). Conclusion: Intraoperative PDT significantly reduces the critical primary ischemic time of the rat fasciocutaneous flap. White light illumination of the operative field does not result in photosensitizer activation and has no effect on the critical primary ischemic time.
Postoperative care in functional endoscopic sinus surgery?
Authors: Fernandes Sylvester Valentine 
Published: November 2003

AbstractObjective: To assess the value of nonintervention after FESS. Study Design: Prospective study. Methods: Fifty‐five patients with diagnosed chronic rhinosinusitis who failed adequate medical therapy were subjected to FESS. No postoperative care, apart from nasal douching with hypertonic saline after the tenth postoperative day, was done. No antibiotics or steroids were administered routinely. Because 10 patients were not available for follow‐up, only 45 patients were included in the study. Results: Success rate judged by at least 50% subjective improvement of symptoms was 95.5%. However, all patients derived some benefit. The occurrence of postoperative synechiae is discussed. Conclusions: The usefulness of postoperative care of the FESS cavity needs reappraisal. Key Words: Postoperative care in FESS, functional endoscopic sinus surgery, FESS.
Breaking the Bad News of Cancer: The Patient's Perspective
Authors: Kim Michael K. , Alvi Aijaz 
Published: November 2003

AbstractObjective: Head and neck cancers present a special challenge to the patient and the physician because they affect the quintessential aspects of living such as breathing, eating, and speaking. Numerous articles have described how the physician should perform the difficult task of conveying bad news, but only a small number of articles specifically assess the patients' perceptions when being told of a serious diagnosis. The purpose of this survey was to evaluate the thoughts and concerns of patients receiving diagnoses of head and neck cancer. Study Design: Questionnaire survey. Methods: A 41‐item questionnaire was sent to head and neck cancer patients who have been treated for and remain free of disease for at least 2 years. Results: All of the respondents felt that their diagnosis was adequately explained to them and that no further explanations were necessary. Eighty‐one percent of the respondents did not wish to have anyone else present at the time of diagnosis. Additionally, 75% of the respondents did not want the physician to touch their hands or hug them when given the bad news. Only 63% of the respondents had further discussions with family, friends, or other physicians after being told of their diagnosis. Conclusion: When patients are told of the diagnosis of head and neck cancer, they want their physician to be truthful, caring, and compassionate. The patients want their diagnosis in simple and direct terms without the incorporation of complex medical terminology. The results of this survey can provide insightful information to physicians when they are undertaking the difficult task of conveying bad news to their patients.
Preoperative Antibiotics and Steroids in Vestibular Schwannoma Excision
Authors: Welling D. Bradley , Thomas Robert , Slater Patrick , Daniels Robert L. , Goodman Joseph H. 
Published: November 2003

AbstractObjective: To examine the benefits of preoperative admission for intravenous steroids and antibiotics for patients undergoing vestibular schwannoma excision. Study Design: Retrospective cohort study. Methods: One hundred twenty patients with pathologically confirmed vestibular schwannoma followed for at least 1 year after surgery were included. Sixty patients were assigned to the preoperative admission group and 60 patients to the same‐day‐admission surgery group. The preoperative admission group was given intravenous dexamethasone (0.1 mg/kg) and intravenous cefazolin (1 g) beginning 12 hours before surgery. The same‐day‐surgery group received the same dosage of medication beginning at induction of anesthesia. Outcomes: Facial nerve function, meningitis, and wound infection rates, duration of hospital stay, and readmission rates were examined. Results: There was no statistical difference in facial nerve function between the groups when controlling for tumor size. Likewise, there was no difference in meningitis or wound infection rates in the groups. As expected, hospital stay was significantly reduced but readmission rates were not affected. Conclusions: There are no apparent facial nerve function or infection control benefits to 1‐day preoperative admission for intravenous steroids and antibiotics for patients undergoing vestibular schwannoma excision.
Nasal Stuffiness During Pregnancy
Authors: Bende Mats , Gredmark Thomas 
Published: November 2003

AbstractObjective: To investigate the occurrence of nasal stuffiness during pregnancy. Study Design: Prospective longitudinal study, with collection of data during 1 year in a cohort of 2,264 pregnant women. Methods: Self‐reported nasal stuffiness in gestational weeks 12, 20, 30, and 36 was correlated to age, parity, body mass index, and smoking habits. Results: The prevalence of nasal stuffiness increased during pregnancy and occurred in 27% of the women at 12 weeks of gestation, in 37% at 20 weeks, in 40% at 30 weeks and in 42% at 36 weeks. Sixty‐five percent of the women reported stuffiness at some time when asked. It was commoner in multiparous than in nulliparous women. Age, body mass index, and smoking habits were not associated with nasal stuffiness. Conclusion: Self‐reported nasal stuffiness for 3 or more weeks was common during pregnancy and could occur at any time in two thirds of the women. Treatment regimens to alleviate this symptom should be developed.