bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Adductor Muscle Stimulation on Speech in Abductor Spasmodic Dysphonia
Authors: Bidus Kimberly A. , Thomas Giovana R. , Ludlow Christy L. 
Published: November 2003

AbstractObjective To determine whether adductor laryngeal muscle stimulation might be a beneficial treatment alternative for abductor spasmodic dysphonia (ABSD).Study Design Baseline comparisons were made on measures of voiceless consonant and syllable duration between patients with ABSD and normal control subjects, and speech and voice production with and without muscle stimulation were compared within 10 patients with ABSD.Methods Baseline group comparisons were conducted on measures of syllable and voiceless consonant duration between the patients and the control subjects. Neuromuscular stimulation was applied to the thyroarytenoid or lateral cricoarytenoid muscles in the patients during e‐tended phonation, and measures were made of fundamental frequency and sound pressure level in the stimulated and nonstimulated conditions. Voiceless consonant duration was compared with and without adductor laryngeal muscle stimulation during syllable repetitions and sentences in the patients.Results Before stimulation, the patients had increased syllable durations in comparison with control subjects (P = .003). Repeated within‐patient comparisons with and without stimulation demonstrated significant (P < .008) reductions in voiceless consonant durations during syllable repetition. The more severely affected patients had the greatest reductions in voiceless consonant duration during sentence production.Conclusions Adductor muscle stimulation improved speech production in patients with ABSD, and the improvement was greatest in the most severely affected patients. Therefore adductor muscle stimulation has potential for benefiting patients with ABSD.
Cartilage Tissue Engineering Using Thyroid Chondrocytes on a Type I Collagen Matrix
Authors: Wambach Beth A. , Cheung Herman , Josephson Gary D. 
Published: November 2003

AbstractObjective/Hypothesis Reconstructive procedures of the head and neck often require materials that offer long‐term structural support. A problem that many surgeons have encountered is identifying a material that offers this support without rejection of the implanted material. This has led many surgeons to prefer autologous cartilage. However, autologous cartilage is of limited supply. Cartilage tissue engineering has become a new modality that allows investigators to harvest a small piece of cartilage and extract its chondrocytes for expansion in culture. These chondrocytes are applied to a matrix that will act as a scaffold and allow for cartilage growth. Finding a compatible matrix seems to be the limiting step in the progress of this research. We describe a new approach of tissue creation using bovine collagen matrices as templates onto which cells are seeded.Study Design Laboratory research.Methods Chondrocytes obtained from thyroid cartilage of dogs were seeded onto bovine collagen type I matrices and grown in vitro. Chondrocyte seeded matrices were evaluated histologically.Results Thyroid chondrocytes expressed themselves phenotypically by producing type II collagen in the presence of this type I collagen matrix.Conclusions This study offers the preliminary findings on an exciting new type of matrix worth exploring in the ability to successfully engineer cartilage.
Histological Study of Injected Autologous Fascia in the Paralyzed Canine Vocal Fold
Authors: Rodgers Bret J. , Abdul‐Karim Fadi W. , Strauss Melvin 
Published: November 2003

AbstractObjective Several methods have been used for the treatment of the unilateral paralyzed vocal fold. Teflon injections have been used e‐tensively but not without complications. The ideal substance for injection is yet to be determined. Injected autologous fascia has been reported as a means of achieving glottic closure. In review of the literature, there are no long‐term results described using autologous fascia in this way. The purpose of this study was to e‐amine the histological changes of the laryn‐ after injection of autologous fascia into a paralyzed vocal fold.Study Design A prospective study with the contralateral side of the laryn‐ used as the control.Methods Si‐ adult dogs underwent severing of one of their recurrent laryngeal nerves. After the vocal folds were confirmed to be paralyzed by direct laryngoscopy, fascia lata that was harvested from the animal was minced and injected into the paralyzed vocal fold. The dogs were then killed at intervals ranging from 3 to 12 months and their larynges reviewed histologically.Results The larynges revealed muscle atrophy of the vocal fold, which is consistent with denervation, but there was no evidence of persistent fascia. In addition, there was no evidence of reaction to the injected fascia. Special stains for collagen were also performed which showed no significant change from the non‐injected vocal fold.Conclusion From this model, it is concluded that injected autologous minced fascia is not a good short‐ or long‐term substance for vocal fold augmentation. Further study is warranted to confirm this observation.
The Role of Fiberoptic Nasopharyngoscopy in the Management of the Acute Airway in Angioneurotic Edema
Authors: Bentsianov Boris L. , Parhiscar Afshin , Azer Marie , Har‐El Gady 
Published: November 2003

AbstractBackground Angioneurotic edema of the upper aerodigestive tract (AEUAT) often challenges the otolaryngologist with the decision of surgical intervention versus observation.Objective To develop a logical approach to the evaluation and management of the airway in patients with AEUAT, emphasizing fiberoptic examination (FOE) findings.Methods A computer‐based retrospective review of all patients diagnosed with AEUAT was performed. The charts were reviewed for demographics, etiology, medical history, presentation, physical examination, imaging studies, intervention, and outcome. Findings on FOE as well as other covariants were statistically compared.Results Seventy patients with AEUAT were identified. The etiologies consisted of 24 cases of angiotensin converting enzyme inhibitor use (33%), 10 allergic reactions (17%), 1 hereditary (1.5%), and 35 idiopathic cases (48%). Fourteen patients underwent airway intervention, including 6 tracheotomies and 8 intubations. Of the 14 patients, 5 underwent emergent intervention before fiberoptic examination, 4 had laryngeal edema only, and 5 had both laryngeal and base of tongue edema. No patients with both laryngeal and base of tongue edema were observed. The remaining 52 patients were observed in a monitored setting and required no subsequent intervention.Conclusion FOE is an invaluable tool in the assessment of the compromised airway in patients with angioneurotic edema. Laryngeal edema alone is an ominous physical finding. When laryngeal and pharyngeal edema are present together, the physician should consider immediate intervention. Our findings indicate that symptoms, including stridor, hoarseness, and dysphagia, do correlate with disease severity; however, they must be confirmed with fiberoptic visualization. Although sound clinical judgment should always be exercised, we present our results in the management of the acute airway in angioneurotic edema.
Lung Cancer After Head and Neck Cancer: Role of Chest Radiography
Authors: Shah Shefali I. , Applebaum Edward L. 
Published: November 2003

AbstractObjective To e‐amine whether screening chest radiographs lead to significantly longer life span in patients found to have pulmonary lesions than in those in whom lung cancer was detected after symptoms developed.Study Design A retrospective study.Material and Methods Charts of 1086 patients with squamous cell cancer of the head and neck treated for cure from January 1, 1974, to December 31, 1998, were analyzed.Results Pulmonary cancer developed in 62 patients. In 41 patients pulmonary malignancy was found because of patient symptoms. In 21 patients lung cancer was detected by routine annual chest radiography. Seventy‐five percent of lung cancers were detected within 3 years of initial treatment of the head and neck cancer.Conclusion Chest radiography is a poor screening tool, because it failed to find pulmonary lesions in more than 65% (41/62) of patients who were later found to have pulmonary cancer. Survival rate did not differ between patients in whom pulmonary cancer was found by screening chest radiography and those in whom symptoms prompted evaluation (P = .48). Using current treatment protocols, routine yearly chest radiography did not improve survival in patients with head and neck cancer. However, there maybe new therapeutic regimens under investigation that would benefit these patients if their lung cancers were found in early stages of disease. Future directives must include the establishment of an effective follow‐up protocol for the early detection of lung malignancies in these patients.
The Free Vascularized Flap and the Flap Plate Options: Comparative Results of Reconstruction of Lateral Mandibular Defects
Authors: Shpitzer Thomas , Gullane Patrick J. , Neligan Peter C. , Irish Jonathan C. , Freeman Jeremy E. , Van den Brekel Michiel , Gur Eyal 
Published: November 2003

AbstractObjectives/Hypothesis Reconstruction of the mandible and oral cavity after segmental resection is a challenging surgical problem. Although osteocutaneous free flaps are generally accepted to be optimal for reconstruction of anterior defects, the need for bony reconstruction for a pure lateral mandibular defect remains controversial.Study Design A retrospective study.Methods A retrospective comparative study of short‐ and long‐term outcomes of three different reconstruction techniques for lateral defects was performed. In total, 57 patients were included, of whom 27 had a plate and pedicled pectoralis major myocutaneous flap (PMMF group), 16 had a plate and free radial forearm flap (FRFF group), and 14 had an osteocutaneous free flap. Functionality, flap failure, and complications were scored.Results Plates had to be removed in 7 of the 27 patients in the PMMF group and 2 of the 16 in the FRFF group; none of the 14 osteocutaneous free flaps failed. The difference was of borderline statistical significance (P = .055). Long‐term functional outcome revealed no statistically significant difference in oral deglutition (P = .76) or in facial contour (P = .36). Oral continence was significantly better in patients in the FRFF group (88%) as compared with the PMMF group (52%) or the osteocutaneous free flap group (43%) (P = .02). On the other hand, the results for speech favored the osteocutaneous free flap group; 13 of 14 patients (92.9%) had a normal score compared with 12 of 16 patients (75%) in the FRFF group and 17 of 27 (63%) in the PMMF group. However, this represented a borderline statistically significant result (P = .06).Conclusions For lateral mandibular defects, the osteocutaneous free flap is reliable and durable in the long term. However, in a selected group of patients either of the two flap‐plate options is a viable reconstructive option.
Prognostic Value of Lymph Node Involvement in Oral Cancers: A Study of 137 Cases
Authors: Tankéré Frédéric , Camproux Anne , Barry Béatrix , Guedon Charles , Depondt Joël , Gehanno Pierre 
Published: November 2003

AbstractObjective The aim of this study was to assess the prognostic value of lymph node involvement in patients with squamous cell carcinoma of the oral cavity.Study Design Retrospective study of 137 patients with T4 squamous cell carcinoma of the oral cavity treated by surgery and radiotherapy (84 N0, 23 N1, 16 N2, 14 N3). Twenty‐three patients in the N0 group had a history of surgery or radiotherapy. One hundred fourteen patients underwent limited or radical neck dissection unilaterally or bilaterally.Methods The histological charts were reviewed and correlated with preoperative lymph node clinical stage. The local failure rate and the overall survival curves were calculated with respect to clinical and histological stages. The causes of death were analyzed.Results No evidence of lymph node metastasis was found in 47.4% of cases (54 of 114 patients). Among the node‐positive (N+) patients, 39 had rupture of the lymph node capsule (R+). In the N0 group, 27.8% of patients were N+. Regional control rates after surgery and radiotherapy were 95% at 1 year and 85.4% at 5 years. The local failure rates were 6% in N0, 8.7% in N1, 31.2% in N2, 51.7% in N3, 9% in node‐negative (N−), and 29% in N+R+ patients. The overall survival rates at 3 and 5 years were, respectively, 44.7% and 34.8% in the N0 group, 37.7% and 37.7% (same rate at 3 and 5 years) in the N1 group, and 31.2% and 15.8% in the N2 group. None of the patients in the N3 group survived beyond 2 years. The overall survival rates at 5 years were 42.8% and 17.5% in the N− and N+ groups, respectively.Conclusions In patients with locally advanced tumors (T4), clinical nodal status and histological nodal invasion were key prognostic factors. The presence of occult metastases in the N0 group justifies routine neck dissection.
Neoadjuvant Therapy for Organ Preservation in Head and Neck Cancer
Authors: Urba Susan G. , Wolf Gregory T. , Bradford Carol R. , Thornton Allan F. , Eisbruch Avraham , Terrell Jeffrey E. , Carpenter Veronica , Miller Tamara , Tang Gong , Strawderman Myla 
Published: November 2003

AbstractObjectives/Hypothesis We designed two sequential trials of induction chemotherapy followed by definitive radiation in patients with potentially resectable head and neck cancer to determine whether organ preservation is feasible without apparent compromise of survival.Study Design Both trials were Phase II studies.Methods Two clinical trials were conducted sequentially at the University of Michigan. Fifty‐two patients enrolled in the first study and were treated with a planned three cycles of carboplatin and 5‐fluorouracil. Patients who achieved at least 50% reduction in the size of the primary tumor received definitive radiation therapy, to a dose of 6600 to 7380 cGy. Patients with minimal response or progression had immediate salvage surgery. Thirty‐seven patients enrolled in the second trial, in which the chemotherapy consisted of carboplatin, 5‐fluororuracil, and leukovorin. Responders were treated with accelerated radiation therapy, to a total dose of 7120 cGy delivered in 41 fractions over 5.5 weeks.Results Toxicity and response were similar in both trials; therefore, the results are reported first separately and then combined for all 89 patients. Tumor sites included: oropharynx, 55 patients; hypopharynx, 34 patients. Eighty‐three percent of patients tolerated all three cycles of chemotherapy and toxicity was mild. Response to chemotherapy was: 48% complete response at the primary tumor site, and 34% partial response at the primary tumor site. Initial organ preservation at individual tumor sites was: oropharynx, 58%; hypopharynx, 59%. Median survival was 28 months, and survival at 3 and 5 years was 40% and 24%, respectively.Conclusions These two regimens were well tolerated, and survival did not appear to be compromised by organ preservation treatment compared with historical controls. This approach warrants further investigation, particularly in those patients for whom surgery could be functionally debilitating.
Immunohistochemical Absence of CD21 Membrane Receptor in Nasopharyngeal Carcinoma Cells Infected by Epstein‐Barr Virus in Spanish Patients
Authors: Burgos Javier S. , Vera‐Sempere Francisco J. 
Published: November 2003

AbstractObjectives/Hypothesis The aim of this study was to analyze the relevance of the CD21 membrane receptor in nasopharyngeal carcinoma (NPC). CD21 is implicated in the introduction of the Epstein‐Barr virus (EBV) genome into epithelial cells and B lymphocytes.Study Design Immunohistochemical analysis of CD21 in NPC.Methods Paraffin‐embedded samples of NPC of different histological types with demonstrated presence of EBV were analyzed for CD21 expression using immunohistochemistry.Results We detected EBV by non‐isotopic in situ hybridization (NISH) and nested polymerase chain reaction (PCR) in 100% of samples, regardless of histological type, supporting the previous view that all the types of NPC are variants of an EBV‐associated malignancy. CD21 was not detected in NPC, and this absence was a typical feature in our data group.Conclusions The loss of the CD21 membrane receptor could be one of the immunophenotypical changes of the neoplastic cells that occur in the evolution of the NPC malignancy.
Effect of Mechanical Reinforcement on Stability of the Rotary Door Flap Laryngotracheal Reconstruction: a Canine Study
Authors: Stein Jeannine M. , Eliashar Ron , Eliachar Isaac , Strome Marshall 
Published: November 2003

AbstractObjective/Hypothesis The rotary door flap (RDF) laryngotracheal reconstructive procedure uses a 180° rotation of the sternohyoid muscle into a laryngofissure. Despite excellent clinical results, there are concerns of flap inspiratory prolapse. This study examined RDF stability and the efficacy of ancillary materials in providing additional support.Methods Seventeen dogs underwent endoscopic induction of subglottic stenosis and delayed RDF reconstruction. Animals received 1) traditional RDF (control), 2) RDF with titanium screen implant, 3) RDF with porous polyethylene implant, or 4) RDF with hydroxyapatite cement (HAC) injection. Four weeks postoperatively the flaps were tested for stability. On qualitative assessment, endoscopic visualization was completed with quiet respiration and then following endotracheal tube occlusion. On quantitative assessment, after animals were killed, the RDF segment was isolated and subjected to negative pressure (maximum pressure, −50 mm Hg). The pressure‐causing collapse was measured.Results In the traditional RDF animals (control), five of six flaps were stable in vivo and with negative pressures. In the titanium screen, porous polyethylene group, and HAC groups, respectively, four of four, three of four, and two of three flaps were stable in vivo and under negative pressure. Flaps that demonstrated instability had granulation, dehiscence, and poor healing. These occurred in 1 of 6 animals in the traditional RDF group and in 2 of 11 animals in the implant groups. In addition, 13 of 24 animals assigned to the implant groups died, compared with 2 of 8 of those in the traditional RDF group.Conclusions The RDF is stable and maintains the airway under physiological conditions. Support materials did not improve stability, render flap harvest more difficult, or increase morbidity and mortality.
Preoperative Functional Assessment of Auditory Cortex in Adult Cochlear Implant Users
Authors: Roland Peter S. , Tobey Emily A. , Devous Michael D. 
Published: November 2003

AbstractObjectives To e‐plore functional neuroanatomical responses to auditory stimulation before and after implantation.Study Design A prospective study of three cochlear implant candidates (pure‐tone averages of 90 dB HL or greater bilaterally and hearing in noise test [HINT] performances of <40%) in which regional cerebral blood flow (rCBF) was assessed using single photon emission computed tomography (SPECT).Methods Candidates watched a 15‐minute videotaped story under four conditions: audio presented monaurally in the right and left ears (aided), audio presented binaurally (aided), and visual‐only presentation of the story. Five minutes into each story, 20 to 25 mCi of technetium 99m (99mTc) hexamethyl‐propyleneamine‐oxime (HMPAO) (Ceratec; Nycomed Amersham, Princeton, NJ, U.S.A.) was injected over a 30‐second period to ensure that subjects were unaware of tracer administration. Subjects were scanned for 20 minutes using a PRISM 3000 gamma camera (Picker International, Cleveland, OH, U.S.A.). Data were normalized and co‐registered, and subtraction images were compiled. Subtraction images contrasted activation patterns generated under the visual‐only control condition to the auditory activation states acquired monaurally and binaurally.Results Right and left ear monaural stimulation in normal hearing subjects resulted in significant bilateral activation of Brodmann areas 41, 42, 21, 22, and 38. Although substantial intersubject response variability was noted, subjects generally failed to bilaterally activate these areas under monaural hearing aid presentations; however, bilateral activation of areas 41 and 22 was noted under binaural presentations.Conclusions Despite relatively similar hearing losses in each ear, significant differences in preoperative auditory corte‐ activation were observed between ears. These data suggest that functional brain imaging provides a useful tool for e‐ploring the responsiveness of the auditory corte‐ in cochlear implant candidates.
Vestibular End‐Organ Impairment in an Animal Model of Type 2 Diabetes Mellitus
Authors: Perez Ronen , Ziv Ehud , Freeman Sharon , Sichel Jean‐Yves , Sohmer Haim 
Published: November 2003

AbstractObjectives/Hypothesis To define and assess the functional impairment of the vestibular part of the inner ear in a diabetic state, using a direct and objective test for evaluating the vestibular end‐organ and an animal model for diet‐induced type 2 diabetes mellitus.Study Design Prospective controlled animal study.Methods Two groups of sand rats (Psammomys obesus) were maintained on two different diets. The experimental group received a specially designed high‐energy diet known to induce a diabetic state, and the control group a low‐energy diet maintaining these animals in a normal metabolic state. After 1 month of documented hyperglycemia in the experimental group, recordings of vestibular evoked potentials (VsEPs) and recordings of auditory brainstem response (ABR) were conducted in all animals. The latency and the amplitude of the first wave of both responses, shown to reflect end‐organ activity, were compared between the two groups.Results The mean latency of the first wave of the VsEPs was significantly (P = .002) prolonged and the amplitude was significantly (P = .005) decreased in the diabetic group in comparison to the control group. The latency of the first wave of ABR was significantly (P = .02) prolonged, the amplitude was not significantly decreased, and threshold was significantly elevated (P = .01) in the diabetic group.Conclusion For the first time, using an objective assessment test, functional impairment of the vestibular part of the inner ear has been demonstrated in the diabetic metabolic state. Despite this being an animal study, these findings would seem to indicate that the vestibular‐end‐organ should be added to the long list of organs and tissues adversely affected by diabetes.