bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methylene Blue and Sestamibi: Complementary Tools for Localizing Parathyroids
Authors: Orloff Lisa A. 
Published: November 2003

AbstractObjective To determine the value and correlation between sestamibi scan and methylene blue staining for localization of parathyroid glands in patients with primary hyperparathyroidism.Study Design Nonrandomized convenience sample, followed prospectively.Methods Twenty‐three consecutive patients underwent 24 operations for primary hyperparathyroidism. All patients underwent preoperative technetium 99m–sestamibi planar scintigraphy, preoperative administration of 7.5 mg/kg methylene blue initiated within 60 minutes of surgical incision, and surgical neck exploration supervised by a single surgeon.Results All patients were cured of hypercalcemia. Sensitivity for sestamibi and for methylene blue staining was 76% and 79%, respectively. Specificity for sestamibi and for methylene blue was 98% and 93%, respectively. Agreement between sestamibi and methylene blue was 96%.Conclusions Sestamibi scanning and methylene blue staining are useful, complementary localizing tools for patients undergoing surgery for primary hyperparathyroidism. When used together, these studies decrease operative time, justify unilateral exploration in patients with parathyroid adenoma, and increase the ease of identification of hyperplastic parathyroid glands.
Vocal Function Following Radiation for Non‐Laryngeal Versus Laryngeal Tumors of the Head and Neck
Authors: Fung K. , Yoo J. , Leeper H. A. , Hawkins S. , Heeneman H. , Doyle Phil C. , Venkatesan V. M. 
Published: November 2003

AbstractObjective The larynx may receive high doses of radiation even in the absence of disease. Preliminary investigation has provided evidence that significant voice alterations exist in patients who received radiotherapy (RT) for non‐laryngeal tumors of the head and neck. This study evaluates subjective and objective parameters of vocal function in this patient population compared with a control group of patients irradiated for early glottic tumors.Study Design Retrospective cohort study.Methods Vocal function in patients irradiated for non‐laryngeal and early glottic tumors was assessed in a comprehensive manner and compared. Microanalytical and macroanalytical acoustic analyses, aerodynamic measurements, and videostroboscopy were performed on vowel production data. The Voice Handicap Index was administered for self‐assessment of voice quality. All subjects were male, smokers, and greater than 12 months post‐RT.Results Seventeen patients with non‐laryngeal tumors and 13 patients with early glottic tumors were evaluated. Microanalytical acoustic parameters were worse for 75% (6 of 8) of the acoustic measures of vowel production in the non‐laryngeal group. These include jitter, relative amplitude perturbation, amplitude perturbation quotient, normalized noise energy, pitch amplitude, and spectral flatness ratio. Macroanalytical acoustic analyses revealed no difference in fundamental frequency but numerically smaller phonational frequency range in the non‐laryngeal group. All aerodynamic measures, including mean phonation time, mean airflow, and vocal fold diadochokinetic rate, were decreased in the non‐laryngeal group. Videostroboscopy demonstrated increased supraglottic activity in the non‐laryngeal group. Voice handicap was significantly greater in the non‐laryngeal group.Conclusions When compared with patients receiving RT for early glottic tumors, there is objective and subjective evidence of vocal dysfunction in patients treated with wide‐field RT for non‐laryngeal tumors.
Endoscopic Inferior Turbinate Reduction: An Outcomes Analysis
Authors: Gupta Ashmit , Mercurio Eduardo , Bielamowicz Steven 
Published: November 2003

AbstractObjectives/Hypothesis In a previous publication, we introduced an endoscopic technique for the treatment of nasal obstruction caused by inferior turbinate hypertrophy. The technique, a modification of the procedure popularized by Mabry, involves resecting the inferior and lateral aspects of the inferior turbinate with a microdebrider under endoscopic guidance. Our preliminary postoperative results were favorable. All 20 patients experienced improvement by postoperative day 5 and the incidence of complications over the first 6 months after surgery was low. The objective of this study is to perform a long‐term outcomes analysis of patients undergoing the procedure.Study Design Follow‐up survey questionnaire and analysis.Methods We sent questionnaires to 60 patients, ranging from 6 to 40 months after surgery, inquiring about continued use of nasal medications, need for further surgery, presence of adverse effects, and improvement in symptoms. Nasal airway obstruction was assessed on a subjective scoring scale from 1 (no obstruction) to 6 (complete obstruction).Results Of the 28 (47%) patients who returned questionnaires, the severity of daytime nasal obstruction was rated as 2.3 and nighttime nasal obstruction as 2.7. The use of nasal steroids and oral decongestants was 25% and 21%, respectively. Adverse effects were minimal and all but one patient (96%) experienced improvement in their nasal airway.Conclusion These results confirm the long‐term effectiveness of this procedure for the relief of nasal obstruction.
Olfactory Epithelium Grafts in the Cerebral Cortex: An Immunohistochemical Analysis
Authors: Holbrook Eric H. , DiNardo Laurence J. , Costanzo Richard M. 
Published: November 2003

AbstractObjective To develop an alternative model for studying the regenerative capacity of olfactory neurons.Study Design An immunohistochemical analysis of mouse olfactory epithelium transplanted to the cerebral cortex.Methods Strips of olfactory epithelium removed from donor mice at postnatal day 5 to day 20 were inserted into the parietal cortex of adult mice. Recipient animals were allowed to survive for 25 to 120 days and then perfused with 4% paraformaldehyde 1 hour after bromodeoxyuridine injection. The brains were processed, and frozen sections were obtained. Sections through transplant tissue were analyzed using immunohistochemistry and compared with normal olfactory epithelium.Results Graft survival approached 85% with mature olfactory neurons detected in 35% of the transplants stained for olfactory marker protein. Transplant epithelium resembled normal olfactory epithelium containing mature olfactory neurons and axon bundles.Conclusions Studies of olfactory neuron regeneration have been limited by the inability to produce cultures with long‐term viability. Olfactory epithelial grafts to the cerebral cortex provide an alternative approach to the study of olfactory neuron regeneration.
The Use of Acellular Dermis in the Prevention of Frey's Syndrome
Authors: Govindaraj Satish , Cohen Michael , Genden Eric M. , Costantino Peter D. , Urken Mark L. 
Published: November 2003

AbstractEducational Objective At the conclusion of this presentation, the participant should be able to discuss the indications and advantages of using acellular dermis in the prevention of post‐parotidectomy gustatory sweating (Frey's Syndrome).Introduction Gustatory sweating is a common postoperative problem and a challenge to treat. The purpose of this study was to evaluate the role of acellular dermis in preventing post‐parotidectomy gustatory sweating.Methods Sixty‐four patients were randomly assigned to two groups. Group I consisted of 32 patients who underwent a superficial lobe parotidectomy. Group II consisted of 32 patients who underwent a superficial lobe parotidectomy and underwent intraoperative placement of acellular dermis within the parotid bed, between the skin flap and the remaining parotid tissue. The implanted volume of acellular dermis was determined by the amount required to aesthetically restore lateral facial contour. All 64 patients were evaluated for gustatory sweating by identical phone and mail questionnaires. Thirty randomly chosen patients (group I = 15, group II = 15) were evaluated using a modified Minor's Starch‐Iodine Test (MSIT). In all 30 patients, the MSIT was administered to both sides of the face.Results The responses to questionnaires (N = 64) demonstrated the subjective presence of gustatory sweating in 3 of 32 patients (9.3%) in group I, whereas group II demonstrated a subjective incidence in 1 of 32 patients (3.1%). The objective incidence determined by those who underwent the MSIT (n = 30) revealed a 40% (6) and 0% incidence of Frey's Syndrome in groups I and II, respectively. The complication rate in group I was 9% (3 seromas) and in group II it was 25% (7 seromas and 1 wound infection).Conclusions Acellular dermis appears to be an effective method for preventing post‐parotidectomy gustatory sweating, despite its higher complication rate.
Quantitative Analysis of Videostroboscopic Images in Presbylarynges
Authors: Bloch Isac , Behrman Alison 
Published: November 2003

AbstractObjective/Hypothesis Age‐related dysphonia, or presbylarynges, is often identified as the cause of voice disorders in older individuals. It is a diagnosis of exclusion that typically includes the subjective videostroboscopic findings of vocal fold bowing or atrophy and incomplete glottal closure. We hypothesize that vocal fold bowing correlates directly with glottal gap in patients with presbylarynges and that these characteristics may be quantified objectively using measures obtained from videostroboscopic images.Study Design Retrospective analysis of patient data and prospective analysis of control subjects.Methods The quantitative measures of bowing index and normalized glottal gap, as well as a novel measure, normalized laryngeal outlet, were calculated from the videostroboscopic examinations of 46 patients with presbylarynges and 20 normal control subjects.Results The mean bowing index values from the presbylarynges and control groups differed significantly, although there was overlap of individual values between groups. Bowing index values did not consistently predict normalized glottal gap values. Mean normalized laryngeal outlet values of the patients with presbylarynges were significantly smaller than those of the control group.Conclusions Bowing does not consistently predict the extent of glottal gap. Therefore, other presbylaryngeal changes are probably contributing to incomplete glottal closure, which are not well‐visualized stroboscopically, so the finding of bowing is not sufficiently specific to identify presbylarynges. The significantly smaller normalized laryngeal outlet values suggest that this identifies a compensatory strategy for glottal gap to optimize vocal function. This is a novel finding that contrasts with medial ventricular fold squeezing, which is more routinely sought and is typically considered a maladaptive compensatory strategy. Despite the advantages of quantitative stroboscopic measures, limitations in reliability limit their clinical utility.
Use of the Round Window Microcatheter in the Treatment of Meniere's Disease
Authors: Hoffer Michael E. , Kopke Richard D. , Weisskopf Peter , Gottshall Kim , Allen Keith , Wester Derin , Balaban Carey 
Published: November 2003

AbstractObjectives/Hypothesis Transtympanic gentamicin is an increasingly popular treatment for Meniere's disease. The present report examines the 2‐year follow‐up of our first 27 patients with Meniere's disease treated with the use of microdose gentamicin through the Round Window Microcatheter. We applied the 1995 American Academy of Otolaryngology—Head and Neck Surgery criteria to this patient group to analyze the results of treatment.Study Design This study is an evaluation of consecutive patients with predetermined data collection on each patient.Methods Patients with confirmed Meniere's disease underwent placement of the Round Window Microcatheter, which was filled with 10 mg/mL gentamicin, after placement into the round window niche was confirmed. Ten milligrams per milliliter of gentamicin was injected into the catheter by hand on two occasions after device placement in the first several patients. The remaining patients had continuous infusion of 10 mg/mL gentamicin at 1μL/h for the next 10 days. The catheter was removed 10 days after placement. All patients underwent an extensive set of hearing and vestibular tests on several occasions before, during, and after treatment.Results In the patients in the study, vertigo was eliminated in 92.6%, with 3.7% of patients (1/27) demonstrating a mild permanent threshold shift in hearing. Tinnitus and pressure were significantly reduced in more than 65% of patients. Only one patient demonstrated a reduction of vestibular function after treatment.Conclusions Results of this study on this group of patients indicate that vertigo can be controlled in the long term using microdose gentamicin without a significant reduction in cochlear or vestibular function in most of the patients in our series. Our results are compared with the published literature examining transtympanic injection. In addition, the underlying science supporting this type of treatment is examined.
Autoimmune Sensorineural Hearing Loss in Young Patients: An Exploratory Study
Authors: Tomasi Jean‐Paul , Lona Alain , Deggouj Naïma , Gersdorff Michel 
Published: November 2003

AbstractObjectives P0 protein is expressed exclusively in myelinating Schwann cells of the peripheral nervous system. In a previous study from our laboratory, 27% of patients with sensorineural hearing loss (SNHL) had antibodies to P0 protein in their serum. The purpose of the present exploratory study was to examine the relationship between the clinical presentation of SNHL among children and young adults (age range, 5–30 y) and the presence of serum anti‐P0 antibodies.Study Design The data were collected by retrospective questionnaires from Belgian otolaryngologists.Methods Patients were divided for comparison into two groups according to the presence or absence of anti‐P0 antibodies.Results Analyses of clinical data and audiometric results indicated that a progressive hearing loss was more frequently recorded in the patients in the anti‐P0 antibody–positive group (82% [14 of 17]) than in those in the anti‐P0 antibody–negative group (35% [6 of 17]) (P <.005).Conclusions Thus, in the age group in the present study, autoimmune SNHL (as measured in the present study by the presence of anti‐P0 antibodies) is more frequently associated with progressive than with sudden hearing loss. The implications of this finding for preventive screening of hearing loss in children and young adults are discussed.
Microbiology of Normal External Auditory Canal
Authors: Stroman David W. , Roland Peter S. , Dohar Joseph , Burt Wayne 
Published: November 2003

AbstractObjectives To isolate and characterize bacteria and fungi from the healthy ear and to obtain susceptibility profiles on each bacterial isolate.Study Design Prospective.Methods Specimens were collected from the external canals and cerumen of healthy subjects. Species‐level identification was obtained by combining phenotypic and genotypic data. End‐point minimal inhibitory concentration testing was performed using National Committee for Clinical Laboratory Standards recommended methods.Results One hundred sixty‐four subjects were cultured. Seventeen canal and 16 cerumen specimens showed no growth. One hundred forty‐eight cerumen specimens yielded 314 organisms, including 23 fungi. One hundred forty‐seven canal specimens yielded 310 organisms, including 7 fungi. Of 291 bacteria isolated from cerumen, 99% were Gram‐positive. Of 302 bacteria isolated from the canal, 96% were Gram‐positive. Staphylococci were 63% of both the cerumen bacteria and the canal bacteria. Coryneforms represented 22% of the bacteria in cerumen and 19% in the canal. Turicella
otitidis was the primary coryneform isolated from both the canal and the cerumen. Streptococci‐like bacteria were 10% from the cerumen, 7% from the canal. In both cerumen and canal, Alloiococcus
otitis was more than 95% of the streptococci‐like bacteria. Fifteen gram‐negative organisms were isolated from the canal and cerumen, including four Pseudomonas aeruginosa strains. The percentages of Staphylococcus epidermidis isolates that had high‐level resistance (≥8 μg/mL) were as follows: to neomycin, 28% from cerumen and 11% from the canal; to oxacillin, 28% from cerumen and 25% from the canal; and to ofloxacin, 15% from cerumen and 19% from the canal.Conclusions Turcella otitidis and A. otitidis were present with a much higher frequency than previously described, lending evidence that they be considered normal otic flora. Corynebacterium auris, previously reported only in children, was isolated from normal adults.
Long‐Term Stapedectomy Results With the McGee Stapes Prosthesis
Authors: Raske Molly , Welling John D. , Gillum Timothy , Welling D. Bradley 
Published: November 2003

AbstractObjective To report long‐term follow up on patients undergoing stapedectomy with the McGee stapes prosthesis.Study Design A retrospective case series.Methods Charts recording 170 stapedectomies (120 primary and 50 revision stapedectomies) from 1989 to 1999 were analyzed, and audiometric data and the findings at repeat exploration reported.Results Over a 10‐year period, 11.2% of patients had failure of their initial air‐bone gap closure with the McGee piston. Seventy‐seven percent (in 10 of 13 patients) of McGee pistons that failed were found to have the platinum ribbon displaced laterally from the incus and the piston pushed out of the stapedotomy. The failure rate was not significantly different (P = .72) from that in our patients who underwent placement of a Robinson cup prosthesis (9.5%), but the pattern of displacement was unique. Failures occurred earlier with the McGee piston (average time to failure of 2.5 y) than with the Robinson cup (average time to failure of 8.6 y).Conclusion The McGee piston was found to have a unique pattern of dislocation that is likely related to the malleable nature of the platinum ribbon and loosening of the crimped “shepherd's crook” over time.
Use of Reconstructed Sagittal Computed Tomography Images to Plan Middle Cranial Fossa Surgery
Authors: Olson Krista L. , Manolidis Spiros , Hayman L. Anne , Chan Ling‐Ling , Taber Katherine H. 
Published: November 2003

AbstractObjective To facilitate planning in temporal bone surgery for the middle cranial fossa approach by using sagittal reconstructed temporal bone computed tomography images.Study Design Comparison of anatomic measurements on random high‐resolution, reformatted computed tomography scans of the temporal bone.Methods High‐resolution computed tomography of 10 normal temporal bones in the axial and coronal planes was obtained, and two‐dimensional sagittal reconstructions were performed using a commercial software program. Eight anatomical relationships between neural and/or vascular structures were measured. Representative images were inverted to recreate the plane of the middle cranial fossa approach.Results Anatomical relationships among the vestibule, superior semicircular canal, internal auditory canal, internal carotid artery, and middle cranial fossa exhibited a high SD in the 10 subjects. The sample size and the large range for the eight anatomical relationships precluded the detection of a significant difference between right and left temporal bones or sex and age of the patient.Conclusion The present report presents a novel, practical measurement protocol for rapidly evaluating important individual anatomical differences in patients before middle cranial fossa surgery. Inverted sagittal reconstructions facilitate presurgical planning for the middle cranial fossa approach by 1) assessing critical anatomical relationships before surgery and 2) providing customized measurements between vital landmarks and the first in vivo measurements. This decreases the likelihood of surgical mishaps and improves teaching by providing the first in vivo measurements of practical anatomical relationships in the sagittal plane.
Endoscopic Neck Dissection in Human Cadavers
Authors: Dulguerov Pavel , Leuchter Igor , Szalay‐Quinodoz Ildiko , Allal Abdelkarim S. , Marchal Francis , Lehmann Willy , Fasel Jean H. D. 
Published: November 2003

AbstractObjective To evaluate the feasibility and efficacy of endoscopic neck dissection (END) in human cadavers.Study Design Experimental self‐controlled study.Methods END on five human cadavers through three openings: one for the camera, one for the dissecting instrument, and one for a grasping one. The tissue specimens removed were divided into traditional neck groups (I to V). After the completion of END, open neck dissection was performed using standard surgical techniques and the remaining tissue within each neck group was retrieved. The important neck structures (carotid artery, internal jugular vein, cranial nerves X, XI, and XII, phrenic nerve) were evaluated for lesions. A pathologist evaluated each specimen, without knowing its exact origin in terms of neck group or side, and type of surgical technique used. For each specimen, the number of retrieved lymph nodes and their anatomic integrity was analyzed.Results Ten neck dissections were performed on 5 cadavers, without any major difficulty. An injury of the internal jugular vein occurred twice and once the phrenic nerve was cut. Little tissue was usually left for open surgical dissection. The average number of retrieved lymph nodes by endoscopy was 4.9 ± 2.7 (mean ± standard deviation). Completion open neck dissection retrieved an additional 0.5 ± 0.5 lymph nodes. Efficacy of END was 92 ± 10%. The majority of retrieved lymph nodes were intact but exhibited important postmortem autolysis artifacts.Conclusions Endoscopic neck dissection is possible in human cadavers and is free of lesions to major structures. The majority of neck lymph nodes can be removed endoscopically.
Thyroarytenoid Muscle Maintains Normal Contractile Force in Chronic Vocal Fold Immobility
Authors: Johns Michael M. , Urbanchek Melanie , Chepeha Douglas B. , Kuzon William M. , Hogikyan Norman D. 
Published: November 2003

AbstractBackground Denervation of skeletal muscle typically results in irreversible denervation atrophy over time. This finding has generated controversy as to the efficacy of reinnervation procedures for chronic vocal fold immobility related to recurrent laryngeal nerve injury.Objective To test the hypothesis that chronic vocal fold immobility after recurrent laryngeal nerve injury does not result in diminished maximal isometric force generation in the thyroarytenoid muscle.Study Design Adult random‐bred cats underwent either unilateral laryngeal denervation (n = 6) or sham surgery (n = 6). After 6 months, videolaryngoscopy was performed followed by in vitro measurement of maximal isometric tetanic force produced by the thyroarytenoid muscle.Results All animals in the denervation group showed right vocal fold paralysis after the initial denervation operation; none of these animals had return of appropriately phased movement with respiration. Four had intermittent disorganized twitching movements. One had these movements plus an occasional weak adduction, and one had no movement. Normal vocal fold mobility was observed in 6 of 6 animals undergoing sham surgery. The maximal isometric tetanic force measured from the thyroarytenoid muscle in the sham group was 438 mN (±92 mN standard deviation [SD]). The maximal isometric tetanic force measured from the thyroarytenoid muscle in the chronically immobile group was 405 mN (±107 mN SD). Differences were not statistically significant.Conclusion Maximal isometric force in the thyroarytenoid muscle is not diminished in chronic vocal fold immobility after recurrent laryngeal nerve injury. We conclude that the possibility for restoration of contractile force to the chronically immobile thyroarytenoid muscle exists. This finding supports the pursuit of reinnervation procedures in the treatment of chronic vocal fold immobility.