bluuebunny/crossref_metadata_2025_split huggingface dataset:
Olfactory and intranasal trigeminal event‐related potentials in anosmic patients
Authors: Kobal Gerd , Hummel Thomas 
Published: November 2003

AbstractThe aim of this study was to investigate the usefulness of chemosensory event–related potentials (CSERPs) in response to both olfactory and intranasal trigeminal stimulation in the diagnosis of anosmia. Forty‐four patients participated. Gaseous CO2 was used for trigeminal stimulation, vanillin and H2S were used as olfactory stimulants. Event‐related potentials to olfactory stimuli could not be obtained in any of the anosmic patients, indicating the complete loss of the sense of smell. However, all patients responded to stimulation of the trigeminal nerve with CO2. These data clearly demonstrate the clinical significance of CSERPs in the assessment of anosmia.
Nasal ciliary beat frequency is age independent
Authors: Jorissen Mark , Willems Tom , Van Der Schueren Bernadette 
Published: November 2003

AbstractObjectives: Evaluate the age‐dependency of ciliary beat frequency (CBF) in biopsies after ciliogenesis in culture. Study Design: Retrospective analysis of CBF and ciliary ultrastructure in biopsies and after ciliogenesis from 203 individuals, aged 3 months to 74 years. Methods: All patients with successful culture were included. Ciliogenesis was obtained using the sequential monolayer‐suspension culture technique for dissociated nasal epithelial cells. CBF was measured using computerized microscope photometry. Secondary ultrastructural abnormalities were evaluated in transmission electron microscopy. Results: There was no correlation between age and CBF, in either the biopsies (7.0 ± 2.6 Hz; n = 113) or after ciliogenesis in culture (8.1 ± 1.3 Hz; n = 203). Even in individuals older than 70 years, CBF was normal in bioptic material (6.7 ± 1.7 Hz) and after ciliogenesis in culture (7.9 ± 1.0 Hz). Also, in individuals less than 1 year of age CBF was normal in biopsies as well as after ciliogenesis. CBF correlated inversely with the percentage of secondary ultrastructural abnormalities in the biopsies as seen with transmission electron microscopy: 8.1 ± 1.8 Hz when ciliary ultrastructure was normal and 3.5 ± 3.3 Hz in cases of severe secondary ciliary dyskinesia. After ciliogenesis in culture, ciliary ultra‐structure was always normal, as was CBF. Conclusion: CBF is age independent but correlates with secondary ultrastructural abnormalities. CBF after ciliogenesis in culture is the intrinsic one.
Mastoid pneumatization in children with congenital cholesteatoma: An aspect of the formation of open‐type and closed‐type cholesteatoma
Authors: Iino Yukiko , Imamura Yukako , Hiraishi Mitsutoshi , Yabe Takao , Suzuki Jun‐Ichi 
Published: November 2003

AbstractObjectives: To clarify mastoid pneumatization in children with congenital cholesteatoma and compare their clinical characteristics. Study Design: The mastoid pneumatization of 34 children with congenital middle ear cholesteatoma, of 34 age‐matched children with unilateral acquired cholesteatoma, and of 17 age‐matched control children without middle ear diseases was studied. Methods: The sizes of the mastoid cells were measured from 1.5‐mm sliced semiaxial sections of a temporal bone computed tomography scan. The sum of the two areas from the two images, one showing the lateral semicircular canal and the other, 3 mm below this, was defined as the area of the pneumatized mastoid cells. Results: The mastoid cells in ears of children with congenital cholesteatoma were poorly pneumatized compared with those of control children without middle ear diseases, but were better pneumatized compared with those of children with acquired cholesteatoma. In children with congenital cholesteatoma, the degree of pneumatization in the cholesteatoma side was significantly poorer than that in the opposite side. A well‐pneumatized mastoid was seen in ears with no episode of otitis media, in ears with the open‐type cholesteatoma, and in ears with ossicular anomalies. Conclusions: The presence of cholesteatoma matrix accelerates the inflammatory response when middle ear infections occur, and this probably leads to the suppression of mastoid pneumatization. The authors also propose the hypothesis that cholesteatoma in most congenital cases is the open type, and that middle ear inflammation may contribute to the formation of cystic and closed‐type cholesteatoma.
Increased risk of salivary gland tumors after low‐dose irradiation
Authors: Modan Baruch , Chetrit Angela , Alfandary Esther , Tamir Arnon , Lusky Ayala , Wolf Michael , Shpilberg Ofer 
Published: November 2003

AbstractObjective: To assess the risk of neoplastic development among persons exposed to scalp irradiation. Study Design: Historical cohort study initially; prospective follow‐up subsequently. Method: Two control groups—population and siblings—matched for age, sex, ethnic origin, and year of immigration. Follow‐up from time of irradiation (1950s) until the end of 1991. Linkage with nationwide cancer registry. Results: A 4.5–fold incidence of cancer (P < .01) and a 2.6–fold increase of benign tumors were noted. The mean length of latency period until tumor development was 11 years for malignant tumors and 21.5 years for benign. A clear dose response effect for both cancer and benign tumors was demonstrated. Conclusions: The study confirms the role of radiation in salivary gland carcinogenesis. It indicates a need for better awareness, a comprehensive examination, and long‐term follow‐up of patients who have been subjected to head and neck radiation.
Soft‐palate reconstruction with a “SCARF” superior‐constrictor advancement‐rotation flap
Authors: Zeitels Steven M. , Kim Jennifer 
Published: November 2003

AbstractReconstruction of hemi‐soft‐palate defects after tumor resection is usually done by means of a regional flap, free‐tissue transfer or a prosthesis. These options vary in complexity and have a number of shortcomings. A local myomucosal flap was designed that employs a superior‐constrictor advancement‐rotation flap (SCARF) to achieve circumferential closure of the velopharynx and to reestablish its valvular sphincteric function. Ten patients underwent a SCARF reconstruction of the velopharynx after 35% to 65% of the soft palate was resected. All patients reestablished normal velopharyngeal function without significant phonatory or deglutitive disability. Two patients did require a second‐stage reinforcement of the suture line after partial dehiscence. The SCARF reconstruction of the soft palate is simple, fast, and reliable and there is no significant donor site morbidity. Patients resume oral intake earlier than standard reconstructive approaches. The SCARF can be done transorally, which allows for primary resection and discontinuous neck dissection. These factors facilitate short hospitalization and effective use of resources.
Silent intratympanic membrane cholesteatoma
Authors: Jaisinghani Vikram J. , Paparella Michael M. , Schachern Patricia A. 
Published: November 2003

AbstractObjective: To detect the presence of intratympanic membrane cholesteatoma in cases of chronic otitis media. Design: Two hundred forty‐three temporal bones from patients with chronic otitis media were studied for the presence of intratympanic membrane cholesteatoma. Methods: Specimens had been previously removed at autopsy, fixed in 10% buffered formalin, decalcified in trichloroacetic acid, dehydrated in a graded series of ethanol, and embedded in celloidin. Sections were cut at a thickness of 20 μm, stained with hematoxylin eosin, and examined using light microscopy. Results: Intratympanic membrane cholesteatomas were found in five of the 243 temporal bones with chronic otitis media. All temporal bones with intratympanic membrane cholesteatomas were from adult patients. Two patients had bilateral intratympanic cholesteatomas in symmetric quadrants of the tympanic membrane, and the remaining patients with unilateral intratympanic membrane cholesteatoma had been operated on previously for a cholesteatoma of the opposite ear. Other common findings included chronic granulation tissue in the middle ears and mastoids, ossicular pathologic conditions, and in four of the five ears, fluid in the middle ears and/or mastoids. Conclusion: When a white area is observed on the tympanic membrane of patients (especially those with “silent” chronic otitis media), differential diagnosis should include not only tympanosclerosis, but also intratympanic membrane cholesteatoma.
Plating techniques and plate orientation in repair of mandibular angle fractures: An in vitro study
Authors: Fedok Fred G. , Van Kooten David W. , Dejoseph Louis M. , Mcginn Johnathan D. , Sobota Bret , Levin Roger J. , Jacobs Christopher R. 
Published: November 2003

AbstractA biomechanical model utilizing polystyrene mandibles was devised to evaluate the fixation efficacy of various plating techniques for repair of mandibular angle fractures. A simple angle fracture was created in the mandible models at a standardized location and was repaired using five different plating techniques. Each experimental group consisted of 15 mandibles, with fracture site, plate placement, load application, and fracture displacement measurement standardized to ensure consistency among experimental groups. Measurement of fracture distraction under load application generated a load deformation curve and corresponding slope for each technique. Comparison of load deformation slopes allowed assessment of fixation stability. When applied with a subapical, medially placed monocortical tension band, bicortical compression plating demonstrated the most stable fracture fixation. The data show that biplanar plate placement in both monocortical noncompression and bicortical compression techniques yields a stronger fixation than monoplanar placement.
Self‐expanding metal stents for the management of bronchial stenosis and bronchomalacia after lung transplantation
Authors: Bolot Guillaume , Poupart Marc , Pignat Jean‐Christian , Bertocchi Michele , Wiesendanger Thérèse , Thevenet François , Gamondes Jean‐Paul , Mornex Jean‐François 
Published: November 2003

AbstractBackground: Airway stenosis or malacia after lung transplantation, usually as a result of anastomotic ischemia, remains a major problem. Methods: The authors report their experience with the Gianturco expandable stent for the management of 23 bronchial stenoses in 18 patients following lung transplantation. Stent placement occurred an average of 5.6 months after transplantation. Results: Stents were well tolerated and produced immediate symptomatic and functional improvement. The mean follow‐up after implantation was 21 months (range, 4 to 48 mo). The authors removed five stents by endoscopy and replaced them, and removed one stent entirely. Laser resection was used to control granulomas or partial fibrosis stenosis that occurred in four stents (14.3%) after an average of 4 months. One stent broke but was still in place and effective 32 months later. One patient died of hemorrhage 4 months after stenting. Conclusion: Although it can still be improved, this expandable metal stent is suitable for the treatment of posttransplantation proximal bronchial stenosis.
Hyperbaric oxygen for the management of radionecrosis of bone and cartilage
Authors: London Scott D. , Park Stephen S. , Gampper Thomas J. , Hoard Martin A. 
Published: November 2003

AbstractObjectives: To review the use of hyperbaric oxygen in the management of radionecrosis of the head and neck. Study Design: A retrospective analysis of patients utilizing chart review and telephone interviews. All patients diagnosed with osteoradionecrosis and chondroradionecrosis of the head and neck and treated with hyperbaric oxygen at the University of Virginia are included. Methods: Demographics, pretreatment data, and precipitating events were recorded. Outcomes were evaluated using a grading scale of symptomatology and physical examination as determined by the patient and physician. Results: Sixteen patients with osteoradionecrosis and five with chondroradionecrosis were reviewed. All patients showed clinical improvement with decreased pain following HBO therapy. None of the patients with chondroradionecrosis required laryngectomies, and two of the four who were tracheotomy dependent were successfully decannulated. The patient and physician grading scores demonstrated moderate to significant improvement in both groups following therapy. Conclusion: The successful use of hyperbaric oxygen for the management of radionecrosis of the head and neck is supported. The unusual prevalence of chondroradionecrosis may be an early reflection of changes in treatment protocols for patients with head and neck cancer. Key Words: Hyperbaric oxygen, osteoradionecrosis, chondroradionecrosis.
Embryonic middle ear mesenchyme disappears by redistribution
Authors: Piza Jorge , Northrop Clarinda , Eavey Roland D. 
Published: November 2003

AbstractObjective: The fate of embryonic middle ear mesenchyme from a postgestational infant ear has been speculative. Recently a volume analysis of human neonatal temporal bones demonstrated that embryonic mesenchyme disappeared by redistribution and thinning to surface a growing middle ear space.1 If this model is accurate, interaction with amniotic fluid and the gestational environment should not influence mesenchymal behavior. Therefore an opossum marsupial model was compared with human data. Methods: The temporal bones of opossum pups (20 to 36 days of age) were sectioned for histologic analysis. Computations were made for the volume of the middle ear air cavity (VAC), volume of the bone cavity (VBC), volume of mesenchyme (VM), and percentage of the middle ear occupied by mesenchyme (%M), which were plotted against height using regression statistics. These data were compared with human neonatal (0 to 30 days of age) temporal bones. Results: In both the opossum and the human the VAC and the VBC increased in parallel with growth of the body. In the opossum the VAC and VBC both grew at 0.148 mm3/mm of body length. In humans, both the VAC and VBC grew 6.1 mm3/cm of body length. The VM in the opossum remained constant at 0.98 mm3, regardless of body length. In humans the VM remained constant at 71.7 mm3, regardless of body length. Therefore the %M proportionately decreased inversely with increasing ear size in both the opossum and the human neonate. Conclusion: This study supports a simple and credible explanation for the illusion of mesenchymal disappearance in the neonatal middle ear. The mesenchymal connective tissue redistributes to cover a larger surface area in a persistently enlarging cavity. These findings occur in different species, whether gestation is completed in an intrauterine or an extrauterine environment.
Systemic neutrophil intrinsic 5‐lipoxygenase activity and CD 18 receptor expression linked to reperfusion injury
Authors: Dolan Robert , Hartshorn Kevan , Andry Chris , McAvoy Daniel 
Published: November 2003

AbstractObjective: To determine if systemic neutrophil intrinsic 5‐lipoxygenase (5‐LO) inhibition correlates with decreased expression of surface adhesion molecules and attenuation of ischemia‐reperfusion (i/r) injury in guinea pig island skin flaps. Methods: Eighty‐one adult female Hartley guinea pigs were divided into one control group, three 2‐hour ischemia groups, and four 10‐hour ischemia groups. Island dorsal skin flaps were developed (except in the control group), and 2 hours before reperfusion, zileutin (a 5‐LO inhibitor) or vehicle was administered orally. Postreperfusion systemic neutrophil receptor expression, neutrophil flap infiltration, and flap survival were measured. Neutrophils from whole blood were analyzed for CD 18 containing surface receptor expression using monoclonal antibodies and cell associated fluorescence. Neutrophil infiltration into a distal centimeter squared of flap tissue was assessed using myeloperoxidase antibodies, and flap survival was determined within 7 days postoperatively. Results: Flaps in the treated 2− and 10‐hour ischemic groups survived totally intact, while the untreated 10‐hour ischemic flaps underwent total necrosis. A significant main effect of the drug was detected using analysis of variance (ANOVA) (P =.0001). Surface receptor detection and neutrophil infiltration were significantly increased in the untreated animals. Conclusions: Zileuton, a 5‐LO inhibitor, reduces adhesion receptor expression on systemic neutrophils and attenuates i/r injury. Systemic neutrophil intrinsic 5‐LO activity and CD18 receptor expression are linked to reperfusion injury and may be fundamental events in its pathogenesis.
Scar recollagenation
Authors: Burres Steven A. 
Published: November 2003

AbstractObjectives: This study was designed to show that native collagen could be regenerated in an area of prior tissue loss. Study Design: Prospective. Methods: Preserved, irradiated human cadaver fascia lata was inserted intradermally to restore topographic skin irregularities. Graft insertion was performed through a skin perforation created by a sterile, hypodermic 20‐gauge needle hole into an intradermal pocket. Eighteen subjects with posttraumatic depressions were treated over a 13‐month period and examined periodically afterward. Biopsies of selected sites were taken. Results: Of the 44 defects treated in the study group, 14 were judged to be excellent or resolved, 23 were improved, and seven were unchanged at 24 weeks' follow‐up. Biopsies showed graft preservation and fibroblast invasion at 12 weeks. Discussion: Recollagenation is the application of a stimulator material into an area of prior collagen destruction to induce collagen production. Commonly, banked human cadaver fascia has been used to enhance the tissue volume in depressed acne scars, but this process has been successfully performed on a variety of postinflammatory and posttraumatic lesions. The process of fascia graft assimilation into human skin is demonstrated histologically. Conclusion: Recollagenation is an effective process for elevation of depressed, posttraumatic scars. Key Words: collagen, graft, scar, fascia, skin.
Diagnosis, management, and follow‐up of congenital head and neck teratomas
Authors: April Max M. , Ward Robert F. , Garelick Jordan M. 
Published: November 2003

AbstractObjective: To describe our clinical experience with congenital teratomas of the head and neck. Study Design: A retrospective review of the six patients as well as a review of the literature in the setting of academic referral centers. Methods: In six infants with teratomas, four in the cervical region and two arising from the nasopharynx, surgical excision of all tumors was performed. Outcome measures were clinical and radiographic follow‐up and the use of α‐fetoprotein (AFP) for postoperative monitoring. Results: There was no recurrence of teratomas. Conclusions: Surgical excision is the treatment for congenital teratomas. Postoperative monitoring for recurrences should include AFP levels in difficult cases.
Transtympanic gentamicin for meniere's syndrome
Authors: Harner Stephen G. , Kasperbauer Jan L. , Facer George W. , Beatty Charles W. 
Published: November 2003

AbstractObjectives: Study the impact of transtympanic gentamicin on patients with unilateral Meniere's syndrome. Partial chemical labyrinthectomy is a relatively recent concept for the treatment of Meniere's syndrome. It uses the ototoxic effect of gentamicin to reduce the symptom of vertigo and maintain cochlear function. Study Design: A prospective study using transtympanic gentamicin was begun in January 1994. Patients selected had failed medical therapy, but were not incapacitated. Patients had preinjection audiometric and electronystagmography data. Most had an imaging study. All had one injection, about half had more than one. Patients were seen 1 month after therapy and repeat studies were obtained. Repeat injection was performed if indicated. Follow‐up from the chart or by telephone was obtained. Data were tabulated using the 1995 American Academy of Otologaryngology—Head and Neck Surgery guidelines. Results: Through December 1996 43 patients with unilateral Meniere's syndrome were treated. The pretherapy function level was 3 through 5. After therapy the function level was 1 or 2. There was almost no change in cochlear function and no patient became deaf. Many patients had mild ataxia or dysequilibrium during the first 2 weeks following therapy. Most patients showed some decrease in labyrinthine function measured on electronystagmography. No attempt was made to ablate labyrinthine function. Seventeen of 18 patients had a vertigo index in the class A or B category after 2 years. Conclusions: Transtympanic gentamicin has become the treatment of choice for patients who fail medical therapy for Meniere's syndrome at the authors' institution. Laryngoscope, 108:1446–1449, 1998
Minimal‐access parathyroid surgery using intraoperative parathyroid hormone assay
Authors: Sofferman Robert A. , Standage Jeanette , Tang Mary E. 
Published: November 2003

AbstractObjectives: Review the most current preoperative localization imaging techniques in patients with primary hyperparathyroidism and demonstrate their applicability to targeted tumor removal with intraoperative parathyroid hormone (PTH) monitoring. Study Design: Retrospective review of 40 consecutive patients undergoing parathyroid surgery with intraoperative PTH assay as the principal determinant of correction of the hyperparathyroid state. Details of the technology, cost analysis, and comparison with other management methods are discussed. Methods: The standard intact PTH chemiluminescent assay (Nichols Diagnostics) and modifications to allow accelerated intraoperative results are discussed in detail. The time intervals between completion of parathyroid excision and postremoval assay and subsequent laboratory investigation present a practical therapeutic algorithm. Results: Forty consecutive patients with hyperparathyroidism were treated surgically with intraoperative PTH as the determinant of satisfactory resolution of the disease state. In most instances, the surgical field was reduced to the targeted pathology identified by preoperative localization, and all patients became eucalcemic when this method was employed. Approximately half of eligible patients were treated under local anesthesia. Conclusions: Intraoperative PTH assay has added a new dimension to primary and revision parathyroid surgery. It is cost‐effective and accurate and may reduce the morbidity of surgical intervention in revision procedures. Laryngoscope, 108:1497–1503, 1998
Classification of otitis media
Authors: Harkness Paul , Topham John 
Published: November 2003

AbstractObjectives: To review the International Classification of Diseases (ICD) system of classifying otitis media. To highlight the failings of this system and to propose an alternative (Read version 3). Study Design: An historical review of the literature and a presentation of two distinct classification schemes. Methods: The advantages and disadvantages of the alternative schemes are analyzed and an algorithm for the classification of otitis media is presented that describes the decisions taken to reach a diagnosis. Results: The proposed classification of otitis media as used in the Read Codes thesaurus is more logical than the ICD classification. Conclusions: The widely used ICD schema of otitis media fails to provide the otologist or general medical practitioner with a logically organized set of terms to describe inflammatory middle ear disease. This article proposes a simple, hierarchical classification that can be used by specialists, generalists and epidemiologists alike. Laryngoscope, 108:1539–1543, 1998